Kussmaul Breathing in Lactic Acidosis

Acute non-cardiopulmonary dyspnoea. 70 ys, DM, vomiting and URQ abdominal pain since 3 days. Recently discharged for acute colecystitis. On arrival, alert, tachypnoeic (see video), BT 37.9*C. On CT scan, abdominal abscess. BGA: severe lactic acidosis 21 mmol/L, gluc 48.

The patient had regularly taken metformin 500mg tid

Treated successfully with IV Bicarb & dialysis. Bottom line. Not every dyspnoea originates in the chest. Kussmaul breathing to compensate for metabolic acidosis

Dr. Roberto Cosentini @rob_cosentini

#Kussmaul #Breathing #Respirations #Clinical #Video #PhysicalExam #Pulmonary #Respiratory
Contributed by

Dr. Priyanka Teckchandani
GrepMed Pulmonary and Critical Care Editor - Academic Hospitalist UC Davis Medical Center Internal Medicine, Pulmonary and Critical Care Medicine Fellow UC Irvine ‘22
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