Yini Okumele Yilindele Uma I-Ventilator Iyadingeka
I-ventilator, eyaziwa nangokuthi umshini wokuphefumula noma umshini wokuphefumula, idivayisi yezokwelapha enikeza isiguli umoya-mpilo lapho bengakwazi ukuphefumula ngokwabo. I-ventilator igxilisa umoya kancane emaphashini futhi ikuvumela ukuthi iphinde iphinde ibuye, njengamaphaphu ayokwenza ngokuvamile uma ekwazi.
Phakathi nanoma yikuphi ukuhlinzwa okudinga i-anesthesia ejwayelekile, i-ventilator iyadingeka.
Kukhona izikhathi lapho i-ventilator iyadingeka emva kokuhlinzwa, njengoba isiguli singase singakwazi ukuphefumula sisodwa ngemva kwenqubo.
Kungani Kudingeka I-Ventilator Phakathi Nokuhlinzwa
I-anesthesia ejwayelekile isebenza ngokuphazamisa imisipha yomzimba okwesikhashana. Lokhu kuhlanganisa imisipha esivumela ukuba sivuselele futhi siphumelele. Ngaphandle kwendiza, ukuphefumula ngesikhathi se-anesthesia jikelele kungeke kwenzeke. Iningi leziguli zisesimweni sokuphuza umoya ngenkathi kuhlinzeka ukuhlinzwa, khona-ke umuthi unikezwa ukuyeka i-anesthesia. Lapho i-anesthesia iyeka, isiguli sikwazi ukuphefumula sodwa futhi sisuswa ku-ventilator.
Kungani I-Ventilator Ingase Yidingeke Ngemuva Kokuhlinzwa
I-ventilator iyadingeka lapho isiguli singakwazi ukuphefumula ngokwanele ukunikeza oksijini ebuchosheni nasemzimbeni.
Ezinye iziguli, ngenxa yokulimala noma ukugula, azikwazi ukuphefumula kahle ngemva kokuba ukuhlinzwa kukhishwe ku-ventilator.
Lokhu kungenzeka ngenxa yomsebenzi ompofu wamaphaphu ngaphambi kokuhlinzwa, okungenzeka uma iziguli zilimaza emaphashini abo okubangelwa yi- Chronic Obstructive Pulmonary Disease (COPD) . Iziguli ezibhema nazo zithola amazinga aphezulu adinga i-ventilator isikhathi eside ngemuva kokuhlinzwa.
Lokhu kwenzeka futhi lapho isiguli sigula kakhulu ukuziphefumula.
Lokhu kungenzeka ngenxa yokulimala (njengengozi yemoto esongela ukuphila), ukutheleleka noma enye inkinga. Isiguli esisevini ngaphambi kokuhlinzeka cishe sizohlala esiveni emva kokuhlinzwa kuze kube yilapho sebephululela ngokwanele ukuze baphefumule kahle.
Okunye ukuhlinzeka kudinga ukuthi isiguli sibe sesivinjini isikhathi esifushane ngemuva kokuhlinzwa njengengxenye yecebo. Isibonelo, iziguli ezinokuhlinzekwa kwenhliziyo evulekile zigcinwa ngokujwayelekile emoyeni ngaphambi kokuba zivuke ngokwanele ukuphakamisa ikhanda emithonjeni yazo futhi zilandele imiyalo elula. Abanikezwa izidakamizwa ukuyeka i-anesthesia, kunalokho kuvunyelwe ukuguga yedwa, futhi isiguli sisuswe ku-ventilator uma sesilungele ukuphefumula sisodwa.
Intubation
Ukuze kufakwe ku-ventilator, isiguli kumele sikhulunywe . Lokhu kusho ukuthi ube ne- tube endotracheal evezwe emlonyeni noma ekhaleni futhi ifakwe phansi emoyeni. Le tube ine-gasket encane engasetshenziselwa ukufaka ithini endaweni. I-ventilator inamathele ku-tube futhi i-ventilator inikeza "ukuphefumula" kwesiguli.
Ukuzijabulisa ngenkathi kuVentilator
Uma isiguli sisesithombeni emva kokuhlinzwa, imithi ivame ukunikezwa ukuze idonsa isiguli.
Lokhu kwenziwa ngoba kungamcasula futhi kuthukuthele isiguli ukuba sibe ne-tube endotracheal endaweni futhi uzizwe i-ventilator igxilisa umoya emaphashini. Umgomo ukugcina isiguli sizolile futhi sinethezekile ngaphandle kokuzihlalisa kakhulu ukuze singakwazi ukuphefumula sodwa futhi sisuswe ku-ventilator.
Ukuphumula kweVentilator
Ukugcoba yigama elisetshenziselwa inqubo yokususa othile kusuka kumoya. Iziguli eziningi zokuhlinzwa zisuswa ku-ventilator ngokushesha futhi kalula. Bangase banikezwe inani elincane le-oxygen yangasese ukuze inqubo ibe lula, kodwa ngokuvamile bayakwazi ukuphefumula ngaphandle kobunzima.
Iziguli ezingakwazi ukususwa ku-ventilisi ngokushesha ngemva kokuhlinzwa zingadinga ukugonywa, okuyinto inqubo lapho izilungiselelo zendiza zilungiswa khona ukuvumela isiguli ukuba sizame ukuphefumula sodwa, noma ukuba umoya we-ventilateur wenze umsebenzi omncane futhi nesineke ukwenza okuningi. Lokhu kungenziwa izinsuku noma ngisho namasonto, kancane kancane uvumela isiguli ukuba sithuthukise ukuphefumula.
I-CPAP, noma ukucindezela okungahambi kahle kwe-airway, isilungiselelo se-ventilator evumela iziguli ukuba zenze umsebenzi wokuphefumula nge-ventilator etholakalayo ukusiza uma isiguli singenzi kahle. Isivivinyo se-CPAP, okusho ukuthi isiguli sifakwe esimisweni se-CPAP isikhathi esithile, singasetshenziselwa ukunquma ukuthi isiguli singakwazi yini ukubekezelela ukususwa ku-ventilator.
Ezinye iziguli ezisefenjini isikhathi eside zingase zibe nge-CPAP phakathi nosuku, zizosekelwa ngokugcwele nge-ventilator ebusuku ukuze zikwazi ukuphumula ngokugcwele futhi ziqhubeke nokuphulukisa ngaphandle kokuphelelwa umsebenzi wokuphefumula.
Ukuxubha Emva kokuhlala eVentilator
Ukukhululwa kuyinkqubo yokuba nethubhu yokugcina isusiwe. Phakathi nale nqubo, umhlengikazi ususa umoya ophuma emgodini okhungetheyo bese ekhishwa emathinini noma ekhishwayo ethinta ithubhu endaweni. I-tube itholakala kahle ngomlomo noma ekhaleni lesiguli. Kuleli phuzu bayakwazi ukuphefumula ngokwabo futhi umshini wokuphuza umoya awukwazi ukunikeza noma yimuphi usizo lokuphefumula. Iningi leziguli zinikezwa umoya-mpilo ukusiza ngale nqubo, noma nge-mask noma nge-nasally.
Iningi leziguli zikhwehlela ngesikhathi senqubo, kodwa akuyona into ebuhlungu kakhulu. Iziguli eziningi zikhononda ngesifo somzimba ngemva kokuthungulwa , ngakho-ke ukuphuza imithi, i-lozenges noma imithi yokugaya ingasetshenziswa, uma isiguli singababekezelela futhi singasetshenziswa ngokuphepha.
Ukunakekelwa Ngenkathi KuVentilator
Ukunakekelwa kwesineke komuntu onomoya ovame ukuhlanganisa ukuvimbela ukutheleleka nokucasula isikhumba. Lezi ziguli cishe zihlala e-unit enkulu yokunakekelwa (ICU) futhi zithole ukuqapha nokuqapha njalo.
Itheyipu noma i-strap isetshenziselwa ukugcina i-tube endotracheal endaweni, lokhu kuyashintsha uma ingcolile futhi ithubhu ishukunyiswa njalo ukusuka kolunye uhlangothi lomlomo kuya komunye. Ukuhambisa ibhuloho kuyenziwa ukuvimbela ukucasula isikhumba nokwehla kwesibhubhe ukuxubha ngokumelene nezicubu zomlomo.
Ukunakekelwa komlomo kuqhutshwa njalo ukuvimbela ukutheleleka. Umlomo uvame ukomile, ngakho umlomo uhlanzwa futhi uswakanyiswe ukuvikela amazinyo futhi unciphise noma yimaphi amabhaktheriya ayingozi angenza indlela yawo emaphashini bese enza imbangela yomoya.
Izindlebe zomlomo zitholakala emlonyeni ukuze zivimbele ukuba zingene emaphashini futhi zibangele i- pneumonia . Iminyango esuka emaphashini itholakele njengoba isiguli singeke sikwazi ukukhwehlela lezi zimfihlo ngenkathi ku-ventilator.
Iziguli ezidinga i-ventilator zivame ukugula noma zibuthakathaka ukuziphindisela ngokwazo, ukuphenduka njalo kubuye kube yingxenye yokunakekelwa njalo.
Ukwelashwa okuphuzayo kuvame ukuhlinzeka ngemithi yokuphefumula noma abahlengikazi, ukusiza ukugcina imimoya evulekile, imfihlo encane engase ibe khona futhi ithathe noma yiziphi izimo zamaphaphu ezingase zibe nesiguli.
Ukunakekelwa kwe-Long Term Ventilator
Kulezi ziguli ezingakwazi ukuchithwa kusuka ku-ventilator, i-tracheostomy ingadingeka. I-tube endotracheal akufanele ishiywe endaweni engaphezu kwamasonto ambalwa njengoba ingagcina idale umonakalo unomphela emigodini yezwi noma i-windpipe futhi ingenza umoya wokugaya ube nzima nakakhulu.
Kulezi ziguli ezilindeleke ukuba zibe ngomoya ohlala isikhathi eside, ukuvulwa okwenziwe ngokuhlinzekwa kwenziwa entanyeni futhi umoya wendiza unamathele lapho, kunokuba usebenze ngokusebenzisa ithubhu ebeka emlonyeni.
Iziguli zivame ukudluliselwa esikhungweni se-Long Term Acute Care (LTAC) esinikeza ukunakekelwa kwe-ventilator. Lezi zakhiwo zivame ukuba nezinyunithi lapho ukugcoba kwe-ventilator kuyisipesheli sabo, futhi inqubo yokusiza isiguli ukuthi ikwazi ukuphefumulela ngempumelelo iyingxenye yokunakekelwa kwansuku zonke.
> Umthombo:
> Yiziphi izingozi zokuba sevini? I-National Heart, i-Lung ne-Blood Institute. Ifinyelele ngo-Septhemba, 2015. http://www.nhlbi.nih.gov/health/health-topics/topics/vent/risks