Kwezinye izimo, kungase kuzuze ukusebenzisa okunye ukucindezela okujwayelekile okuqhubekayo kwe-airway (CPAP) okuthiwa i-bilevel positive airway pressure (BiPAP). Iyini ukwelashwa kwe-BiPAP futhi nini isetshenziswa njalo? Funda ukuthi i-BiPAP isetshenziselwa kanjani ukuphazamisa ukuphefumula okuphazamisa ukulala ne-apnea yokulala ebusweni ngokuletha izingcindezi ezimbili ezithinta ukuhamba nge-mask ubuso.
Kuyini i-BiPAP noma i-Bilevel Therapy?
Izingxenye eziningi zomshini we-BiPAP zifana nomshini ojwayelekile we- CPAP . Isibonelo, kusadinga ubuso bokubukeka nesibhubhe esixhunywe kudivayisi. Isici esiqakathekileko sokuhlukanisa i-BiPAP ngukuthi umoya ophefumulwako unikezwa emazingeni amabili wokutjhugulula. Ukucindezela okuhle kwe-airway pressure (i-IPAP) kuphezulu futhi kusekela ukuphefumula njengoba kuthathwa. Ngakolunye uhlangothi, ukucindezeleka okuhle komphefumulo womoya (EPAP) ingcindezi ephansi evumela ukuba uphefumule kahle. Lezi zicindezelo zihlelwe ngokusekelwe kadokotela ohlinzekwe ngudokotela wakho wokulala futhi okunye okufana nephethini yakho yokuphefumula.
Ngaphandle kwalezi zilungiselelo ezijwayelekile, kunokunye okuhlukile okukhona okukhona. I-Bilevel ST ihlanganisa ukulethwa kwesikhathi kokuphefumula uma ukuphefumula kuphelile. Lezi zindlela zokumisa zivame ukutholakala e-central apnea yokulala. Ngaphezu kwalokho, i-servo-ventilation ye-auto noma evumelanayo (i-ASV) ihlanganisa izilungiselelo eziningi eziyinkimbinkimbi ezihluka isikhathi, ubude, nomthamo wokuphefumula okunikezwayo.
Uma ukwelashwa kwe-BiPAP kusetshenziselwa ukwelashwa kwe-apnea yokulala
I-BiPAP yindlela yokuphefumula okuvame ukusetshenziselwa ukwelapha i- central apnea yokulala , isimo esenzeka esimweni sokusebenzisa i-opioid, ukwehluleka kwenhliziyo kwangempela, kanye nokushaya kanzima. Kungase futhi isetshenziswe ekuphefumuleni okunamandla okuvimbela ukulala, ikakhulukazi uma kunezimo eziphambene ne-apnea ezikhona, okubonisa ukuthi ingxenye ye-apnea yokulala ephakathi.
Kungasetshenziselwa ukuphatha abantu abangenakubekezelela ukucindezela okuqhubekayo kwe-airway (CPAP), ikakhulukazi labo abakhononda ukuthi kunzima ukuphefumula ngaphandle kokucindezela. Lokhu kungenzeka ukuthi kwenzeke ekucindezelekeni okuphakeme uma lokhu kudingekile ukuba kugcinwe umoya. Nakuba le mingcele ihlukahluka, kuvame ukudingeka ekucindezelekeni okuphakeme kunama-centimitha angu-15 wokucindezela kwamanzi (i-CWP). Kungasiza ekuthuthukiseni ukuthobela phakathi kwalabo abanobunzima be-CPAP.
Ngaphezu kwalokho, kuyindlela yokusekela engeyona engavamile engasetshenziswa kubantu abahlala esibhedlela abacindezelekile bokuphefumula kodwa abafisa ukufakwa efeni. Kungaba usizo kulabo abanebuthakathaka be-neuromuscular, njengokungathi kungenzeka nge-amyotrophic lateral sclerosis (ALS).
Amagama ahlukene: I-BiPAP ihluke kanjani ku-VPAP Therapy?
Kukhona ukudideka mayelana negama elithi BiPAP ngokwayo, ikakhulukazi ukuthi lihluke kanjani kwi-bilevel. Lezi empeleni into efanayo. Amagama wedivaysi azohluka ngendlela ethile ngokusekelwe kumakhi.
Omunye wabakhiqizi abakhulu balawa madivaysi, ama-Respironics, ubhalise i-BiPAP njengegama lophawu lokuthengisa lobuchwepheshe obubizwa nge-bilevel.
Omunye umncintiswano omkhulu, u-ResMed, ubiza izingcingo ezifanayo ze-VPAP.
I-ResMed manje ithengisa idivayisi ebizwa ngokuthi i-AirCurve yile divayisi ye-bilevel.
Nakuba amagama angase ahluke, izimiso eziyisisekelo ziyafana.
Indlela Yokunquma: Ingabe Ngidinga I-CPAP noma i-BiPAP?
Ezimweni eziningi ze-apnea yokuvimbela ukulala, i-CPAP yedwa yanele njengelashwa. Ezimweni eziyinkimbinkimbi ezichazwe ngenhla, noma uma kunzima ukubekezelela i-CPAP, i-BiPAP ingahle ibe yindlela ewusizo. Iningi labantu lizoqala ukwelashwa nge-CPAP futhi uma kudingeka ukuthi kwenziwe isifundo se-titration ukuze kunqunywe ukulungiselelwa okudingekayo ukuze uthole impendulo enhle ekwelashweni kwe-bilevel.
Kumele kuqashelwe ukuthi i-BiPAP iyabiza ngaphezu komshini ojwayelekile we-CPAP.
Kungaba ngentengo kabili noma kathathu izindleko ze-CPAP. Izithombe ze-ASV zingadla ngaphezu kuka-$ 4,000.
Izwi elivela
Uma ufuna ukwazi ukuthi i-BiPAP ingaba yindlela efanele yokwelapha, ungaqala ngokukhuluma nodokotela wakho olele . Ngemuva kokuhlolwa kwezingozi zakho futhi, njengoba kudingeka, ukuhlolwa okukhethiwe, ukwelashwa okufanele kunganikezwa ukuxazulula isimo sakho. Lesi yisinqumo esenziwe kahle ngokubonisana nodokotela wakho ozobe ebeka ukwelashwa.
Imithombo:
Kryger, MH et al . "Izimiso Nemikhuba Yokulala Imithi." Elsevier , edition 6, 2017.
Reeves-Hoche, MK et al . "Ukucindezela okuqhubekayo kwe-airvel for breathing apnea." Am J Respir Crit Care Med 1995; 151: 443.