So worehyia ɔhaw wɔ ahomegye mu? Momma yɛnka Respiratory Failure ho asɛm

So ɛtɔ mmere bi a wote nka sɛ ɛyɛ den ma wo sɛ wobɛhome? Anaasɛ wote nka sɛ wuntumi nhome? Ɛnyɛ adwene pa sɛ wubebu w’ani agu saa nneɛma yi so kɛkɛ. Efisɛ, eyi betumi ayɛ tebea bi a emu yɛ den a wɔfrɛ no Respiratory Failure ho sɛnkyerɛnne . Ɛnnɛ, yɛbɛka eyi ho asɛm wɔ ɔkwan tiawa bi so a wubetumi ate ase. Eyi betumi ayɛ aduruyɛ mu tebea a egye ntɛmpɛ, enti ɛho hia sɛ wuhu eyi.

Yɛyɛ dɛn home? Sɛ eyi anyɛ adwuma yiye a, dɛn na ɛba?

Susuw ho hwɛ, oxygen yɛ ma yɛn nipadua te sɛ pɛtro ma kar, anaasɛ te sɛ pɛtro a yehia na yɛde atu mmirika wɔ yɛn asetra mu. Sɛ yɛhome a, mframa a ɛsom bo a wɔfrɛ no oxygen yi kɔ yɛn ahurututu mu. Sɛ yɛbɛka no pɛpɛɛpɛ a, mframa pa yi kɔ mframa kotoku nketenkete a ɛwɔ ahurututu no mu a wɔfrɛ no alveoli . Ɛte sɛ bɔs bi a ɛretwe akɔ bɔs gyinabea bi.

Efi hɔ no, mogya no "de" oxygen yi kɔ nipadua no afã horow nyinaa, a yɛn amemene, koma, ntini, ne akwaa afoforo ka ho. Sɛ oxygen yi ankɔ saa mmeae no a, yɛn nipadua mu nkwammoaa rentumi nyɛ adwuma, te sɛ kar a pɛtro nnim.

Afei, bere a wɔde oxygen no "akɔ" saa mmeae no akyi no, mogya nkwammoaa no, bere a ɛsan ba no, boaboa carbon dioxide, mframa a mfaso nni so mma nipadua no ano ne ade a wɔsɛe no ano. Eyi te sɛ nea wode nneɛma a wobɛtɔ akɔ sotɔɔ mu na wode nnaka a hwee nni mu asan aba. Sɛ carbon dioxide yi boaboa ano wɔ nipadua no mu a, ɛno nso yɛ ɔhaw. Efisɛ afei baabi nni hɔ a mogya no betumi de mframa pa foforo akɔ. Enti, saa carbon dioxide yi san ba ahurututu no mu na sɛ yɛhome a, ɛpam fi nipadua no mu. Ɛno ne bere a yenya baabi a yɛbɛfa oxygen foforo bi bio.

Sɛ adeyɛ yi nyinaa fã biara ankɔ yiye a, yɛn nipadua mu ntini ahorow no nnya mframa pa a ɛdɔɔso. Ɛno ne nea yɛfrɛ no Ɔhome a Ɛnyɛ Den .

So ɔhome a entumi nyɛ adwuma yiye ahorow bi wɔ hɔ?

Yiw, tebea yi ahorow pii wɔ hɔ, a egyina sɛnea ɛba ne nea ɛka no titiriw so. Ɛtɔ mmere bi a ebetumi aba mpofirim (ɛyɛ den) , na mmere foforo nso ebetumi aba nkakrankakra bere a bere kɔ so no (ɛyɛ nea enni sabea) . Nneɛma atitiriw abien no ne:

1. Hypoxemic Ɔhome a Ɛnyɛ Den - Ɔkwan 1

Sɛ yɛbɛka no tiawa a, eyi yɛ tebea a wo mogya mu oxygen dodow sua (`hypoxemia`) . Eyi ba bere a wohome nanso wo mogya nnya oxygen a ɛdɔɔso no. Koma mu yare ne ahurututu mu yare titiriw na ɛde eyi ba. Nnipa binom nso frɛ no hypoxic respiratory failure.

2. Hypercapnic Ɔhome a Ɛnyɛ Den - Ɔkwan 2

Eyi ne bere a carbon dioxide (CO2) dodow a ɛwɔ wo mogya mu no kɔ soro.. Sɛ yɛn nipadua ntumi nyi mframa bɔne a wɔfrɛ no CO2 no mfi hɔ yiye a, ɛboaboa ano wɔ mogya no mu. Afei, sɛnea yɛadi kan aka no, baabiara nni mogya no mu. Saa tebea yi betumi afi koma, ahurututu, ntini, ne ntini (amemene ne akyi berɛmo) mu nyarewa. Nnuru bi nso betumi de eyi aba.

Ahorow afoforo nso wɔ hɔ:

• Perioperative Respiratory Failure (Type 3): Eyi betumi aba bere a wɔreyɛ oprehyɛn no. Ɛtɔ mmere bi a aduru a wɔde kum nipadua no bere a wɔreyɛ oprehyɛn no betumi ama ahome ayɛ den. Afei nso, mframa kotoku a ɛwɔ ahurututu mu no betumi abubu (atelectasis), na amma mframa pa ankɔ mogya no mu.
• Ɔhome a Ɛnyɛ Yiye Esiane Ahodwiriw (Type 4): Ahodwiriw yɛ tebea a emu yɛ den a mogya mmoroso so tew mpofirim ne ɔhaw ahorow te sɛ ahurututu mu akisikuru. Eyi nso betumi ama ɔhome a entumi nyɛ adwuma yiye. Nneɛma te sɛ sepsis ( ɔyare mmoawa a emu yɛ den a ɛtrɛw kɔ nipadua no mu nyinaa), komayare a ɛba mpofirim , ne mogya a ɛtɔ dodo betumi de ahodwiriw aba.

Dɛn ne tebea yi ho sɛnkyerɛnne?

Ɔhome a entumi nyɛ adwuma yiye ho sɛnkyerɛnne betumi ayɛ soronko a egyina nea ɛde ba no so. Nanso, sɛnkyerɛnne ahorow bi wɔ hɔ a ɛtaa ba:

• Ɔhome a ɛyɛ den anaasɛ ɔhome a ɛyɛ den (dyspnea).
• Ɔhome a wɔhome ntɛmntɛm (tachypnea).
• Ɔbrɛ kɛse a wɔte nka (ɔbrɛ).
• Sɛ wote nka sɛ wo koma rebɔ ntɛmntɛm anaasɛ wo koma bɔ ntɛmntɛm.
• Nsõ anaa mogya a wɔfe (hemoptysis).
• Fifiri a ɛboro so.
• Ahomegye a wonni, basabasayɛ.
• Wora a ɛyɛ mmerɛw.
• Honam ani, anofafa, anaa nsateaa nnadewa a ɛsakra kɔla bruu (cyanosis) - Eyi yɛ sɛnkyerɛnne a anibere wom a ɛkyerɛ sɛ oxygen nni hɔ.
• Tipaeɛ .
• Anisoadehu a ɛyɛ kusuu.
• Dadwen, adwene a ɛyɛ basaa, wontumi nsusuw nneɛma ho yiye.
• Nsakrae a ɛba suban mu, a ɛnyɛ sɛnea ɔtaa yɛ no.

Nea ɛho hia: Sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi a, ɛsɛ sɛ wohwehwɛ oduruyɛfo afotu ntɛm ara , efisɛ eyi betumi ayɛ nea egye ntɛmpɛ.

Dɛn ne nneɛma a ɛde ɔhome a entumi nyɛ adwuma yiye ba?

Sɛ yɛbɛka no tiawa a, tebea yi ba bere a biribi nti tumi a yɛn nipadua no tumi gye mframa pa na ɛpam carbon dioxide no asɛe no. Nneɛma a ebetumi aka eyi bi ne:

• Mframa a ɛnkɔ yiye anaasɛ mogya a ɛkɔ ahurututu no mu a ɛso tew .
• Ahurututu mu akwanside, akuru, anaa nsu a ɛbɛboaboa ano wɔ ahurututu no mu.
• Ɔhome a wontumi nhome yiye anaasɛ nkɔ akyiri.Eyi betumi afi nyarewa a ɛka ahurututu, ntini anaa ntini a ɛboa wo ma wohome ho haw, anaa koko a wopirapira.
• Mogya a ɛsen fa koma no mu a ɛnteɛ.

Henanom na wɔwɔ asiane kɛse mu? (Nneɛma a Ɛma Asiane) .

Nnipa binom wɔ asiane kɛse mu sɛ wobenya ɔhome a entumi nyɛ adwuma yiye. Wɔne:

• Nnipa a wɔwɔ ahurututu mu nyarewa: Sɛ nhwɛso no, nyarewa te sɛ acute respiratory distress syndrome (ARDS) , chronic obstructive pulmonary disease (COPD) , ahurututu mu yare , ayamtu , cystic fibrosis , ahurututu mu edema (nsu a ɛwɔ ahurututu mu) , ahurututu mu embolism (mogya a ɛtɔ wɔ ahurututu mu ntini mu) , ne ahurututu mu fibrosis (akuru a ɛwɔ ahurututu mu) .
• Nnipa a wɔwɔ koma anaa mogya a ɛkɔ nipadua no mu nyarewa: te sɛ komayare , komayare a wɔde awo wɔn , koma a entumi nyɛ adwuma yiye , ne ahodwiriw .
• Nnipa a wɔwɔ nyarewa a ɛka ntini ne ntini a ɛboa ma wɔhome: tebea horow te sɛ ntini mu yare , amyotrophic lateral sclerosis (ALS) , scoliosis a emu yɛ den (akyi berɛmo a ɛkɔ akyiri) , ne Guillain-Barré syndrome .
• Apirakuru a ɛba koko, akyi berɛmo, anaa amemene mu (a ɔyare a ɛma obi hwe ase ka ho).
• Sigaretnom anaa nneɛma afoforo a ɛhyɛ ahurututu mu abufuw a wɔde wɔn ho bɛhyɛ mu: nnuru wusiw, mfutuma, mframa a wɔsɛe no (te sɛ mframa a emu yɛ duru a kar ahorow tow gu yɛn akwan so, adwumayɛbea wusiw, ne mfutuma a efi mmeae a wosisi adan), ne asbestos.
• Oprehyɛn ahorow a ɛhwehwɛ sɛ wɔde aduru a ɛma obi dwensɔ.
• Nnubɔne a wɔde di dwuma anaa nsa a wɔnom boro so.
• Mfe a wɔadi: Mmofra a wɔawo wɔn foforo (titiriw wɔn a wɔwo wɔn a wonnyin pii) ne mpanyimfo a wɔadi boro mfe 65 wɔ asiane kɛse mu.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Oduruyɛfo bɛhwɛ sɛ ɔhome ntumi nyɛ adwuma yiye denam oxygen ne carbon dioxide dodow a ɛwɔ wo mogya mu a ɔbɛhwɛ so . Wɔbɛsan nso ahwɛ wo mogya mmoroso na wɔde afiri ketewa bi a wɔde twitwa (a wɔfrɛ no `pulse oximeter` anaa `pulse ox`) ahwɛ oxygen dodow a ɛwɔ wo mogya mu. Wɔbɛtie wo koma ne w’ahurututu nso na wɔahwehwɛ wo mu. Sɛ wosusuw sɛ tebea yi wɔ hɔ a, wobetumi ayɛ nhwehwɛmu afoforo pii.

Dɛn ne saa sɔhwɛ ahorow no?

• Pulse oximetry a wɔde yɛ adwuma:Nea ɛka eyi ho ne sɛ wode sensor bi bɛto wo nsateaa so de asusuw oxygen dodow a ɛwɔ wo mogya mu. Wɔtaa yɛ eyi bere a wokɔ oduruyɛfo nkyɛn no.
• Arterial Blood Gas (ABG) nhwehwɛmu: Wɔde ade fa mogya ketewaa bi fi nsateaa, abasa atifi, anaa asen mu na wɔsusuw oxygen ne carbon dioxide dodow. Eyi betumi ama yɛanya nsɛm a ɛyɛ nokware paa.
• Pulmonary Function Tests (PFT): Wɔ sɔhwɛ yi mu no, wɔka kyerɛ wo sɛ fa ano aduru a wɔde abɔ afiri bi ho no so home na firi mu. Eyi betumi ahwɛ sɛnea w’ahurututu reyɛ adwuma yiye.
• Mfoniniyɛ mu nhwehwɛmu: X-ray ne CT scan twa nipadua no mu mfonini. Bere a eyinom ntumi nhu ɔhome a entumi nyɛ adwuma yiye no, wobetumi aboa ma wɔahu nea ɛde ba.
• Electrocardiogram (EKG): Eyi kyerɛ sɛnea koma no reyɛ adwuma yiye. Sɛ oduruyɛfo no susuw sɛ ɔhaw no fi komayare a, ɔbɛkra sɛ wɔnyɛ EKG.

Ɔkwan bɛn so na wɔsa eyi?

Ayaresa a wɔde sa ɔhome a entumi nyɛ adwuma yiye no gyina sɛnea emu yɛ den ne nea ɛde ba so . Botae titiriw a ɛwɔ ayaresa mu ne sɛ wɔbɛsa nea ɛde ba no, ama wo oxygen pii, anaasɛ wɔde afiri a wɔde home (`mfiri a wɔde home`) bedi dwuma kosi sɛ w’ankasa wubetumi ahome bio.

Ɔhome a entumi nyɛ adwuma yiye no yɛ ade a egye ntɛmpɛ na ɛsɛ sɛ wɔsa no ntɛm ara. Nanso, ɛtɔ mmere bi a wobetumi asa ɔhome a entumi nyɛ adwuma yiye (a enni sabea) wɔ fie denam tebea a ɛde ba no a wobedi so no so.

Dɛn ne ayaresa pɔtee no?

• Mfiri a wɔde ma mframa: Nea ɛka eyi ho ne sɛ wɔde wo bɛka afiri a wɔde home ne afiri bi a wɔde hyɛ wo mframa kwan mu, a ɛhome mframa na ɛtwe kɔ w’ahurututu mu no ho.
• Extracorporeal Membrane Oxygenation (ECMO): Eyi yɛ ayaresa a ɛyɛ den kakra. Nea ɛka ho ne sɛ wɔde afiri bi a wɔde twa mogya fi nipadua no mu, de mframa pa gu mu, yi mframa bɔne a wɔfrɛ no carbon dioxide, na afei ɛsan kɔ nipadua no mu bio.
• Oxygen ayaresa: Afiri bi nam akatasoɔ a wɔde home anaa afiri ketewa bi (cannula) a wɔde ahyɛ hwene mu so de oxygen foforo ma. Wobetumi ayɛ eyi wɔ ayaresabea anaa fie.
• Nsuo: Wɔde nsuo ma wɔ ntini mu (IV - tẽẽ kɔ ntini bi mu). Eyi ma mogya no kɔ nipadua no mu yiye na ɛboa ma oxygen pii kɔ ntini ahorow no mu.
• Ayaresa mu tebea horow a ɛda adi pefee a wɔbɛsa: Ɛdenam nea ɛde ɔhome a entumi nyɛ adwuma ba so no, oduruyɛfo no betumi akamfo nnuru anaa ayaresa afoforo akyerɛ.

So ɔkwan bi wɔ hɔ a wɔbɛfa so asiw eyi ano?

Wontumi nsiw ɔhome a entumi nyɛ adwuma yiye ano bere nyinaa. Nanso, wubetumi atew asiane a ɛwɔ hɔ sɛ wubenya ɔhome mu yare a enni sabea no so denam koma, ahurututu, anaa ntini mu yare biara a ɛhyɛ wo ase a ebia wowɔ no a wobɛhwɛ so no so. Sɛ wowɔ asiane bi a ɛbɛma woanya saa tebea yi a, wo ne wo duruyɛfo nkasa mfa akwan a wobɛfa so atew asiane a ɛwɔ hɔ no so.

So wobetumi asa ɔhome a entumi nyɛ adwuma yiye?

Eyi yɛ tebea a emu yɛ den yiye. Nnipa dodow no ara ho tɔ wɔn fi mu. Egyina nea ɛde yare no ba, sɛnea emu yɛ den, ne sɛnea wɔsa no ntɛm so.

Ɛwom sɛ wobetumi asa nneɛma pii a ɛde ɔhome a emu yɛ den ba de, nanso sɛ wɔansa no ntɛm a, ebetumi akum obi. Nnipa a wɔde wɔn kɔ ayaresabea esiane ɔhome a emu yɛ den nti no mu bɛyɛ nkyem abiɛsa mu biako wuwu. Mpɛn pii no, yare bi a bere kɔ so no mu yɛ den na ɛma ɔhome a enni sabea ba.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ yare bi a enni sabea a ɛde wo to asiane mu sɛ wobɛhome a, wo ne wo duruyɛfo nkasa. Obetumi akyerɛ wo ɔhome a entumi nyɛ adwuma yiye ho sɛnkyerɛnne ahorow a ɛsɛ sɛ wohwɛ yiye wɔ ho ne sɛnea wubedi wo tebea no ho dwuma.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Department (ETU) ?

Sɛ wowɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ wo home ntumi nyɛ adwuma yiye a, kɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ a ɛbɛn wo ntɛm ara, anaa frɛ 911. Sɛ wɔansa eyi ntɛm a, ebetumi akum wo.

Dɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Ebia ɛbɛyɛ nea mfaso wɔ so sɛ wubebisa wo duruyɛfo nsɛm te sɛ eyinom:

• Ayaresa ahorow bɛn na mewɔ?
• Dɛn nti na ɛte saa?
• Ɔkwan bɛn so na ɛsɛ sɛ mede me nnuru di dwuma?
• Ɔkwan bɛn so na ɛsɛ sɛ mede saa afiri yi di dwuma (e.g., oxygen afiri)? So wubetumi akyerɛ me sɛnea wɔyɛ no?
• Bere bɛn na metumi ahwɛ kwan sɛ me ho bɛtɔ me?
• Bere bɛn na ɛsɛ sɛ meba bɛhwɛ wo bio?

Nkrasɛm a Wɔde Kɔ Fie

Ɔhome a entumi nyɛ adwuma yiye yɛ tebea a emu yɛ den, na ɛtɔ mmere bi a ekum obi. Sɛ wususuw sɛ worenya ɔhome mu yare a emu yɛ den a, yɛsrɛ wo frɛ 911 ntɛm ara anaa kɔ ayaresabea ntɛm ara. Sɛ wowɔ ɔhome a enni sabea, anaasɛ wowɔ tebea horow a ɛma asiane a ɛwɔ hɔ sɛ wubenya no yɛ kɛse a, wo ne wo duruyɛfo nkasa mfa ayaresa a ɛfata ho. Obetumi agyina wo tebea no so akyerɛkyerɛ ayaresa a wubetumi apaw ne nea wobɛhwɛ kwan mu. Hwɛ wo home so yiye, efisɛ ɛyɛ wo nkwa!

` Ɔhome a entumi nyɛ adwuma yiye, ahome a ɛyɛ den, oxygen, carbon dioxide, ahurututu, ayaresa a egye ntɛmpɛ, ARDS, COPD