It is a form of hyperventilation, which is any breathing pattern that reduces carbon dioxide in the blood due to increased rate or depth of respiration.
Adolf Kussmaul referred to breathing when metabolic acidosis was sufficiently severe for the respiratory rate to be normal or reduced.
[2] This definition is also followed by several other sources,[3][4] including for instance Merriam-Webster, which defines Kussmaul breathing as "abnormally slow deep respiration characteristic of air hunger and occurring especially in acidotic states".
Indeed, Kussmaul originally identified this type of breathing as a sign of coma and imminent death in diabetic patients.
Duration of fasting, presence or absence of liver enlargement and Kussmaul breathing provide clues to the differential diagnosis of high blood sugar in the inborn errors of metabolism.