• Saturday February 22,2020

Kussmaul breathing

The kiss-mouth breathing describes a type of breathing, which may indicate a disease. This condition is an acidosis, the over-acidification of the body due to a disturbance of the acid-base balance.

What is a kiss mouth breathing?

The symptoms of kiss-mouth breathing are altered breathing, similar to hyperventilation and metabolic acidosis. This acidosis can be determined by the characteristic odor of the person's breath.
© Henrie - stock.adobe.com

The Kussmaul breathing was named after the biologist and physician Adolf Kussmaul. It is also referred to as acidosis breathing and as Azidoseausgleichsatmung. It is a type of breathing called hyperventilation. It comes to a very deep and fast breathing to the increased absorption of oxygen.

This breathing comes about through metabolic acidosis. This leads to a hyperacidity of the blood in the body of the person concerned. The pH of the blood drops below 7.35 due to an accumulation of protons. The pH value is a measure of the acidity due to acids and bases in the body. Acids in aqueous solution have a pH of less than 7 and bases have a pH above 7. The physiological pH of humans is between 7.35 and 7.45.


The causes of kiss-mouth breathing are mainly metabolic acidosis. The reasons for the occurrence of acidosis are many. It can come from diabetes mellitus, which has not been properly adjusted by medication, or from lactic acidosis, the accumulation of lactic acid in the body, to acidosis.

Other causes include alcoholic ketoacidosis or prolonged starvation. Other causes of acidosis include methanol or salicylic poisoning. Acidosis can also be triggered by diarrhea, a condition that leads to conspicuously high intestinal emptying.

In addition, renal insufficiency, the failure of the kidneys, which leads to an accumulation of so-called urinary substances in the blood, or Addison's disease are causes of acidosis. Addison's Disease is a life-threatening condition that results in a loss of adrenal function.

Symptoms, complaints & signs

The symptoms of kiss-mouth breathing are altered breathing, similar to hyperventilation and metabolic acidosis. This acidosis can be determined by the characteristic odor of the person's breath. Through the kiss-mouth breathing, the body tries to remove carbon dioxide, which can be a source of acidosis, by exhaling strongly from the body, to normalize the pH in the blood and thus to reduce acidosis.

In addition to respiration, liver enlargement and high blood sugar, which also suggests diabetes mellitus, are indicators of an inborn metabolic disorder. It is a congenital disorder, which is divided into different categories, depending on the type of metabolism or metabolism is impaired.

Differences are the carbohydrate, the amino acid, the steroid metabolism and the metabolism of lysosomal storage. Lysosomes are small membrane formations that contain enzymes that break down parts of the cell that are no longer needed or no longer functional, so that they can be reused.

Diagnosis & disease course

Kussmaul breathing is based on metabolic acidosis. This is determined by means of a blood gas analysis. In this analysis, the pH and the concentration of oxygen and carbon dioxide in the blood is determined. The pH of an adult should be between 7.35 and 7.45. The carbon dioxide partial pressure is normally 35 to 45 mm. It can also come to a so-called compensated hyperacidity.

Then the pH is in the normal range, but the other values ​​in the analysis point to a disturbance. In addition, it is also possible to determine the pH of the urine in order to test the person for possible acidosis. In the course of acidosis, there is an oxygen deficiency. The organs are not supplied with enough oxygen. To compensate for the increased acidity, the body releases more water.

The increased acidification of the body can lead to tachycardia (tachycardia). Other sequelae include disorders of consciousness, a reduction in blood pressure, osteoporosis, rheumatoid arthritis, arteriosclerosis and heart disease. Atherosclerosis is arteriosclerosis, which can lead to a heart attack. Rheumatoid arthritis is a disease of the joints that often appears with increasing age.


In Kussmaul breathing sufferers suffer in most cases from severe hyperventilation. This causes breathing difficulties and sufferers sometimes suffer from a strong fatigue and a fatigue. Likewise, it is not uncommon for a reduced resilience of the patient. The liver is often enlarged and leads to pain.

Complaints about the liver are generally dangerous and, in the worst case, can lead to the death of the person affected. Also the metabolism of the patient is restricted by the Kussmaul breathing, so that it comes to disturbances of the digestion and to further complaints. The quality of life of the patient is significantly reduced by this disease. Not infrequently, the symptoms also lead to mental illness or depression.

Furthermore, it is not uncommon for tachycardia and disorders of consciousness. Patients may pass out or fall into a coma. The treatment of kiss-mouth breathing is done with the help of medication. Complications usually do not occur. However, the treatment of the underlying disease is necessary to prevent further complications.

When should you go to the doctor?

Anyone who notices a strong bad breath, which can not be resolved by strict oral hygiene, should visit the house or dentist. If accompanying signs of enlargement of the liver (such as liver pain or jaundice), must be conferred immediately with a physician. Severe tiredness, breathing difficulties and a reduced load capacity are further warning signs that require immediate clarification. In the case of cardiovascular complaints or hyperventilation, the emergency physician must be called or the patient must visit a clinic.

Patients suffering from diabetes, alcoholic ketoacidosis, chronic diarrhea, or renal insufficiency are particularly susceptible to the development of kissmouth breathing. Also in the context of Addison's disease and a lactic acidosis the symptoms occur. Persons who are part of these risk groups are best advised to go directly to the doctor's office so that any complications can be clarified and comprehensively treated. During treatment, the patient must go regularly to the doctor. Since metabolic acidosis can occur again and again, further examinations are necessary after treatment.

Treatment & Therapy

Depending on the cause, metabolic acidosis is treated with various therapies. Diabetes mellitus is caused by the administration of insulin. In case of hyperacidity of the respiratory system, the respiratory system is treated directly. This happens with bronchospasmolytics, a drug that causes dilation of the bronchi.

The bronchial system of the lungs includes the airways, which takes the inhaled or exhaled air in the lungs. For the treatment of metabolic acidosis, buffer substances are administered to return the pH to normal. Tris buffer or sodium bicarbonate solutions are such buffer substances. If it comes to acidosis due to renal insufficiency, this is treated by dialysis.

Outlook & Forecast

The kissmouth breathing is a specific type of breathing. This is caused by diabetes-related or metabolic acidosis of the body. The associated hyperventilation indicates a serious and immediate medical problem. The Kussmaul breathing represents the attempt of over-acidified or comatose organism to create by extensive exhalation of carbon dioxide to compensate for acidosis.

If this very deep hyperventilation breathing is not recognized correctly for what it is, the person is threatened with a coma and then death. Those affected mostly suffer from Type 1 diabetes, very rarely Type 2 diabetes. A diabetic coma associated with a kiss-mouth breathing is an emergency situation. This requires immediate emergency medical treatment. The cause of kiss-mouth breathing is often seen in severe hypoglycemia. However, it may also be present ketoacidosis, which is recognizable by an acetone odor from the mouth of the person concerned.

The emergency procedures for the onset of kiss-mouth breathing must take into account that the person concerned may have given too much insulin. Alternatively, he has not received enough food. The prognosis is good for immediate emergency measures. It is bad, if not immediately help is brought. This is the case, for example, when the patient lives alone and can not perceive his gradual onset.


The metabolic acidosis and thus also the kiss mouth breathing can be avoided if the underlying diseases are treated, which lead to an acidification of the body. Lung dysfunction and diabetes mellitus and renal insufficiency must be treated early enough to prevent acidosis.

In addition, a healthy diet and a moderate intake of alcohol is advisable to prevent the occurrence of acidosis and kiss mouth breathing. Also, a sufficient amount of liquid, mainly water, has a positive effect on the state of health.


In the case of kiss-mouth breathing, after-care proves to be relatively difficult in most cases, whereby in many cases the patient has no special follow-up measures at his disposal. For this disease, therefore, a doctor should be consulted early, so that no further symptoms occur. Only by early diagnosis complications can be prevented, so that the person ideally goes into treatment at the first sign of Kussmaul breathing.

A self-healing can usually not occur. Most sufferers are dependent on the intake of different medicines. Always follow the doctor's instructions. When taking it is also important to ensure a proper dosage and continue to take regular medication.

Since Kuhmaul breathing also requires diabetes treatment, sufferers should pay attention to their diet and, if necessary, follow a nutritional plan from a doctor. The further course of the disease is highly dependent on the time of diagnosis, so that a general prediction can not be given in the rule. However, in many cases, the kiss-mouth breathing significantly limits the life expectancy of the person affected.

You can do that yourself

Patients diagnosed with kiss-mouth breathing should consult with a specialist for clarification. Depending on the underlying disease of metabolic acidosis, various measures can be taken to relieve the symptoms.

If diabetes mellitus is the cause, the patient must take regular insulin. The most important measure is to ensure well-adjusted medication and reduce the risk of low blood sugar. In addition, the lifestyle needs to be adjusted to reduce any overweight and to relieve the body as a whole. In consultation with the specialist or a nutritionist further measures can be developed to reduce the symptoms in the long term. If the kiss-mouth breathing is based on a disease of the respiratory system, a drug treatment is indicated. Breathing exercises can contribute to the dilation of the bronchi and reduce the symptoms in the long term.

If metabolic acidosis is due to alcoholic ketoacidosis or prolonged fasting, the diet or lifestyle needs to be changed. Since these symptoms usually have a psychological cause, a visit to a therapist is also advisable in addition to the medical treatment.

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