Rosh Emergency Medicine Practice Test 2025 - Free Emergency Medicine Practice Questions and Study Guide

Kussmaul's breathing is characterized by deep, rapid respirations and is commonly associated with metabolic acidosis, particularly diabetic ketoacidosis (DKA). In this condition, the body attempts to compensate for the low pH (acidity) of the blood by increasing the rate and depth of breathing to eliminate excess carbon dioxide, which helps to raise the pH back toward normal levels.

In the context of DKA, as insulin levels drop and ketone body production increases, the resulting acidosis stimulates hyperventilation as a compensatory mechanism. This clinical presentation helps to differentiate DKA from other conditions, as Kussmaul's breathing is not typically observed in respiratory conditions like chronic obstructive pulmonary disease, asthma exacerbations, or congestive heart failure.

Each of those conditions may present with different breathing patterns due to their unique pathophysiologies; for instance, COPD is associated with prolonged expirations due to airway obstruction, while asthma exacerbations may present with wheezing and difficulty with both inspiration and expiration. Congestive heart failure primarily leads to orthopnea and may cause Cheyne-Stokes respiration, which is not the same as Kussmaul's breathing. Thus, the strong association of Kussmaul's