Ukwelashwa okuvamile kwe-ARDS
Ukwelashwa kwe-ARDS
I-ARDS, noma i-syndrome yokucindezeleka yokuphefumula, iyinkinga yokuphefumula enamandla engabangela isifo esongela ukuphila. Ukuxilongwa kokuqala kanye nokwelashwa kubalulekile ekunqandeni i-ARDS ngaphambi kokuba kube nzima kakhulu ukuthi umonakalo wegciwane noma ukufa kungenakugwemeka. Ukuxilongwa kokuqala kanye nokwelashwa kubalulekile ukugcina impilo yesiguli esitholwe nge-ARDS.
Ukwelapha Okuvamile Kwa-ARDS
Oxygen: Ukwelashwa kuqala ngokunikeza i-oksijeni yesiguli ukusiza ukugcina amazinga afanele oksijini egameni legazi. Lokhu kuvame ukwenza ngokufaka intubating isiguli bese usebenzisa ventilator . Lokhu kwenza isiguli siphefumule, ngisho nalapho bebuthakathaka kakhulu ukuphefumula ngokwabo, futhi singakwazi ukuhambisa oksijeni okwedlula kunatholakala nge- cannula yomzimba noma ubuso obuso.
Ama-antibiotics: Ama-antibiotics anikezwa iziguli ze-ARDS ngokutheleleka , njenge-pneumonia, noma ezinye izinhlobo zokutheleleka. Amacala amaningi e-ARDS aqala njenge-pneumonia noma i-aspiration pneumonia, okwenza ama-antibiotic abalulekile.
IV Fluids: Izifo zidlala indima ebalulekile ekusizeni umzimba ukusekela yonke imisebenzi yayo ebalulekile, kodwa ukuthola ibhalansi elungile lomswakama kungaba yinkinga. I-fluid encane encane futhi umzimba uyancipha, okwenze kube nzima ukuthumela igazi elanele ne-oksijini ezithombeni nasemiphakathini. Uketshezi oluningi kungalimaza ikhono lamaphaphu lokuphefumula igazi.
Ukumiswa komzimba: Kwezinye izimo kungasiza ukuphefumula ukuze isiguli sigqoke esiswini. Kodwa, iziguli eziningi ze-ARDS ziyagula kangangokuthi ngisho nezinguquko ezincane ezikhundleni zingenza isimo sabo sibe sibi nakakhulu, okwenza ukuthi ukukhishwa kwabasebenzi kube nzima kakhulu. Umbhede oguqula isiguli esiswini sakhe ngenkathi uvumela i-IV ukwesekwa komswakama nokusekela umoya ukuqhubekela phambili kuyinto evamile yokwelashwa.
- Bheka i-RotoProne, umbhede osetshenziselwa ukwelashwa kwe-ARDS nezinye izifo zokuphefumula. Ukubukeka kombhede akuyona into engavamile futhi kungasabeka kumalungu omndeni uma beqala ukubona abathandekayo babo kuwo.
Imithi Engenayo:
- I-Oxyde Nitric: I-Nitric Oxyde, noma i-INO, engenawo ama-gesi angenakubala futhi angenangenangqamuzana esetshenziswa ngeziguli ngeziguli ze-ARDS. Kunikelwa ukuthuthukisa ukujikeleza ngaphakathi kwe-pulmonary system, okwenza ukwanda kwe-oxygenation. Izifundo azihambisani nokusebenza kwe-INO.
- I-Albuterol: Imithi ephikisiwe , i-albuterol isetshenziselwa ukuphatha izimpawu ze-asthma ngokuvula i-bronchus. Kungasetshenziselwa ukwelashwa kwe-ARDS ukusiza ukugcina imimoya ivulekile.
I-Steroids: Ukuphathwa kwe-IV steroids ezigulini ezitholwe ukuthi zinama-ARDS yisifundo esivumelwaneni esicashunwe kakhulu kwezokwelapha. Odokotela bahlukaniswe ukuthi noma ngabe i-steroids iyindlela yokwelapha ephumelelayo ye-ARDS.
I-Levophed: Le mithi inikezwa ukuthuthukisa ukucindezelwa kwegazi ngokuvimbela imithwalo yegazi yomzimba. Iziguli eziningi ezine-ARDS zinzima ukugcina ukucindezelwa kwegazi; le mithi inikeza ukuxhaswa kwegazi futhi kuyisidakamizwa esizikhethela iziguli ezise-septic futhi zinezinkinga zokuphefumula.
Ama-Sedative and Paralytics: Izidakamizwa zinikezwa ukugcina isiguli sithulile futhi sizisize ukuba zibekezelele ekubeni se-ventilator, ezingabangela ukukhathazeka okuningi. Ukukhubazeka, noma izidakamizwa ezikhubaza iningi lezinsimba zomzimba, zisetshenziswa lapho isiguli simelana nomoya wokuvotela ukuvumela i-ventilateur ukuba yenze umsebenzi wayo. Ukukhubazeka akukaze kusetshenziswe ngaphandle kokudalwa, kepha ukugujwa kungasetshenziswa ngaphandle kokukhubazeka.
Umswakama oshonile: I- Surfactant yinto eyenziwe ngamafutha namaprotheni atholakala kuma-alveoli (ama-air bags) emaphaphu. I-surfactant ithuthukisa umsebenzi we-alveoli, ngcono i-oxygenation.
Indoda eyenza i-surfactant ivame ukunikezwa ezinganeni zakudala, okungenzeka ukuthi azikhiqizi okwanele. Le mithi efanayo inikezwa iziguli ze-ARDS ezimweni ezingavamile.
Ngemuva kwe-ARDS
Uma isiguli sithola ukuthi sinesifo se-ARDS, izinga lokufa likhuphuka cishe ku-40%, okusho ukuthi iziguli ezine eziyishumi ezitholakale zine-ARDS ziyafa. Iziguli ezisinda zivame ukwenza kanjalo ngoba zatholakala ukuthi ziphuthumayo futhi ziphathwa kabi ngokuphathwa ngendlela efanele. Ngenkathi izibalo zinzima, ukwelashwa kwe-ARDS kuthuthukisa unyaka ngamunye, kanti iziguli eziningi ziqhubeka zisinda.
Kungokwemvelo ukuzizwa ukhathele, ukuphefumula futhi ngokuvamile ugula ngemva kokuphelelwa kwe-ARDS. Kungathatha amasonto noma izinyanga ukuba uzizwe ujwayelekile, ngisho nangemva kokukhishwa esibhedlela. Kwezinye iziguli, ukwehluleka kwamapayipi kungase kusho ukuthi i-oxygenation ayiyona into enhle ngaphambi kokugula, okwenza kube nomuzwa wokukhathala.
Imithombo:
I-Oxyde Nitric Inhaled For Adult Respiratory Distress Syndrome. I-New England Journal of Medicine. Kufinyelelwe ngoJanuwari 2011. http://www.nejm.org/doi/full/10.1056/NEJM199307153290313
Amanani Okufa Kweziguli Ezinezifo Ezinzima Zokulimala / Ama-ARD Aye Nciphise Isikhathi Esiningi. UMnuz Zambon, J. Vincent. Isifuba: I-Journal ye-American College of Lung Physicians. Julayi 2008.
Kuyini i-ARDS? I-National Heart Lung ne-Blood Institute. Kufinyelelwe ngoJanuwari 2011. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhatIs.html