Hyperpnea vs. Hyperventilation vs. Kussmaul's | allnurses

Hyperpnea vs. Hyperventilation vs. Kussmaul's

  1. 0 Could anyone explain the difference between these 3 terms?

    I'm not necessarily looking for particular websites or textbook definitions, because I already know what they are. Although if you happen to know of any sites that are particularly good (ie, besides wikpedia, webmd, and all the other walmart-quality of sources out there), feel free to post them.

    What I would really be interested in, though, is hearing a layman's definition from a nurse who already works with pulmonary-problem patients. ie, someone who has actual experience, understands these term, and can do more than just quote a textbook. (Not to belabor the point, but I'm just having a hard time establishing some consistency among all the texts that I'm researching.)

    I know that there is already a student forum for questions. I don't normally post questions outside of that forum, but I would really, really like to hear from a pulmonary-experienced RN on this.

    Thanks so much.
  2. Visit  Jedi of Zen profile page

    About Jedi of Zen

    Joined Jul '07; Posts: 277; Likes: 40.

    16 Comments so far...

  3. Visit  Eve Ryone profile page
    0
    Hi.

    I asked three of the instructors at my school the difference between Kussmaul's and hyperventilation. One of them, who I respect, said "Kussmaul's? I've never heard of Kussmaul's." My anatomy and physiology instructor said they are pretty much the same.

    The head of the program told me that Kussmaul's is marked by heavy, forced expiration. She said that during ketoacidosis, the body is trying to expel CO2. It can look like hyperventilation because for every deep expulsion of air, the patient needs to take a corresponding inspiration, but the expulsion os much more pronounced. She said during hyperventilation, the breaths are usually shallower.

    I found your question because I googled "hyoerventilation vs Kussmaul's", after seeing differing and vague distinctions in my 7 textbooks! It was a direct hit, but I didn't find the answer here! It is very disconcerting to find so many different answers.

    Hope this helped.:spin:
  4. Visit  NRSKarenRN profile page
    1
    hyperpnea:
    abnormal increase in the depth and rate of breathing ... may be normal rate or >30+ breaths per minute. more commonly called tachypnea in my neck of the woods. inhalation and exhalation usually same depth but appears force; tired haggerd appearance if long standing illness.
    can answer questions about health.
    seen in persons with copd, asthma, tension pneumothorax, head injury


    hyperventilation:
    is rapid or deep breathing. shorter inspiration and longer expiration with rates over 30-40 + breaths per minute.
    often caused by anxiety or panic, seen distance runners at end of run.
    breathing pattern heightens feeling of breathlessness. patients can usually answer questions.

    kussmaul:
    pattern of deep and rapid respiration...also called air hunger---worsening above scenerios.
    seen particularly in metabolic acidosis.
    patients can rarely speak a sentence, usually 1-2 word answers to questions being asked.
    prompt use venturi non-rebreathing mask, cpap or prepare to intubate....especially if they tell you their tired and just going to sleep + suddenly nod off.
    streptococcus likes this.
  5. Visit  Jedi of Zen profile page
    0
    Quote from nrskarenrn
    hyperpnea:
    abnormal increase in the depth and rate of breathing ... may be normal rate or >30+ breaths per minute. more commonly called tachypnea in my neck of the woods. inhalation and exhalation usually same depth but appears force; tired haggerd appearance if long standing illness.
    can answer questions about health.
    seen in persons with copd, asthma, tension pneumothorax, head injury
    so hypernea = tachypnea? same thing?
  6. Visit  Jedi of Zen profile page
    0
    Quote from Eve Ryone
    Hi.

    I asked three of the instructors at my school the difference between Kussmaul's and hyperventilation. One of them, who I respect, said "Kussmaul's? I've never heard of Kussmaul's." My anatomy and physiology instructor said they are pretty much the same.

    The head of the program told me that Kussmaul's is marked by heavy, forced expiration. She said that during ketoacidosis, the body is trying to expel CO2. It can look like hyperventilation because for every deep expulsion of air, the patient needs to take a corresponding inspiration, but the expulsion os much more pronounced. She said during hyperventilation, the breaths are usually shallower.

    I found your question because I googled "hyoerventilation vs Kussmaul's", after seeing differing and vague distinctions in my 7 textbooks! It was a direct hit, but I didn't find the answer here! It is very disconcerting to find so many different answers.

    Hope this helped.:spin:

    Thanks. Yes, I agree - sometimes it seems like the terms become entirely arbitrary after a certain point.
  7. Visit  Ventjock profile page
    0
    Quote from Jedi of Zen
    So hypernea = tachypnea? Same thing?
    my understanding was that tachypnea is a measure of rate only, shallow/deep breathing is not accounted for.

    hypernea is a measure of depth AND rate like others have said, most common example is during exercise

    hyperventilation is all that it implies: "hyper-ventilation". ventilation deals with CO2 elimination. hyperventilation has nothing to do with rate

    example: on a ventilated pt (sedated of course) you can get a patient down to a PaCO2 of 25 with a RR of 8-10 by increasing the VT. by definition this patient is being hyperventilated, even with the slow RR.

    on the other hand you can have a pt on a control rate of 20-25 with small VTs, yet the pt is not hyperventilating because the CO2 would be rising, thus the pt is really HYPOventilating.
  8. Visit  Trans-am profile page
    0
    hypercapnea is like someone with COPD that retains air (barrel chest) which is like normal breathing, hypervenelation is very rapid breathing and kussmals is rapid but very deep to breath off co2 to help rid of acid
  9. Visit  Aneroo profile page
    0
    Quote from Eve Ryone
    Hi.

    I asked three of the instructors at my school the difference between Kussmaul's and hyperventilation. One of them, who I respect, said "Kussmaul's? I've never heard of Kussmaul's." My anatomy and physiology instructor said they are pretty much the same.

    The head of the program told me that Kussmaul's is marked by heavy, forced expiration. She said that during ketoacidosis, the body is trying to expel CO2. It can look like hyperventilation because for every deep expulsion of air, the patient needs to take a corresponding inspiration, but the expulsion os much more pronounced. She said during hyperventilation, the breaths are usually shallower.

    I found your question because I googled "hyoerventilation vs Kussmaul's", after seeing differing and vague distinctions in my 7 textbooks! It was a direct hit, but I didn't find the answer here! It is very disconcerting to find so many different answers.

    Hope this helped.:spin:
    What helped me remember Kussmauls was this: "Get the DR" (DR= Deep and Rapid). The depth of the respirations in Kussmauls is what sets it apart. I thought I had seen it before, and knew I had during an hour long ambulance transfer with a teen in DKA. Normally we do the deep part with a sigh, but if you notice- there is usually a small pause in respirations after that sigh. This pause isn't there with Kussmaul's.
  10. Visit  FranEMTnurse profile page
    0
    Kussmaul:
    pattern of deep and rapid respiration...also called air hunger---worsening above scenerios.
    Seen particularly in metabolic acidosis.
    Patients can rarely speak a sentence, usually 1-2 word answers to questions being asked.
    Prompt use Venturi non-rebreathing mask, CPAP or prepare to intubate....especially if they tell you their tired and just going to sleep + suddenly nod off.

    I had this one once, and another time I just felt like going to sleep, but was actually crashing. My sats were dropping rapidly.
  11. Visit  canada123 profile page
    0
    In summary and as mentioned above, Kussmaul's respirations are rapid and /deep/, whereas hyperventilation or tachypnea is rapid and /shallow/.

    It typically occurs in patients with metabolic acidosis, as they are trying very hard to blow off the acid (H+) in their blood.

    (Recall the differential of metabolic acidosis - MUDPILES
    methanol, uremia, DKA, propylene glycol, isoniazid, lactic acidosis, ethylene glycol, salicylate.)

    Reference: Evidence-Based Physical Diagnosis, by Steven McGee, p. 193.

    PGY-1 Family Medicine
  12. Visit  PageRespiratory! profile page
    0
    Quote from canada123
    In summary and as mentioned above, Kussmaul's respirations are rapid and /deep/, whereas hyperventilation or tachypnea is rapid and /shallow/.

    It typically occurs in patients with metabolic acidosis, as they are trying very hard to blow off the acid (H+) in their blood.

    (Recall the differential of metabolic acidosis - MUDPILES
    methanol, uremia, DKA, propylene glycol, isoniazid, lactic acidosis, ethylene glycol, salicylate.)

    Reference: Evidence-Based Physical Diagnosis, by Steven McGee, p. 193.

    PGY-1 Family Medicine
    >
    Above bolded is incorrect, ones ventilation cannot be assed without a CO2 measurment. (ABG/endtidal/ect.). Even though a Pt. is tacypneic, they may not be hyperventilating. And yes hyperventilation is associated with metobolic acidosis compensation, however I feel hypoxemia is a more common cause.
  13. Visit  tewdles profile page
    0
    I know I went to school a long time ago...and I am not a respiratory therapist (but I stayed in a holiday inn last night)...

    I believe that respiration is mechanism by which we obtain oxygen from the air and eliminate CO2 from our blood. Ventilation is part of that process, the part involving the movement of air into and out of the lungs. Because the gas exchange is a separate process in respiration it is possible to have adequate ventilation and have poor blood gases.

    Therefore, it is possible to assess the ventilation quality of a patients respiratory status independent from the blood gases.

    It is true that the tachypneic patient is not necessarily hyperventilating. In my line of work the tachypneic patient is frequently hypoventilating and we can often correct this with use of opioids to depress the respiratory rate.
  14. Visit  PageRespiratory! profile page
    0
    Quote from tewdles
    I know I went to school a long time ago...and I am not a respiratory therapist (but I stayed in a holiday inn last night)...

    I believe that respiration is mechanism by which we obtain oxygen from the air and eliminate CO2 from our blood. Ventilation is part of that process, the part involving the movement of air into and out of the lungs.
    So far, so good. Ventilation = bulk movement of air.
    Quote from tewdles
    Because the gas exchange is a separate process in respiration it is possible to have adequate ventilation and have poor blood gases.
    Perhaps. The Pt may indeed have adequate ventilation and still be hypoxic. CO2 is far more diffusible than O2. So there may be inpaired gas exchange, but normal ventilation. Of course you may have a perfectly healthy person from a pulmonary stantpoint with a metabolic component reflected in the blood gas. (metabolic acidosis compensated [or partially compensated] for by hyperventilation.) [Kussmauls in DKA Pt's.]
    Quote from tewdles
    Therefore, it is possible to assess the ventilation quality of a patients respiratory status independent from the blood gases.
    NEVER! the ONLY measurement of ventilation is by CO2. Exhaled CO2 may be monitored, but like any non invasive measurement, its not as precise as (in this case) a blood gas. Again, the Pt's CO2 is the ONLY true measurement of ventilation. A Pt's WOB certainly may be visually assesed however.
    Quote from tewdles
    It is true that the tachypneic patient is not necessarily hyperventilating. In my line of work the tachypneic patient is frequently hypoventilating and we can often correct this with use of opioids to depress the respiratory rate.
    It seems you have your terminology mixed up a bit.....if your tachypneic Pt is indeed hypoventilating, supressing thier RR would not correct the hypercapnea it would make it worse. Administering an opiate to relieve dyspnea for a hospice/palliative care Pt will certainly reduce WOB and make them more comfortable.


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