Which respiratory pattern is commonly observed with metabolic acidosis in diabetes/renal failure?

• A. Apneustic breathing
• B. Cheyne-Stokes
• C. Kussmaul breathing
• D. Tachypnea

Answer: (C)

Metabolic acidosis prompts the body to compensate by blowing off CO2, and the typical pattern seen with this compensation is Kussmaul breathing. This involves deep, laborious, and often rapid breaths with a relatively regular rhythm, as the lungs work harder to reduce hydrogen ion concentration by lowering PaCO2. It’s commonly observed in diabetic ketoacidosis and uremic (renal) acidosis because those states produce significant metabolic acid load.

Other patterns are linked to different problems. For example, apneustic breathing shows a prolonged inspiration and is usually due to brainstem injury; Cheyne-Stokes involves cyclical waxing and waning with apneas and is seen in advanced heart failure or central neurological disorders; tachypnea is simply faster breathing and isn’t the characteristic compensatory pattern for metabolic acidosis.