Flapping Tremor as a Diagnostic Tool for Evaluation of Hypercapnia.
A 76 year-old woman was admitted to our hospital because of aspiration pneumonia. Four days after initiation of the antibiotic treatment, her respiratory status became to be better; however, hypoxemia was recurred with tachypnea.
On physical examination, she had a hot hand and flapping tremor, but not loss of consciousness, suggesting of acute type 2 respiratory failures with the increased level of PCO2 ranged from 15 to 30 mmHg. Accumulation of the evidence showed that the PCO2 retention from the usual level for each patient could be assessed by physical sings.
Thus, even in the modern era, general physicians can easily diagnose the rapid increase the level
of PCO2 from the prior status by using the physical findings such as hot
hands, flapping tremor, and loss of consciousness as in the present case.
The diagnosis of acute type 2 respiratory failure needs a multidisciplinary assessment. Among them, physical diagnosis would be a pivotal role for rapid and precise diagnosis. A 76 year-old woman was admitted to our hospital with a chief complaint of dyspnea.
She had primary Sjogren’s syndrome with pulmonary involvement two years previously, and
underwent home oxygen therapy for recent three months. On admission, vital signs were as follows, blood pressure of 180/100 mmHg, heart rate of 120 beats/min, respiratory rate of 24 breaths/min, body temperature of 37.1°C, and SpO2 of 84% with a 4 L/min oxygen supply via nasal mask.
Pulm Res Respir Med Open J. 2(1): 49-51. doi: 10.17140/PRRMOJ-2-107
