Ukufa Ngezidingo Neurologic
Lapho umuntu efa, ngokuvamile bafa ngalokho okubizwa ngokuthi "ukufa komzimba." Lolu hlobo lokufa lwenzeka lapho inhliziyo ingasabi ukunikeza igazi emzimbeni nasebuchosheni, okuholela ekufeni. Iningi labantu abafayo, cishe angu-99%, bafa nge-cardiac. Nokho, kukhona olunye uhlobo lokufa, okubizwa ngokuthi ukufa komqondo. Ngaphansi kwamaphesenti angu-1 abo bonke abantu abake bebizwa ukuthi bafile ebuchosheni.
Ukufa kwengqondo kuyisifo sokuthola ukufa komtholampilo nokusemthethweni. Umqondo wokufa kobuchopho ungaba udidekile kakhulu ngoba inhliziyo yomuntu isabetha futhi isifuba sabo sisasukuma futhi siwawo wonke umoya ovela emoyeni. Isikhumba sishisa futhi umuntu angase abonakale ephumule, kunokuba agula kakhulu futhi engasebenzi ngaphandle kobuchopho. Lokhu kungenxa yokuthi ukulimala okungokwemvelo kunabo bonke empeleni kufihlwe ebuchosheni, kunokuba kubonakale emzimbeni.
Amaseli obuchopho awabuyiselwa kahle. Lokhu kwenza kube nzima ukuthi ubuchopho buyisindiswe ekulimazeni. Uma ubuchopho bubulawa yiksijini okwanele okwanele ukuthi amangqamuzana obuchopho afe, ngeke ashintshwe. Uma kwenzeka umonakalo okwanele ukuvimbela ubuchopho ekutholeni igazi ne-oxygen, futhi ubuchopho buhamba ngaphandle kwe-oxygen isikhathi eside ngokwanele, ukufa kwengqondo kungase kubangele.
Ukumemezela Ukufa Kwebongo
Ukufa kwengqondo kusho ukuthi udokotela oqeqeshiwe, ngokuvamile ochwepheshe bezinzwa, wahlola ngokujulile isiguli futhi wathola ukuthi isiguli sihlangabezana nezinqubo zokufa kobuchopho.
Ngaphambi kokufa kwengqondo ebuchosheni, kufanele kube nemigomo emithathu yokutholwa:
- Ukungaphenduli
- Ukungabi nokucabanga
- I-apnea (ukungakwazi ukuphefumula ngaphandle kweventilator)
Ukuhlolwa kokufa kweBongo
Ukuhlolwa kwe-Brain kokufa kubangelwa izigaba ezintathu eziyinhloko:
- Ukuhlolwa komzimba
- Ukuhlolwa kwe-apnea
- Okunye ukuhlolwa, okubizwa nangokuthi ukuhlolwa okuyisisekelo
Ukuhlolwa Kwemvelo
Ukuhlola okwenyama kwenziwa ukuqinisekisa ukuthi isiguli siyasabela kanjani. Uma kungenjalo, ukuhlola ngokomzimba kungabheka ukucabanga. Isiguli esibuchopho esifile ngeke sibe nanoma iyiphi i-brainstem reflexes. Isibonelo, isiguli esivamile singabhinqa noma sithuthele ikhanda uma othile ethinta iso ngendwangu yekotini. Isiguli esiphefumula esibuchosheni ngeke sibonakale uma udokotela ethinta iso lakhe ngendwangu yokotini. Ngakho-ke, uma kungekho ukukhanya, lokho kusho ukuthi i-brainstem ingasebenzi ngendlela efanele.
Olunye uhlobo lokuhlolwa ngokomzimba yi-caloric ebandayo. Lokhu kuhlolwa kwenziwa ngokusebenzisa i-syringe yamanzi abandayo abandayo bese uyijova endlebeni. Isiguli esiphefumula ebuchosheni ngeke siphendule ngaloluhlobo lwezinto eziqhamukayo, umuntu onomsebenzi wengqondo uzoba nempendulo, okungaqondana nokunyakaza kweso ukuhlanza. Ukuhlolwa kwe-caloric okubandayo akumele kwenziwe kumuntu owaziwa ukuthi unomsebenzi ophuthumayo wobuchopho njengokuhlanza kwe-projectile ngokuvamile umphumela.
Ukuhlolwa kwe-Apnea
Isiguli esigula ngokwanele ekuhlolweni kokubulawa kobuchopho sizoba sevini . Isiguli esivela echosheni ngempela asikwazi ukuphefumula ngaphandle kwendiza. Ukuze uhlolwe ukuze ubone ukuthi ukuphefumula okuphefumulayo kungasebenzi yini noma akusikho, isiguli sisuswe ku-ventilator ngenqubo ebizwa ngokuthi i-apnea test.
Ngokuvamile, i- ABG idonselwa ngokushesha ngaphambi kokuhlolwa kokuhlolwa kwe-apnea, lapho isiguli sithathwa ku-ventilator. I-oksijeni inganikezwa isiguli ngesikhathi sokuhlolwa kwe-apnea, kodwa i-ventilator ayikwazi ukusiza isiguli ukuphefumula.
Isiguli esiphila ebuchosheni-ukufa ngeke siphefumle ngesikhathi sokuhlolwa kwe-apnea. Isiguli esivamile sizozama ukuphefumula uma ubuchopho butshela umzimba ukuthi kuyadingeka. Kuziguli eziphethwe ubuchopho, ubuchopho abukwazi ukuthumela isibonakaliso sokuphefumula nokuphefumula okwenzekayo ngaphandle kokusekelwa kweventilator.
Okunye ukuhlolwa kokubulawa kobuchopho
Ngemva kokuqeda ukuhlola ngokomzimba, udokotela angakhetha ukwenza ukuhlolwa okwengeziwe.
Nakuba kubonakala kokubili ukuhlola ngokomzimba kanye nokuhlolwa kwe-apnea okumele kwenziwe, kwezinye iziguli isiguli asikwazi ukubekezelela ukuhlolwa kwe-apnea. Ngokuvamile, kulawo mahlakalo, ukutadisha kuzothathwa. Lezi zifundo zenziwa ukuze ubone ukuthi igazi lihamba yini ebuchosheni ngegazi. Uma isifundo sibonisa ukuthi akukho igazi elifinyelela ebuchosheni, ukuhlolwa kuhambisana nokufa kwengqondo.
Abanye odokotela bazosebenzisa i-EEG, noma i-electroencephalogram, okuyinto yokuhlola okwenza amagagasi ochopho. Isiguli esiphefumula ubuchopho sizoba ne-EEG "flat", njengoba amagagasi obuchopho engekho.
Ubunzima bokumemezela ukufa
Lapho isiguli sisho ukuthi uboshiwe buchopho, bafa ngokomthetho. Isitifiketi sabo sokufa sizobonisa usuku lapho ubuchopho buchazwa khona, hhayi lapho inhliziyo yabo iyeka ngokuhamba kwesikhathi. E-United States, uma isiguli sisho ukuthi ubuchopho bufile futhi isiguli sihlangabezana nezimiso ezithile zezokwelapha, iminikelo yomzimba ingaba yindlela yokukhetha. Ezimweni eziningi, lo muntu usevele wenza isinqumo sokunikela futhi ubonise ukukhetha kwabo kwilayisense yabo yokushayela noma ngentando yabo.
Imithombo:
I-Practice Parameters: Ukunquma Ubuningi Ukufa Kubantu Abadala. I-American Academy ye-Neurology. http://www.aan.com/professionals/practice/guidelines/pda/Brain_death_adults.pdf