So woahu obi a ɔwɔ ayaresabea a wɔhwɛ wɔn a wɔyare denneennen (ICU) anaa obi a wɔde no aba baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ (ETU) a ne home mu yɛ den kɛse pɛn, na nnuruyɛfo no de ahopere ka kyerɛ wɔn sɛ "wɔnyɛ ABG" pɛn? Eyi yɛ mogya mu nhwehwɛmu a ɛho hia yiye na ɛyɛ soronko kakra. Ɛnnɛ, yɛbɛka ho asɛm tiawa, wɔ ɔkwan a wobɛtumi ate aseɛ so.
Sɛ yɛbɛka no tiawa a, dɛn ne ABG sɔhwɛ yi?
ABG (Arterial Blood Gas) yɛ nhwehwɛmu a wogye mogya kakraa bi fi ntini bi a ɛwɔ yɛn nipadua mu mu. Afei ebia woredwene sɛ, "Mogya mu nhwehwɛmu afoforo gye mogya fi ntini bi mu, nsonsonoe bɛn na ɛwɔ mu?"
Susuw ho saa kwan yi so. Yɛn nipadua te sɛ kurow.
- Ntini te sɛ akwan akɛse a ɛde nneɛma a ɛho hia te sɛ mframa pa ne aduannuru ba kurow bi mu.
- Ntini te sɛ akwan dedaw a ɛwɔ kurow no mu a ɛde nwura te sɛ carbon dioxide san kɔ kurow no mu.
Enti, sɛ yɛpɛ sɛ yehu oxygen dodow pɔtee a ɛrekɔ yɛn nipadua akwaa ahorow mu, titiriw amemene ne koma no a, ɛsɛ sɛ yɛsɔ mogya a ɛwɔ saa "ɔkwan kɛse" no so no hwɛ, ɛnte saa? Ɛno nti na woyi mogya fi ntini bi mu de yɛ ABG nhwehwɛmu no.
Saa sɔhwɛ yi susuw oxygen ne carbon dioxide dodow a ɛwɔ wo mogya mu titiriw. Ɛsan nso susuw wo mogya mu acid ne base a ɛkari pɛ, anaa pH . Saa kari pɛ yi ho hia ma nneɛma a ɛkɔ so wɔ yɛn nipadua mu nyinaa.
Dɛn ankasa na ABG sɔhwɛ susuw?
Sɛ wohwɛ ABG amanneɛbɔ bi a, wobɛhunu nkrataa bi a ɛyɛ den kakra sɛ wobɛte aseɛ. Nanso nea ɛkyerɛ no yɛ mmerɛw yiye. Ma yɛnhwɛ nea saa gyinapɛn ahorow no mu biara kyerɛ.
| Nsusuwii a wɔde susuw nneɛma | Nkyerɛase a ɛyɛ mmerɛw |
|---|---|
| pH | Eyi ma wuhu sɛnea wo mogya mu asikre te. Ɛsɛ sɛ saa botae yi yɛ 7.35 ne 7.45 ntam. Biribiara a ɛba fam sen saa no kyerɛ sɛ wo mogya no yɛ acidic, na biribiara a ɛkɔ soro no kyerɛ sɛ ɛyɛ alkaline. |
| PaO2 (Oxygen nhyɛso fã bi) . | Oxygen dodow a apete mogya no mu. Eyi kyerɛ sɛnea oxygen rekɔ mogya no mu yiye afi w’ahurututu mu. |
| PaCO2 (Carbon dioxide nhyɛso fã bi) . | Carbon dioxide dodow a ɛwɔ wo mogya mu. Eyi kyerɛ sɛnea wo nipadua no reyi carbon dioxide afi hɔ yiye. |
| HCO3 (Bicarbonate) a ɛwɔ nipadua no mu. | Eyi yɛ nnyinaso wɔ yɛn mogya mu. Asaabo na ɛhwɛ so. Ɛho hia yiye ma mogya no pH a ɛkari pɛ. |
| O2Sat (Oxygen a ɛdɔɔso) . | Ɛkyerɛ protein hemoglobin a ɛwɔ mogya no mu dodow a ɛde mframa pa kɔ, sɛ ɔha biara mu nkyem 100. Pulse oximeter a wode gu wo nsateaa so no susuw bo koro no ara. |
Bere bɛn na ɛho hia sɛ wɔyɛ ABG sɔhwɛ?
Eyi nyɛ sɔhwɛ a wɔyɛ de yɛ nhwehwɛmu a wɔyɛ no daa. Wɔtaa yɛ wɔ tebea horow a egye ntɛmpɛ mu na wɔde hwɛ ayarefo a wɔde wɔn akɔ ayaresabea dedaw no tebea so . Nneɛma atitiriw a enti oduruyɛfo betumi ahyɛ sɛ wɔbɛyɛ nhwehwɛmu yi no bi ni:
- Ɔhome mu haw a emu yɛ den: Wɔ nsɛm te sɛ ayamtu a emu yɛ den ne nsu a ɛboaboa ano wɔ ahurututu mu (ɔhome a entumi nyɛ adwuma yiye) mu.
- Tebea horow a emu yɛ den a ɛde ɔyare mmoawa ba: Wɔ ɔyare mmoawa a ɛde nkwa to asiane mu te sɛ sepsis anaa septic shock mu.
- Nsɛnnennen a efi asikreyare mu ba: Wɔ tebea horow a mogya no dan asikre, te sɛ asikreyare ketoacidosis (DKA) mu.
- Koma mu yare anaa komayare: Bere a koma no gyae adwumayɛ mpofirim (Acute heart failure) anaa bere a koma no gyae (Cardiac arrest).
- Asaabo a entumi nyɛ adwuma yiye: Sɛ asaabo no ntumi nyi acid mfi mogya no mu yiye a, mogya no dan asikre. Sua tebea yi ho ade.
- Awuduru: Sɛ wɔwe awuduru bi a, mogya no pH sesa.
- Ansa na wɔayɛ oprehyɛn akɛse ne bere a wɔayɛ oprehyɛn akɛse no: Hwɛ sɛnea ɔyarefo no home tebea te bere a wɔreyɛ no oprehyɛn a ɛma obi dwensɔ ne bere a wɔreyɛ no oprehyɛn akyi no.
- Ahurututu mu nyarewa a enni sabea: Hwɛ sɛ ayaresa no di yiye ma nnipa a wɔwɔ nyarewa te sɛ COPD (Chronic obstructive pulmonary disease).
Ɔkwan bɛn so na wɔyɛ sɔhwɛ yi? So ɛyɛ yaw?
ABG nhwehwɛmu a wɔyɛ no yɛ soronko kakra wɔ mogya mu nhwehwɛmu a wɔyɛ daa no ho.
Ansa na wɔreyɛ sɔhwɛ no
Ɛtɔ mmere bi a, sɛ wɔrema wo oxygen foforo a, wobetumi agyae bɛyɛ simma 20 ansa na wɔayɛ nhwehwɛmu no. Eyi yɛ sɛnea ɛbɛyɛ a wubehu sɛnea wo nipadua no yɛ adwuma a oxygen nni mu. Nanso sɛ wuntumi nyɛ adwuma koraa a oxygen nni mu a, ebia worenyɛ saa. Sɛ wɔregye mogya afi wo nsateaa mu a, oduruyɛfo anaa ɔsraani panyin a wɔatete no no betumi ayɛ nhwehwɛmu a ɛnyɛ den a wɔfrɛ no ‘Allen sɔhwɛ’ de ahwɛ sɛ mogya no kɔ wo nsa mu yiye anaa.
Bere a ɔreyɛ sɔhwɛ no
1. Oduruyɛfo anaa oduruyɛfo a wɔatete no behu ntini bi wɔ wo nsateaa mu (radial artery), ɛbɛn wo nsateaa (brachial artery), anaa wo srɛ mu (femoral artery).
2. Siesie beae no yiye na fa aduru a ekum mmoawa gu so.
3. Afei, wɔde ade ketewaa bi hyɛ ntini no mu na wɔtwe mogya kakraa bi kɔ syringe mu.
4. Sɛ yɛbɛka nokware a , eyi betumi ayɛ yaw kakra sen sɛ wobeyi mogya afi ntini bi mu. Nea enti a ɛte saa ne sɛ ntini no mu dɔ kakra wɔ yɛn honam ani na ntini pii atwa ho ahyia. Nanso ɛyaw no yɛ bere a wɔde ade no hyɛ mu no nkutoo.
5. Sɛ woboaboa mogya dodow a ɛho hia ano wie a, yi ade no na fa kotoku anaa gauze bi hyɛ beae no na ama mogya no agyae bɛyɛ simma 5 kosi 10 . Sɛ worenom nnuru a ɛma mogya yɛ mmerɛw a, ebia ebehia sɛ wode nhyɛso kyɛ.
Sɔhwɛ no akyi
Beae a wɔde ade no guu mu no betumi ayɛ nea akuru kakra anaa bruu. Eyi yɛ ade a ɛfata. Wo duruyɛfo bɛka akyerɛ wo sɛ kwati sɛ wode saa basa no bɛma nneɛma a emu yɛ duru so nnɔnhwerew 24 wɔ mogya a wɔatwe no akyi.
ABG sɔhwɛ no mu aba no nya ntɛmntɛm yiye, mpɛn pii no wɔ simma 10-15 mu, efisɛ saa nea efi mu ba yi ho hia yiye ma gyinaesi ntɛmntɛm wɔ tebea horow a egye ntɛmpɛ mu.
Sɛ wɔkyekyem pɛpɛɛpɛ a, gyinapɛn ahorow a ɛwɔ amanneɛbɔ no mu no te dɛn?
Saa gyinapɛn ahorow yi betumi ayɛ soronko kakra wɔ lab biara mu, nanso eyinom ne gyinapɛn ahorow a wɔkyekyem pɛpɛɛpɛ ma ɔpanyin a ɔwɔ apɔwmuden wɔ po so. Ɛyɛ papa sɛ wubebisa wo duruyɛfo no ma ɔmma no nkyerɛkyerɛmu a edi mũ wɔ gyinapɛn ahorow a ɛwɔ w’amanneɛbɔ no mu no ho.
| Nsusuwii a wɔde susuw nneɛma | Normal Range a Ɛyɛ Fɛ |
|---|---|
| pH | 7.35 - 7.45 na ɛwɔ hɔ |
| PaO2 | 75 - 100 mmHg na ɛyɛ den |
| PaCO2 | 35 - 45 mmHg na ɛyɛ den |
| HCO3 | 22 - 26 mEq/L na ɛyɛ adwuma |
| O2Sat | 95% - 100% . |
Sɛ saa gyinapɛn ahorow yi nni nea ɛfata a, ebetumi akyerɛ sɛ wo nipadua no nnya oxygen a ɛdɔɔso , anaasɛ carbon dioxide ntumi mfi wo nhyehyɛe no mu yiye , anaasɛ wo mogya mu acid/base kari pɛ . Wo duruyɛfo de amanneɛbɔ yi, wo sɛnkyerɛnne ahorow, ne nhwehwɛmu afoforo bedi dwuma de ahu nea ɛhaw wo ankasa.
Nkrasɛm a Wɔde Kɔ Fie
- ABG nyɛ mogya mu nhwehwɛmu a wɔyɛ no daa fi ntini bi mu, na mmom ɛyɛ nhwehwɛmu titiriw a wɔyɛ fi ntini bi mu, mogya ntini kɛse bi a ɛde mframa pa kɔ nipadua no mu.
- Eyi titiriw na ɛkyerɛ oxygen, carbon dioxide, ne acidity (pH) a ɛwɔ mogya no mu.
- Eyi ho hia na ama wɔahu ayaresa tebea horow ntɛm wɔ tebea horow a egye ntɛmpɛ ne tebea horow a emu yɛ den te sɛ ɔhome a ɛyɛ den, ɔyare mmoawa a emu yɛ den, ne komayare mu.
- Ɛwom sɛ ebia ɛbɛyɛ yaw kakra sen mogya mu nhwehwɛmu a wɔyɛ no daa de, nanso nsɛm a ɛde ma no betumi aboa ma wɔagye obi nkwa.
- Bere nyinaa wo ne wo duruyɛfo a ɔresa wo yare no nkasa mfa nea efii wo ABG nhwehwɛmu no mu bae ne nea ɛkyerɛ ho asɛm.
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