Which finding is typically present in DKA, but not in HHS?

Kussmaul respirations are deep, labored breaths that are often associated with diabetic ketoacidosis (DKA). This respiratory pattern occurs as the body attempts to correct the acidosis that results from the accumulation of ketones in the bloodstream. In DKA, the blood pH decreases due to metabolic acidosis, leading the body to increase respiration rate and depth in order to expel carbon dioxide and raise blood pH levels back towards normal.

In contrast, hyperglycemic hyperosmolar state (HHS) primarily involves severe hyperglycemia and dehydration without significant acidosis. Hence, Kussmaul respirations are not a characteristic finding in HHS because the metabolic derangement in HHS does not typically include ketosis or resultant acidosis to the degree seen in DKA.

Understanding the physiological differences between DKA and HHS helps clarify why Kussmaul respirations serve as a hallmark of DKA specifically, reflecting the body's attempt to compensate for the acidosis caused by elevated ketone bodies.