So oxygen dodow a ɛwɔ wo mogya mu no teɛ? Momma yensua ABG (Arterial Blood Gas) sɔhwɛ no ho ade wɔ ɔkwan a ɛnyɛ den so!

Yɛn nyinaa nim sɛnea oxygen ho hia ma yɛn nipadua. Sɛ obi home yiye na onya mframa pa dodow a ɛfata wɔ mogya no mu a, ɛho hia na ama yɛanya apɔwmuden. Enti, ɛtɔ mmere bi a, ɛsɛ sɛ nnuruyɛfo hu oxygen ne carbon dioxide dodow a ɛwɔ wo mogya mu no pɛpɛɛpɛ. Ɛno na wɔyɛ sɔhwɛ a wɔfrɛ no ABG (Arterial Blood Gas) yi.

Dɛn ne ABG (Arterial Blood Gas) nhwehwɛmu yi?

Sɛ yɛbɛka no tiawa a, ABG (Arterial Blood Gas) nhwehwɛmu yɛ nhwehwɛmu a wɔde mogya a wogye fi wo ntini mu di dwuma de susuw oxygen ne carbon dioxide dodow a ɛwɔ wo mogya mu. Susuw ho hwɛ, mogya ntini ahorow abien na ɛwɔ yɛn nipadua mu, biako ne ntini ahorow, na biako nso ne ntini ahorow. Ntini no de mogya a ɛho tew a oxygen pii wom fi koma no mu kɔ nipadua no fã a aka no mu. Enti, wɔ ABG nhwehwɛmu yi mu no, wogye mogya fi saa ntini ahorow no mu.

Ɛnyɛ oxygen ne carbon dioxide nko na nhwehwɛmu yi susuw, na mmom ɛsusuw acid-base balance , anaa pH, a ɛwɔ wo mogya mu nso. Mpɛn pii no, yɛn nipadua no hwɛ oxygen ne carbon dioxide dodow a ɛwɔ yɛn mogya mu no so yiye. Sɛ oxygen dodow a ɛwɔ yɛn mogya mu no so tew (a yɛfrɛ no wɔ aduruyɛ mu `hypoxemia`) a, ebetumi de ɔhaw ahorow a emu yɛ den yiye aba . Ebetumi asɛe w’amemene ne w’akoma titiriw.

ABG sɔhwɛ no boa nnuruyɛfo ma wɔte nyarewa a ɛfa wo home nhyehyɛe , mogya a ɛkɔ nipadua no mu , ne nipadua mu nneɛma a ɛsakra (ɔkwan a wofa so dan aduan a wudi no ma ɛyɛ ahoɔden) ase. Eyi ho hia titiriw wɔ tebea horow a egye ntɛmpɛ mu .

Sɔhwɛ foforo bi wɔ hɔ a wɔfrɛ no "mogya mu mframa mu nhwehwɛmu." Wɔ nhwehwɛmu yi mu no, wobetumi agye mogya afi nipadua no mu baabiara (ntini, ntini, anaa ntini a ɛma mogya tu). Nanso, wɔ ABG nhwehwɛmu no mu no, ɛsɛ sɛ woyi mogya fi ntini bi mu .

Saa ABG sɔhwɛ yi wɔ din afoforo pii:

• Mogya mu mframa mu nhwehwɛmu
• Mogya mu mframa a ɛwɔ ntini mu
• ABG na ɔkyerɛwee
• Mogya mu mframa mu nhwehwɛmu

Dɛn ankasa na ABG sɔhwɛ susuw?

ABG sɔhwɛ taa susuw sɛ:

• Oxygen dodow (O2CT) : Eyi kyerɛ oxygen dodow a ɛwɔ wo mogya mu.
• Hemoglobin : Hemoglobin yɛ protein a ɛwɔ yɛn mogya mu nkwammoaa kɔkɔɔ mu a ɛde mframa pa kɔ nipadua no mu nyinaa. Eyi kyerɛ hemoglobin dodow.
• Oxygen saturation (O2Sat) : Eyi kyerɛ oxygen dodow a hemoglobin a ɛwɔ wo mogya mu no de kɔ.
• Oxygen nhyɛso fã bi (PaO2) : Eyi kyerɛ oxygen a apete wo mogya mu no nhyɛso. Ɛkyerɛ sɛnea oxygen fi w’ahurututu mu rekɔ wo mogya mu yiye.
• Carbon dioxide (PaCO2) nhyɛso fã bi: Eyi kyerɛ sɛnea carbon dioxide dodow a ɛwɔ wo mogya mu ne sɛnea wɔreyi carbon dioxide afi wo nipadua mu yiye.
• pH (`pH`) : Eyi kyerɛ sɛnea acid ne bases a ɛwɔ wo mogya mu no kari pɛ. Mpɛn pii no, ɛsɛ sɛ mogya mu pH yɛ 7.35 kosi 7.45. Wobu biribiara a ɛba fam sen saa sɛ ɛyɛ acid dodo, na wobu biribiara a ɛkorɔn sen saa sɛ ɛyɛ mfitiasede dodo anaasɛ ɛyɛ alkaline .
• Bicarbonate (`Bicarbonate - HCO3`) : Wɔde pH ne PaCO2 na ɛbu eyi ho akontaa. Ɛkyerɛ dodow a base compound a efi carbon dioxide mu ba.

Bere bɛn na wɔyɛ ABG sɔhwɛ?

Nnuruyɛfo taa hyɛ sɛ wɔnyɛ ABG nhwehwɛmu wɔ nsɛm te sɛ eyinom mu:

• Aduruyɛ a egye ntɛmpɛ : Eyi kyerɛ nyarewa anaa akwanhyia a ehia sɛ wɔkɔ ayaresabea ntɛm ara.
• Anesthesiology : Aduruyɛ adwuma a ɛfa ayarefo a wɔhwɛ wɔn ansa na wɔayɛ oprehyɛn, bere a wɔreyɛ wɔn oprehyɛn, ne bere a wɔayɛ oprehyɛn akyi.
• Pulmonology : Adwuma a ɛfa nyarewa a ɛfa wo home nhyehyɛe ho.

Nnuruyɛfo de ABG nhwehwɛmu di dwuma de hu tebea horow pii, a nea ɛka ho ne:

• Acute respiratory distress syndrome (ARDS) : Eyi yɛ ahurututu mu yare a ɛde nkwa to asiane mu a ɛma mframa pa a ɛwɔ mogya no mu no so tew wɔ ɔkwan a ɛyɛ hu so. Ebetumi afi tebea horow te sɛ sepsis ne COVID-19 mu aba.
• Sepsis a emu yɛ den : Sepsis yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛde wo nkwa to asiane mu a efi sɛnea wo nipadua yɛ n’ade wɔ ɔyare mmoawa ho.
• Septic shock : Eyi nso yɛ tebea a ɛde nkwa to asiane mu a wo mogya mmoroso so tew wɔ ɔkwan a ɛyɛ hu so bere a woanya ɔyare mmoawa akyi.
• Hypovolemic shock : Tebea a egye ntɛmpɛ a koma no ntumi mfa mogya a ɛdɔɔso nkɔ nipadua no mu esiane mogya a ɛyera dodo anaasɛ nsu afoforo a ɛyera nti.
• Asikreyare a ɛne ketoacidosis (DKA) : Eyi yɛ ɔhaw a emu yɛ den a ɛde nkwa to asiane mu a ɛka nnipa a wɔwɔ asikreyare (titiriw asikreyare a ɛto so 1) ne asikreyare a ɛto so 1 a wonhuu bi. Ɛma mogya no yɛ asikre.
• Renal tubular acidosis (RTA) : Wɔ tebea yi mu no, w’asaabo ntumi nyi acid mfi wo mogya mu nkɔ wo nsu mu yiye, na ɛma wo mogya mu yɛ acid kɛse.
• Ɔhome a entumi nyɛ adwuma yiye : Wɔ tebea yi mu no, nsu boaboa ano wɔ mframa kotoku a ɛwɔ w’ahurututu mu no mu, na ɛma ɛyɛ den ma ahurututu no sɛ ɛbɛma mframa pa akɔ mogya no mu.
• Koma a entumi nyɛ adwuma yiye: Eyi yɛ tebea a ɛma koma no yɛ mmerɛw mpofirim na ne dwumadi ano hye.
• Koma a ɛyɛ den : Eyi ne bere a wo koma gyae bɔ mpofirim.
• Asthma attack : Akisikuru ho sɛnkyerɛnne a ɛkɔ soro mpofirim a ɛnam ntini a atwa mframa kwan no ho ahyia a ɛyɛ den nti.
• Mfomso a wofi awosu mu wɔ nipadua mu nneɛma a ɛsakra mu : Eyinom yɛ tebea horow a ɛntaa nsi, a efi awosu mu (a wonya fi awo mu) a wo nipadua ntumi nsakra aduan nyɛ ahoɔden yiye.

Sɛ wowɔ ahurututu mu yare yi bi a, wo duruyɛfo nso betumi ayɛ ABG nhwehwɛmu de ahwɛ sɛ w’ayaresa no reyɛ adwuma yiye anaa:

• Akisikuru
• Ahurututu mu yare a enni sabea (COPD) .
• Cystic fibrosis a ɛma mogya tu
• Koma mu yare

Hena na ɔyɛ ABG sɔhwɛ no?

Ɔhome ho ɔyaresafo taa fa mogya de yɛ ABG nhwehwɛmu. Wogye mogya fi ntini bi a ɛwɔ wo nsateaa, wo nsa, anaa wo srɛ mu mu. Afei wɔn ankasa sɔ mogya no mu nhwehwɛmu, anaasɛ wɔde kɔ aduruyɛdan mu ntɛm ara, na aduruyɛ mu aduruyɛdan mu nyansahufo bɛsɔ nhwɛsode no ahwɛ.

Dɛn na ɛba ansa na wɔayɛ ABG sɔhwɛ?

Ansa na ɔhome ho ɔyaresafo no begye mogya afi wo nsateaa mu no, ebia wɔbɛyɛ mogya a ɛkɔ mu ho nhwehwɛmu a wɔfrɛ no Allen nhwehwɛmu . Nea ɛka eyi ho ne sɛ wobɛma wo nsa akɔ soro de wo nsa akɔ soro. Oduruyɛfo no bɛmia ntini a ɛwɔ wo nsateaa mu no so sikani kakraa bi. Saa sɔhwɛ a ɛnyɛ den yi hwɛ sɛ ebia ntini abien a ɛwɔ wo nsateaa mu no reyɛ adwuma yiye na abue anaa.

Sɛ woreyɛ oxygen aduru foforo a, ebia wo duruyɛfo no bedum wo oxygen bɛyɛ simma 20 ansa na wɔatwe mogya no. Wɔfrɛ eyi sɛ dan mu mframa sɔhwɛ . Nanso, sɛ wuntumi nhome a oxygen foforo nka ho a, wɔrenyɛ sɔhwɛ yi.

Osuahu bɛn na wunya bere a woreyɛ ABG sɔhwɛ no?

Mogya mu nhwehwɛmu dodow no ara gye mogya fi wo ntini mu. Nanso sɛ wobɛyɛ ABG nhwehwɛmu a, ɔhome ho ɔyaresafo no gye mogya fi wo ntini mu . Nea enti a ɛte saa ne sɛ oxygen a ɛwɔ ntini mu mogya mu dɔɔso sen ntini mu mogya.

Mpɛn pii no, ɔhome ho ɔyaresafo no gye mogya fi radial artery a ɛwɔ wo nsateaa mu no mu. Ɛtɔ da bi nso a wobetumi agye mogya afi ntini bi a ɛwɔ wo nsa (brachial artery) anaa wo srɛ mu (femoral artery) mu.

Sɛ akokoaa a wɔawo no foforo hia ABG nhwehwɛmu a, oduruyɛfo betumi ayi mogya afi akokoaa no nan ase anaa ne awotwaa mu.

Nea ɛho hia: Mpɛn pii no, mogya a wogye fi ntini bi mu no betumi ayɛ yaw kakra asen mogya a wobɛfa afi ntini mu. Nea enti a ɛte saa ne sɛ ntini ahorow no mu dɔ wɔ nipadua no mu sen ntini ahorow, na ntini ahorow atwa ho ahyia. Ebia wo ho bɛtɔ wo kakra, wo tirim ayɛ wo hare, anaasɛ wo ho bɛtɔ wo bere a wɔnom wo mogya no.

Eyinom ne anammɔn a ɛsɛ sɛ wudi akyi bere a woregye mogya akɔyɛ ABG nhwehwɛmu no:

1. Wobɛtena nkongua so anaasɛ wobɛda mpa so. Ɔhome ho ɔyaresafo no behu ntini bi, mpɛn pii no wɔ wo nsateaa mu. Wobetumi nso de ultrasound scan (`ultrasound imaging`) adi dwuma de ahu ntini no.

2. Sɛ wohu ntini no wie a, wɔhohoro baabi a ɛwɔ no na wɔde nnuru a ekum mmoawa gu mu.

3. Afei wɔde ade ketewaa bi bɛhyɛ wo ntini mu na wɔafa mogya. Ebia wobɛte ɛyaw a ano yɛ den nka bere a ade no kɔ ntini no mu no.

4. Sɛ wɔde ade no hyɛ mu wie a, wɔboaboa mogya kakraa bi ano gu syringe mu.

5. Sɛ wɔfa mogya a ɛdɔɔso ma nhwehwɛmu no wie a, wobeyi ade no na wɔde cotton anaa gauze asinasin ahyɛ baabi no nhyɛso na ama mogya no agyae. Sɛ worenom nnuru a ɛma mogya yɛ mmerɛw a, ebia ebehia sɛ wokura nhyɛso no mu simma anum kosi du anaa nea ɛboro saa.

6. Wɔde aduru a wɔde kyekyere nneɛma ho guu baabi a ɛwɔ no. Afei adwuma no yɛ.

Dɛn na wubetumi ahwɛ kwan wɔ ABG sɔhwɛ akyi?

Ebia wobɛte akuru bi nka ne/anaasɛ ɛyaw bi wɔ baabi a wɔde ade no hyɛɛ mu no. Ebia wo duruyɛfo bɛka akyerɛ wo sɛ mma biribiara a emu yɛ duru so nnɔnhwerew 24 wɔ mogya a wɔtwe no akyi.

So asiane ahorow bi wɔ ABG sɔhwɛ no mu?

Sɛ ɔhome ho ɔyaresafo no yɛ nhwehwɛmu yi yiye a, asiane a ɛwɔ ABG nhwehwɛmu no mu no sua koraa . Ɛsono obiara ntini akɛse, na ɛsono nipadua no fã biako. Enti ebetumi ayɛ den kakra sɛ wobɛtwe mogya afi nnipa binom hɔ asen afoforo.

Asiane ahorow a ɛwɔ mogya a wɔbɛtwe de ayɛ ABG nhwehwɛmu mu no sua koraa, nanso nneɛma a ɛte sɛɛ betumi asi:

• Sɛ wote nka sɛ wo ho ayɛ wo yaw anaasɛ wo ti ayɛ hare.
• Ɛsɛ sɛ wɔbɔ ade no mu mpɛn pii na ama wɔahu ntini no.
• Mogya a ɛtwetwe (hematoma - mogya a wɔaboaboa ano wɔ honam ani).
• Mogya a ɛtɔ dodo.
• Nyarewa (asiane ketewaa bi wɔ hɔ bere biara a honam ani abubu).

Bere tenten ahe na egye ansa na woanya ABG sɔhwɛ no mu aba?

Mpɛn pii no ABG sɔhwɛ ahorow no ma wonya nea efi mu ba ntɛmntɛm yiye . Ɔhome ho ayaresa ho animdefo ne aduruyɛdan mu nyansahufo taa de mfiri a wɔde hwehwɛ mogya mu mframa mu a wɔde wɔn ankasa yɛ di dwuma, na ebetumi ama wɔanya nea efi mu ba wɔ simma 10-15 mu.

Dɛn na nea efii ABG sɔhwɛ no mu bae no ka?

Mogya mu nhwehwɛmu amanneɛbɔ ahorow a ABG nhwehwɛmu amanneɛbɔ ka ho no taa kura nsɛm a edidi so yi:

• Mogya mu nhwehwɛmu no din anaa nea wɔsusuu wɔ wo mogya mu.
• Wo mogya mu nhwehwɛmu aba no dodow anaa susuw.
• Ɛno ne susuw a wɔtaa de yɛ sɔhwɛ no.
• Nsɛm a ɛkyerɛ sɛ ebia nea efi mu ba no yɛ nea ɛfata, ɛnyɛ nea ɛfata, anaasɛ ɛkɔ soro anaasɛ ɛba fam.

Sɛ wo ABG sɔhwɛ mu aba no nyɛ nea ɛfata a, ebetumi akyerɛ nneɛma te sɛ:

• Worennya oxygen a ɛdɔɔso.
• Wonnye mframa bɔne a ɛdɔɔso mfi mu.
• Wo mogya no pH a ɛnkari pɛ (a ɛyɛ acid dodo anaasɛ alkaline dodo).

ABG nhwehwɛmu betumi aboa ma wɔahu nyarewa bi. Sɛ nea efi mu ba no nyɛ nea ɛfata a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu foforo (te sɛ mogya mu nhwehwɛmu afoforo ne/anaasɛ scan) de si so dua anaasɛ wɔapow sɛ wɔahu yare bi.

Dɛn ne gyinapɛn ahorow a ɛfata ma ABG sɔhwɛ?

Normal ranges betumi ayɛ soronko kakra wɔ lab biara mu. Sɛ wunya wo mogya mu nhwehwɛmu aba a, wɔde nsɛm a ɛkyerɛ nea ɛyɛ daa ranges ma susuw biara a efi saa lab no bɛka ho. Sɛ wowɔ nsɛmmisa bi fa nea efi mu ba no ho a, hwɛ hu sɛ wubebisa wo duruyɛfo .

Mpɛn pii no, sɛ wɔkyekyem pɛpɛɛpɛ a, dodow a ɛwɔ po so no te sɛ nea edidi so yi:

• pH : 7.35-7.45 na ɛwɔ hɔ
• Oxygen nhyɛso fã bi (`PaO2`) : Mercury milimita 75 kosi 100 (mmHg) .
• Nhyɛso a ɛwɔ carbon dioxide (`PaCO2`) fã bi : 35 kosi 45 mmHg
• Bicarbonate (`HCO3`) : 22 kosi 26 miliequivalents wɔ lita biara mu (mEq/L) .
• Oxygen a ɛdɔɔso (`O2Sat` anaa `SaO2`) : 95% kosi 100% .

Wɔ mmeae a ɛkorɔn anammɔn 3,000 (mita 900) ne nea ɛboro saa no, sɛ wɔkyekyem pɛpɛɛpɛ a, mframa pa a ɛwɔ nipadua no mu no sua koraa.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Sɛ wowɔ ahurututu mu yare a enni sabea te sɛ COPD anaa ayamtu a, ɛda adi sɛ ebehia sɛ wokɔ wo duruyɛfo nkyɛn daa na woyɛ ABG nhwehwɛmu de hwɛ sɛ w’ayaresa no reyɛ adwuma yiye. Sɛ wunya sɛnkyerɛnne biara a ɛhaw adwene a ɛfa w’ahurututu mu yare no ho a, wo ne wo duruyɛfo nkasa ntɛm ara sɛnea wubetumi.

Nea etwa to no, nneɛma a ɛsɛ sɛ yɛkae

ABG sɔhwɛ yɛ adwinnade a mfaso wɔ so a wɔde hu yare , titiriw wɔ tebea horow bi a egye ntɛmpɛ mu. Nnuruyɛfo nso de sɔhwɛ yi di dwuma de hwɛ akwahosan tebea horow bi. Sɛ woreyɛ ABG nhwehwɛmu a, ma ɛntra w’adwenem sɛ ɛyɛ ɔkwan soronko kakra wɔ mogya mu nhwehwɛmu a wɔyɛ no daa ho, na ebetumi ayɛ yaw kakra. Sɛ wowɔ nsɛmmisa bi fa ayaresa no anaa nea wobɛhwɛ kwan ho a, ntwentwɛn wo nan ase sɛ wubebisa wo duruyɛfo . Wɔwɔ ha sɛ wɔrebɛboa wo.

` Mogya mu mframa mu nhwehwɛmu, ntini mu mogya mu mframa, oxygen, carbon dioxide, pH bo, ɔhome nhyehyɛe, aduruyɛ mu nhwehwɛmu