So ɛsɛ sɛ yesua ‘Perfusion Pressure’ nso ho ade, ɛnyɛ mogya mmoroso a yɛte nka wɔ yɛn nipadua mu no nkutoo?

Ebia woate ‘mogya mmoroso’ ho asɛm, ɛnte saa? Nanso ɛnnɛ yɛbɛka biribi a ɛho hia saa ara ho asɛm, nanso ebia wontee ho asɛm pii. Ɛno ne 'Perfusion Nhyɛso'. Sɛ yɛbɛka no tiawa a, eyi ne nhyɛso a ehia na ama yɛatumi de mogya akɔ yɛn nipadua no afã horow no mu yiye. Bere a saa nhyɛso yi teɛ nkutoo na yɛn akwaa no betumi anya mframa pa ne aduannuru a ehia.

Dɛn ne ‘Perfusion Pressure’? Momma yɛnte ase tiawa.

Fa no sɛ, sɛ wubetumi agugu afifide a ɛwɔ wo turo mu no nsu a, ɛsɛ sɛ nhyɛso pa ba paipu a efi nsu pɔmpɛ no mu ba no mu, ɛnte saa? Saa ara na sɛ yɛn nipadua mu akwaa a ɛho hia sen biara, a ɛne koma, amemene, asaabo, eyinom nyinaa betumi afa mogya no so anya mframa pa ne aduannuru a, ɛsɛ sɛ nea wɔfrɛ no ‘perfusion pressure’ yi wɔ hɔ. Sɛ yɛbɛka no tiawa a, ‘perfusion pressure’ yɛ nhyɛso a ɛho hia na ama mogya akɔ ntini anaa akwaa bi mu. Bere tenten a saa nhyɛso yi wɔ dodow a ɛfata mu no, saa akwaa no benya mogya dodow a wɔhwehwɛ. Ɛno nti na eyi yɛ yɛn mogya a ɛkɔ nipadua no mu no fã a ɛho hia yiye no. Wo de susuw ho hwɛ, sɛ nhyɛso yi so tew wɔ mmeae bi a, dɛn na ɛba? Ɛno ne bere a ɔhaw akɛse sɔre. Nhyɛso a ɛso tew yi betumi ayɛ nea asiane wom, titiriw wɔ yɛn koma ne yɛn amemene mu. Efisɛ sɛ akwaa yi annye mogya yiye a, ebetumi de tebea horow a emu yɛ den a ɛtɔ mmere bi a ɛde nkwa to asiane mu aba.

Ɔkwan bɛn so na ‘perfusion pressure’ yi yɛ adwuma?

Yɛn koma te sɛ pɔmpɛ. Ɛyɛ adwuma bere nyinaa, ɛnte saa? Bere biara a yɛn koma bɛbɔ no, ɛpia mogya kakra fi koma no mu na ɛde kɔ mogya ntini (ntini) a ɛwɔ yɛn nipadua nyinaa mu no mu. Afei mogya yi fi ntini ahorow no mu kɔ ntini nketenkete no mu. Ɛhɔ na oxygen a ɛwɔ mogya no mu no ne yɛn nipadua mu nkwammoaa sesa. Sɛ wɔyɛ saa adwuma no a, mogya a ɛwɔ ntini no mu no san fa ntini no mu kɔ koma no mu. Saa kyinhyia yi si sekan biara a koma no bɔ no. Enti sɛ saa adeyɛ yi bɛyɛ adwuma yiye a, nea wɔfrɛ no ‘perfusion pressure’ no ho hia.

Wobɛyɛ dɛn ahu sɛ ebia saa ‘perfusion’ yi rekɔ so yiye?

Mpɛn pii no, wɔde afiri bi a wɔfrɛ no pulse oximeter na efi ase yɛ nhwehwɛmu a wɔde perfusion a ɛnyɛ akwaa a ɛwɔ nipadua no mu ho. Ebia woahu, ɛtɔ mmere bi a wode afiri bi a ɛte sɛ clip gu wo nsateaa so de hwɛ oxygen a ɛwɔ wo mogya mu. Ɛno ne no. Ɛma hann kɔkɔɔ ne infrared fa wo honam ani. Molekyule a ɛwɔ yɛn mogya mu a wɔfrɛ no hemoglobin no de mframa pa kɔ. Ɛsono sɛnea saa hemoglobin yi twetwe hann bere a ɛde mframa pa kɔ ne bere a ɛnkɔ no. Sɛ wɔde saa nsonsonoe no di dwuma a, pulse oximeter no betumi abu oxygen dodow a ɛwɔ wo mogya mu ne sɛ ebia mogya rekɔ beae pɔtee bi yiye anaa. Saa pulse oximeters yi bi te sɛ clip a wode gu wo nsateaa so. Ebinom de sensor bi a wode bata wo nsateaa so anaa baabi foforo te sɛ sticker ba. Ɛtɔ da bi a, eyi betumi abata aso anaa moma so.

Enti dɛn ne ‘Perfusion Index’ yi?

Perfusion Index (PI) yɛ nea ɛkyerɛ sɛnea mogya di akɔneaba yiye wɔ wo nipadua no fã pɔtee bi. Ɛsusuw mogya dodow a oxygen wom wɔ saa beae no ho bere a wɔde toto mogya dodow a oxygen nnim ho. Tumi koro no ara a pulse oximeter tumi susuw oxygen dodow a ɛwɔ mogya no mu no nso boa wɔ Perfusion Index no mu. Ɛdenam oxygen dodow a hemoglobin de fa so a wosusuw so no, wobetumi asusuw mogya foforo dodow (i.e. mogya a ɛda so ara wɔ oxygen) a ɛresen fa saa beae no. Peripheral Perfusion Index yɛ ɔkwan a wɔfa so de nnyinasosɛm yi di dwuma de boa nnuruyɛfo ma wɔhwehwɛ obi a ɔyare na wɔsa no yare. Botae a ɛba fam kyerɛ sɛ wo koma ntumi nkɔ mogya a ɛdɔɔso, anaasɛ biribi wɔ hɔ a ɛmma mogya nkɔ wo nipadua no afã horow a ɛne wo koma ntam kwan ware sen biara (te sɛ wo nsa ne wo nan) no yiye.

Nsonsonoe bɛn na ɛda ‘Perfusion Index’ ne ‘Blood Pressure’ ntam?

Eyinom abien nyinaa yɛ nea ɛkyerɛ sɛnea yɛn mogya a ɛkɔ nipadua no mu no reyɛ adwuma yiye. Nanso ɛsono akwan a wɔfa so yɛ no, na wɔnsusuw ade koro.

• Perfusion Index: Eyi yɛ nea ɛkyerɛ mogya dodow a ɛsen fa beae pɔtee bi. Botae a ɛkɔ soro kyerɛ sɛ mogya no kɔ yiye . Ebia bo a ɛba fam no bɛkyerɛ sɛ ɔhaw bi wɔ wo koma anaa wo mogya ntini mu .
• Mogya Nhyɛso : Eyi susuw nhyɛso a ɛwɔ wo mogya ntini mu, a wɔde mercury milimita (mm/Hg) susuw. Botae a ɛwɔ soro ne nea ɛba fam wɔ hɔ. Botae a ɛwɔ soro (`Systolic` pressure) ne nhyɛso a ɛba ntini ahorow no so bere biara a koma no bɛbɔ. Botae a ɛba fam (` Diastolic` nhyɛso) ne nhyɛso a ɛwɔ ntini ahorow no so wɔ koma bɔ abien ntam.

Nea ɛho hia: Esiane sɛ ɛsono nneɛma abien yi susuw nti, wuntumi nsusuw sɛ biako ye na biako nso ye. N’abien nyinaa ho hia.

Ɔkwan bɛn so na ‘perfusion pressure’ yɛ adwuma wɔ wo koma mu?

Yɛn koma yɛ ntini a ɛsɛ sɛ ɛkɔ so yɛ adwuma wɔ yɛn asetra nyinaa mu. Sɛ koma no bɛyɛ n’adwuma yiye a, ehia mframa pa a wɔde ma bere nyinaa. Enya eyi fi mogya ntini titiriw bi a wɔfrɛ no coronary arteries mu . Fa no sɛ, koma no de oxygen a ɛfa saa ntini ahorow yi mu no 70% kosi 80% na edi dwuma! Akwaa foforo biara nni hɔ a ɛde mframa pa di dwuma saa.Coronary Perfusion Pressure (CPP) ne nea ɛma mogya kɔ so fa saa ntini ahorow yi mu. Sɛ saa nhyɛso yi so tew a, koma no nnya mogya ne mframa pa a ɛdɔɔso. Eyi betumi de nsɛnnennen a ɛde nkwa to asiane mu aba.

Wobɛyɛ dɛn ahu eyi?

Wɔmfa pulse oximetry nni dwuma mfa nsusuw coronary perfusion pressure (CPP) ho. Nea ɛbɛyɛ na nnuruyɛfo asusuw eyi ho no, wɔde susuw nneɛma abien foforo na wɔde bu mogya a wɔde ma wɔ komayare mu no ho akontaa. Wobetumi de echocardiography (koma no mu mfonini) anaasɛ koma no mu catheterization ( sɔhwɛ a wɔde afiri a ɛyɛ tratraa hyɛ koma no mu) asusuw saa nneɛma yi. Nsusuwii abien no ne: 1. Aortic Diastolic Pressure: Eyi ne nhyɛso a ɛwɔ wo aorta (mogya ntini kɛse a ɛde mogya fi koma no mu kɔ nipadua no fã a aka) mu wɔ koma a ɛbɔ ntam. Wohu eyi denam wo ‘mogya mmoroso’ a ɛfata a wosusuw so. Eyi ne wo mogya mmoroso no nɔma a ɛwɔ ase (`Diastolic` pressure). 2. ‘Left Ventricular End-Diastolic Pressure` (LVEDP): Eyi ne nhyɛso a ɛwɔ benkum ventricle mu, koma no ase adan abien no mu biako, wɔ koma no bɔ abien ntam. Afei wohu saa ‘coronary perfusion pressure’ (CPP) yi sɛnea edidi so yi: ‘Aortic Diastolic Pressure’ - ‘Left Ventricular End-Diastolic Pressure’ = ‘Coronary Perfusion Pressure’.

Enti ɔkwan bɛn so na saa ‘nhyɛso a ɛma mogya tu’ yi ka amemene no?

Koma no akyi no, akwaa foforo a ɛho hia paa a ehia mframa pa ne yɛn amemene. Cerebral Perfusion Pressure (CPP) ne nea ɛma mogya kɔ amemene no afã horow nyinaa yiye. Sɛ amemene no nnya mogya a ɛdɔɔso a, wubetumi ahwere w’adwene wɔ sikɔne kakraa bi mu. Saa na ɛho hia.

Wobɛyɛ dɛn ahu eyi?

Sɔhwɛ abien nso ho hia na ama wɔabu amemene no ‘amemene mu nsu a wɔde ma’ (CPP) no ho akontaa. 1. Mogya Nhyɛso: Nea edi kan no, wɔsusuw ‘mogya mmoroso’. Afei, nnuruyɛfo bu ‘Mean Arterial Pressure’ (MAP) ho akontaa . Saa MAP yi ne nhyɛso a ɛwɔ wo ntini mu wɔ koma no kyinhyia biako mu (bere a ɛda bere a wo koma twetwe na ɛyɛ mmerɛw ntam). Wɔabu saa MAP yi ho akontaa sɛnea edidi so yi:

• Fa wo ‘mogya mmoroso’ (`Diastolic` nhyɛso) no dodow a ɛwɔ ase no bɔ ho abien.
• Fa botae a ɛwɔ atifi hɔ (`Systolic` nhyɛso) no ka mmuae a wubenya no ho.
• Fa ne nyinaa bom na kyekyɛ bo a efi mu ba no mu 3. (MAP = [Systolic BP + (2 x Diastolic BP)] / 3)

2. Intracranial Pressure (ICP): Intracranial kyerɛ sɛ "wɔ ti nhwi no mu." Yɛn amemene ne ti nhwi dompe no ntam no , amemene mu nsu (CSF) wɔ hɔ.Nsu bi wɔ hɔ a wɔfrɛ no intracranial pressure. Saa ICP yi ne nhyɛso a ɛwɔ ti nhwi no mu nyinaa esiane w’amemene, mogya a ɛwɔ mu, ne CSF nsu no nti. Akwan titiriw bi wɔ hɔ a wɔfa so susuw eyi, na ɛtɔ mmere bi a ɛsɛ sɛ wode adwinnade bi a ɛyɛ mmerɛw hyɛ ti nhwi no mu. Afei, wohu ‘amemene mu nsu a wɔde ma’ (CPP) no te sɛ eyi: ‘Mean Arterial Pressure’ (MAP) - ‘Intracranial Pressure’ (ICP) = ‘Amemene mu nsu a wɔde ma’ (CPP) .

Dɛn ne aduruyɛ mu tebea horow a ɛtaa ba a ɔhaw ahorow a ɛfa ‘perfusion pressure’ ho de ba?

Ɔhaw titiriw a ɛba bere a ‘perfusion pressure’ a ɛdɔɔso nni wo nipadua mu baabiara no, wɔfrɛ no ‘ischemia’ . Eyi kyerɛ sɛ beae no nnya mogya a ɛdɔɔso, enti ɛrenya mframa pa ne aduannuru a ɛdɔɔso. Sɛ ‘ischemia’ yi ba abasa anaa nan bi mu a, ntini a ɛwɔ saa beae no betumi afi ase awu. Eyi betumi ama nneɛma te sɛ ‘gangrene’ (ntini a ɛporɔw) ne ɔyare mmoawa aba. Sɛ eyi ka akwaa titiriw bi a, saa akwaa no betumi afi ase adi huammɔ nkakrankakra, na ɛde ɔhaw ahorow a emu yɛ den kɛse, a edi awu mpo aba. Tebea horow a ebetumi afi ‘perfusion pressure’ haw ahorow mu aba anaasɛ ɛne no wɔ abusuabɔ no bi ni:

• Koma mu yare
• Koma a entumi nyɛ adwuma yiye
• Coronary ntini mu yare
• Nnwodwoɔ
• Koma mu ahodwiriw a ɛma obi ho dwiriw no
• Cerebral hypoxia (amemene a ɛsɛe esiane oxygen a enni amemene no mu nti) .
• Ntini mu ntini a ɛyɛ den
• Nan ne nan mu akisikuru
• Raynaud yare (mogya a ɛkɔ nipadua no mu no so tew) .

Dɛn na metumi ayɛ na ama me ‘perfusion pressure’ no akɔ so ayɛ nea ahobammɔ wom?

Wo ‘perfusion pressure’, titiriw wɔ wo koma ne w’amemene mu no, ntaa nyɛ ɔhaw gye sɛ wowɔ yare pɔtee bi a ɛfa wo koma ne mogya a ɛkɔ wo mogya mu ho. Nanso, wubetumi ayɛ saa nneɛma yi de asiw nyarewa yi ano anaasɛ wobɛtwentwɛn so:

• Kura mu duru a ɛfata mu. Ɛnyɛ papa sɛ wobɛyɛ kɛse dodo anaasɛ wobɛyɛ teateaa dodo.
• Di aduan a ahoɔden wom. Di nnuan a ngo, nkyene, ne asikre nnim pii, na nnuaba ne nhabannuru pii wom.
• Gyae tawa nneɛma a wɔde di dwuma (a tawa a wusiw nnim ne vaping ka ho). Eyinom sɛe mogya ntini kɛse.

"Susuw ho hwɛ, asetra a ahoɔden wom te sɛ yɛn nipadua a yɛbɛhwɛ so. Te sɛ nea yɛresiesie kar na ama akɔ so ayɛ papa no, ɛsɛ sɛ yɛhwɛ yɛn nipadua yiye."

Ɔkwan a eye sen biara a wobɛfa so ahu ɔhaw biara a ebetumi aka ‘perfusion pressure’ ne sɛ wɔbɛyɛ nipadua mu nhwehwɛmu afe biara.Wɔsan frɛ eyi sɛ ‘akwahosan ho nhwehwɛmu’. Sɛ woyɛ nhwehwɛmu a ɛnyɛ den wɔ wo duruyɛfo nkyɛn a, mpɛn pii no wubetumi ahu ɔhaw ahorow a emu yɛ den ansa na woada sɛnkyerɛnne ahorow mpo adi. Sɛ wokyere wɔn ntɛm a, wubetumi anya ayaresa na woagyae sɛe a ɛtra hɔ daa anaasɛ wobɛtew nkɛntɛnso a wonya no so. Sɛ wowɔ tebea bi a ɛka ‘perfusion pressure’ dedaw a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn daa akɔhwɛ wo tebea no na sɛ ɛho hia a, woanya ayaresa. Afei nso, di wo duruyɛfo akwankyerɛ akyi na fa wo nnuru sɛnea wɔakyerɛw ama wo no. Sɛ wowɔ nsɛmmisa anaa wuhia mmoa a, wo duruyɛfo no ne onipa a oye sen biara a wo ne no bɛkasa.

Nkrasɛm a Etwa To a Wɔde Kɔ Fie

Nhyɛso a wɔde ma wɔ mogya mu ho hia na ama yɛn nipadua no fã biara, akwaa biara, atumi ayɛ adwuma yiye. Sɛ saa ‘perfusion’ yi nni hɔ a, mogya nkɔ mmeae a ɛsɛ sɛ ɛkɔ nyinaa. Saa mogya a ɛnkɔ yi betumi de ɔhaw a emu yɛ den aba bere a bere kɔ so no, anaasɛ ɛde ɔhaw ahorow a emu yɛ den a ɛde nkwa to asiane mu mpo aba. Sɛ wopɛ sɛ wuhu pii fa saa ‘perfusion pressure’ yi ne sɛnea ɛka wo ho a, hwɛ hu sɛ wo ne oduruyɛfo bɛkasa. Wɔyɛ nnipa a wɔsen biara a wɔbɛka nea wuhia ne nea ɛsɛ sɛ woyɛ de hwɛ wo ho so pɛpɛɛpɛ akyerɛ wo. Afei wubetumi ahwɛ w’akwahosan so na wode bere ayɛ nneɛma a ɛho hia wo paa no. Biribiara nni hɔ a ɛsom bo sen sɛ wubenya apɔwmuden, ɛnte saa?

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Perfusion pressure, mogya mmoroso, koma akwahosan, amemene akwahosan, mogya a ɛkɔ nipadua no mu, oxygen, akwahosan