Ðe oxygen ƒe agbɔsɔsɔ si le wò ʋu me sɔa? Mina míasrɔ̃ nu tso ABG (Arterial Blood Gas) dodokpɔa ŋu le mɔ bɔbɔe aɖe nu!

Mí katã míenya alesi gbegbe ɔksidzin le vevie na míaƒe ŋutilã. Gbɔgbɔ nyuie kple oxygen agbɔsɔsɔme si sɔ nanɔ ʋua me le vevie be wòanɔ lãmesẽ me. Eyata, ɣeaɖewoɣi la, ehiãna be ɖɔktawo nanya oxygen kple carbon dioxide agbɔsɔsɔme si tututu le wò ʋu me. Ɣemaɣie wowɔa dodokpɔ sia si woyɔna be ABG (Arterial Blood Gas).

Nukae nye ABG (Arterial Blood Gas) dodokpɔ sia?

Kpuie ko la, ABG (Arterial Blood Gas) dodokpɔ nye dodokpɔ si me wozãa ʋu si woɖe tso wò ʋuka me tsɔ dzidzea oxygen kple carbon dioxide ƒe agbɔsɔsɔ si le wò ʋu me. Bu eŋu kpɔ, ʋuka ƒomevi eve le míaƒe ŋutilã me, ɖeka nye ʋukawo, eye evelia nye ʋukawo. Ʋukawo tsɔa ʋu dzadzɛ si me oxygen sɔ gbɔ ɖo tso dzia me yia ŋutilãa ƒe akpa mamlɛa. Eyata le ABG dodokpɔ sia gome la, woɖea ʋu tso ʋuka mawo me.

Menye oxygen kple carbon dioxide koe dodokpɔ sia dzidzea o, ke edzidzea wò ʋu ƒe acid-base balance , alo pH hã. Zi geɖe la, míaƒe ŋutilã ɖɔa oxygen kple carbon dioxide ƒe agbɔsɔsɔ si le míaƒe ʋu me ɖo nyuie ŋutɔ. Ne oxygen ƒe agbɔsɔsɔ si le míaƒe ʋu me ɖiɖi (si míeyɔna le atikewɔwɔ me be `hypoxemia`), ate ŋu ahe kuxi sesẽ ŋutɔwo vɛ . Ate ŋu agblẽ nu le wò ahɔhɔ̃ kple dzi ŋu vevietɔ.

ABG dodokpɔa kpena ɖe ɖɔktawo ŋu wosea dɔléle siwo do ƒome kple wò gbɔgbɔtsixe , ʋu ƒe sisi , kple lãmenugbagbeviwo ƒe dɔwɔwɔ (alesi nètrɔa nuɖuɖu si nèɖuna wòzua ŋusẽ) gɔme. Esia le vevie ŋutɔ le nɔnɔme kpatawo me .

Dodokpɔ bubu aɖe li si woyɔna be "ʋu me gas me dzodzro." Le dodokpɔ sia me la, woate ŋu axɔ ʋu tso ŋutilãa ƒe akpa ɖesiaɖe (ʋuka, ʋuka, alo ʋuka si me ʋu sina tona). Gake le ABG dodokpɔa me la, ele be woaɖe ʋu tso ʋuka aɖe me .

Ŋkɔ bubu geɖewo le ABG dodokpɔ sia ŋu:

• Ʋu ƒe gas dodokpɔ
• Ʋuka siwo me ʋu sina tona
• ABG
• Ʋu me gas me dzodzro

Nuka tututue ABG dodokpɔ dzidzena?

Zi geɖe la, ABG dodokpɔ dzidzea:

• Oxygen content (O2CT) : Esia dzidzea oxygen agbɔsɔsɔme si le wò ʋu me.
• Hemoglobin : Hemoglobin nye protein si le míaƒe ʋumenugbagbevi dzĩwo me si tsɔa oxygen yia ŋutilã bliboa me. Esia dzidzea ʋumenugbagbeviɣi ƒe agbɔsɔsɔ.
• Oxygen saturation (O2Sat) : Esia dzidzea oxygen agbɔsɔsɔme si hemoglobin si le wò ʋu me tsɔna.
• Oxygen ƒe akpa aɖe ƒe nyaƒoɖeamenu (PaO2) : Esia dzidzea oxygen si ƒo ɖe wò ʋu me ƒe nyaƒoɖeamenu. Eɖea alesi oxygen le gegem ɖe wò ʋu me nyuie tso wò lãkusi me fiana.
• Carbon dioxide ƒe akpa aɖe ƒe nyaƒoɖeamenu (PaCO2): Esia dzidzea carbon dioxide ƒe agbɔsɔsɔ si le wò ʋu me kple alesi wole carbon dioxide ɖem le wò ŋutilã me nyuie.
• pH (`pH`) : Esia dzidzea acid kple base siwo le wò ʋu me ƒe dadasɔ. Zi geɖe la, ele be ʋu ƒe pH nanɔ 7.35 va ɖo 7.45 dome. Wobua nusianu si bɔbɔ wu ema be enye acid akpa, eye wobua nusianu si lolo wu ema be enye basic alo alkaline akpa .
• Bicarbonate (`Bicarbonate - HCO3`) : Wobua esia to pH kple PaCO2 zazã me. Efiaa alesi gbegbe gɔmeɖoanyi si wowɔ tso ya si woyɔna be carbon dioxide me.

Ɣekaɣie wowɔa ABG dodokpɔ?

Zi geɖe la, ɖɔktawo ɖea gbe be woado ABG kpɔ le nɔnɔme siawo tɔgbe me:

• Atikewɔwɔ kpata : Esia fia dɔléle alo afɔku siwo hiã be woakpɔ egbɔ enumake.
• Anesthesiology : Atikewɔwɔ ƒe akpa si ku ɖe dɔnɔwo dzi kpɔkpɔ do ŋgɔ na amekoko, le amekoko me, kple emegbe ŋu.
• Aklãŋutinunya : Akpa si kpɔa dɔléle siwo do ƒome kple wò gbɔgbɔtsixe ƒe dɔwɔwɔ gbɔ.

Ðɔktawo zãa ABG dodokpɔ tsɔ dea dzesi dɔléle geɖe, siwo dometɔ aɖewoe nye:

• Acute respiratory distress syndrome (ARDS) : Esia nye lãkusidɔ si dea ame ƒe agbe afɔku me si nana oxygen ƒe agbɔsɔsɔ si le ʋua me dzi ɖena kpɔtɔna le mɔ si me afɔku le nu. Ate ŋu atso nɔnɔmewo abe sepsis kple COVID-19 gbɔ.
• Dɔlékuiwutike sesẽ : Dɔlékuiwutike nye atikewɔwɔ kpata si ate ŋu ade ame ƒe agbe afɔku me si tsoa alesi wò ŋutilã wɔa nui ne èxɔ dɔlékui aɖe gbɔ.
• Septic shock : Esia hã nye nɔnɔme si dea ame ƒe agbe afɔku me si me wò ʋu ƒe sisi dzi ɖena kpɔtɔna afɔkutɔe le dɔlékui aɖe xɔxɔ vɔ megbe.
• Hypovolemic shock : Nɔnɔme kpata si me dzia mete ŋu tsɔa ʋu si sɔ yia ŋutilãa me o le ʋu si bu fũ alo tsi bubuwo ƒe bu ta.
• Ketoacidosis si do ƒome kple suklidɔ (DKA) : Esia nye kuxi sesẽ aɖe si ate ŋu ade ame ƒe agbe afɔku me, si dzea amesiwo ŋu suklidɔ le (vevietɔ suklidɔ ƒomevi 1) kple suklidɔ ƒomevi 1 si womekpɔ o. Ena ʋua va zua acid.
• Renal tubular acidosis (RTA) : Le nɔnɔme sia me la, wò ayikuwo meɖea acid siwo le wò ʋu me yia wò aɖuɖɔ me nyuie o, si wɔnɛ be wò ʋu me zua acid geɖe wu.
• Yagbɔgbɔ ƒe dɔmawɔmawɔ nyuie : Esiae nye esime tsi ƒoa ƒu ɖe yakotoku siwo le wò lãkusi me me, si wɔnɛ be wòsesẽna na lãkusiwo be wòaɖe ya si nye oxygen ayi ʋua me.
• Dzi ƒe dɔmawɔmawɔ nyuie: Esia nye nɔnɔme si me dzia gbɔdzɔna zi ɖeka eye eƒe dɔwɔwɔ dzi ɖena kpɔtɔna.
• Dzi ƒe dɔmawɔmawɔ nyuie : Esiae nye esime wò dzi dzudzɔa ƒoƒo zi ɖeka.
• Asrã ƒe amedzidzedze : Asrã ƒe dzesiwo ƒe dzidziɖedzi kpata si tsoa lãmeka siwo ƒo xlã yaƒoƒomɔ̃wo ƒe tete me.
• Vodada siwo wodzina le lãmenugbagbeviwo ƒe dɔwɔwɔ me : Esiawo nye nɔnɔme siwo mebɔ o, siwo tso domenyiŋusẽfianu (siwo ƒe dome wonyi) siwo me wò ŋutilã mate ŋu atrɔ nuɖuɖu wòazu ŋusẽ nyuie o.

Ne lãkusidɔ siawo dometɔ aɖe le ŋuwò la, wò ɖɔkta ate ŋu awɔ ABG dodokpɔ hã atsɔ akpɔe ɖa be wò atikewɔwɔa le dɔ wɔm nyuie hã:

• Asrãdɔ
• Aklãdɔléle si xea mɔ na dɔléle si nɔa anyi didi (COPD) .
• Cystic fibrosis ƒe dɔléle
• Dzidɔ

Amekae wɔa ABG dodokpɔa?

Zi geɖe la, gbɔgbɔtsixeŋutinunyala xɔa ʋu hena ABG dodokpɔ. Woxɔa ʋu tso ʋuka aɖe si le wò asibidɛ, alɔnu, alo akɔta me. Emegbe woawo ŋutɔwo doa ʋua kpɔna, alo woɖonɛ ɖe nudokpɔƒe kaba ŋutɔ, afisi atikewɔƒe ƒe dzɔdzɔmeŋutinunyalawo doa ʋua kpɔna le.

Nukae dzɔna hafi woawɔ ABG dodokpɔ?

Hafi gbɔgbɔtsixeŋutinunyala naɖe ʋu le wò asibidɛ me la, woate ŋu awɔ ʋu ƒe sisi dodokpɔ si woyɔna be Allen dodokpɔ . Esia bia be nàkɔ wò abɔ ɖe dzi kple asi le asi me. Atikewɔla la azi ʋuka si le wò asibidɛ me dzi sɛkɛnd ʋɛ aɖewo. Dodokpɔ bɔbɔe sia léa ŋku ɖe wò asibidɛ ƒe ʋuka eveawo siaa le dɔ wɔm nyuie eye woʋu hã.

Ne èle oxygen kpeɖeŋutɔ zãm la, wò atikewɔla ate ŋu atsi wò oxygen abe miniti 20 ene hafi woaɖe ʋua. Woyɔa esia be xɔme ya dodokpɔ . Gake ne màte ŋu agbɔ oxygen kpeɖeŋutɔ manɔmee o la, womawɔ dodokpɔ sia o.

Nuteƒekpɔkpɔ ka ƒomevie nèkpɔna ne èle ABG dodokpɔa wɔm?

Ʋudodokpɔ akpa gãtɔ xɔa ʋu le wò ʋuka me. Gake le ABG dodokpɔ gome la, gbɔgbɔtsixeŋutinunyala la xɔa ʋu tso wò ʋuka me . Esia le alea elabena oxygen sɔ gbɔ ɖe ʋukawo me ʋu me wu ʋuka me ʋu.

Zi geɖe la, gbɔgbɔtsixeŋutinunyala xɔa ʋu tso ʋuka si le ʋuʋu ɖi si le wò asibidɛ ƒe akpa si le eme la me. Ɣeaɖewoɣi la, woate ŋu axɔ ʋu hã tso ʋuka aɖe si le wò alɔnu (brachial artery) alo akɔta (femoral artery) me.

Ne vidzĩ si wodzi yeyee hiã be woado ABG kpɔ la, ɖɔkta ate ŋu aɖe ʋu tso vidzĩa ƒe afɔkpodzi alo vidzidɔ me.

Vevietɔ: Zi geɖe la, ʋu ɖeɖe tso ʋuka me ate ŋu ase veve vie wu ʋu ɖeɖe tso ʋuka me. Esia le alea elabena ʋukawo goglo le ŋutilãa me wu ʋukawo, eye lãmekawo le wo ŋu. Àte ŋu ase le ɖokuiwò me be yeƒe ta natsi vie, yeƒe ta le ƒoƒom, alo yeƒe lãme nasẽ ne wodo wò ʋu.

Esiawoe nye afɔɖeɖe siwo dzi wòle be woawɔ ne wole ʋu nom hena ABG dodokpɔ:

1. Ànɔ zikpui dzi alo mlɔ aba dzi. Yagbɔgbɔdɔdala akpɔ ʋuka aɖe, si zi geɖe le wò asibidɛ ƒe eme. Woateŋu azã ultrasound scan (`ultrasound imaging`) hã atsɔ adi ʋukaa.

2. Ne wonya ke ɖe ʋukaa ŋu ko la, wokɔa teƒea ŋu hewua dɔlékuiwo.

3. Emegbe woatsɔ aŋe sue aɖe ade wò ʋuka me eye woaɖe ʋu. Àte ŋu ase veve vevie ne aŋea le yiyim ɖe ʋukaa me.

4. Ne wotsɔ aŋea de eme vɔ la, woƒoa ʋu sue aɖe nu ƒu ɖe atikekui aɖe me.

5. Ne woɖe ʋu si sɔ na dodokpɔa vɔ la, woaɖe aŋea ɖa eye woatsɔ kotoku alo gaze aɖe aƒoe ɖe teƒea be ʋua natɔ te. Ne èle atike siwo nana ʋu mekɔna o zãm la, ɖewohĩ ahiã be nàlé nyaƒoɖeamenua ɖe te aɖabaƒoƒo atɔ̃ va ɖo ewo alo esi wu nenema.

6. Wotsɔa aŋe blaa teƒea. Emegbe wowu dɔa nu.

Nukae nàte ŋu akpɔ mɔ na le ABG dodokpɔ vɔ megbe?

Àte ŋu ase abi aɖewo kple/alo abi aɖe le afisi wotsɔ aŋea de. Ðewohĩ wò ɖɔkta agblɔ na wò be mègakɔ nu kpekpe aɖeke ɖe dzi gaƒoƒo 24 le ʋuɖeɖe vɔ megbe o.

Ðe afɔku aɖewo le ABG dodokpɔa mea?

Ne gbɔgbɔtsixeŋutinunyala wɔ dodokpɔ sia nyuie la, afɔku si le ABG dodokpɔa me la mesɔ gbɔ kura o . Amesiame ƒe ʋukawo ƒe lolome to vovo, eye wotoa vovo tso ŋutilã ƒe akpa ɖeka yi akpa kemɛ. Eyata ate ŋu asesẽ vie be woaɖe ʋu tso ame aɖewo gbɔ wu ame bubuwo.

Afɔku siwo le ʋuɖeɖe hena ABG dodokpɔ me la le sue ŋutɔ, gake nu siawo tɔgbe ate ŋu adzɔ:

• Sese le eɖokui me be taɖuame alo ta le ƒoƒom.
• Ele be woaƒo aŋea zi geɖe be woake ɖe ʋukaa ŋu.
• Ʋu ƒe sisi (hematoma - ʋu si ƒo ƒu ɖe ŋutigbalẽ te).
• Ʋu si le dodom fũu akpa.
• Dɔlékuiwo xɔxɔ (afɔku sue aɖe le eme ɣesiaɣi si ŋutigbalẽa gbã).

Ɣeyiɣi didi kae wòxɔna hafi wokpɔa ABG dodokpɔa me tsonu?

Zi geɖe la , ABG dodokpɔwo naa emetsonuwo kaba ŋutɔ . Zi geɖe la, gbɔgbɔtsixetsixeŋutinunyalawo kple nudokpɔƒe dzɔdzɔmeŋutinunyalawo zãa ʋumenugbagbeviɣidɔlékuiwutike siwo wowɔna le wo ɖokui si, siwo ate ŋu ana woakpɔ emetsonuwo le miniti 10-15 me.

Nukae ABG dodokpɔa me tsonu gblɔ?

Zi geɖe la, nyatakaka siawo nɔa ʋudodokpɔ ŋuti nyatakakawo me, siwo dome ABG dodokpɔ ŋuti nyatakakawo hã le:

• Ʋudodokpɔa ƒe ŋkɔ alo nusi wodzidze le wò ʋu me.
• Wò ʋudodokpɔ me tsonu ƒe xexlẽme alo dzidzenu.
• Emae nye dzidzenu si sɔ na dodokpɔa.
• Nyatakaka siwo ɖenɛ fiana ne wò emetsonua sɔ, mesɔ o, alo lolo alo le sue.

Ne wò ABG dodokpɔ me tsonu mesɔ o la, ate ŋu afia nusiwo le abe:

• Mèle oxygen si sɔ xɔm o.
• Mèle ya si woyɔna be carbon dioxide si sɔ gbɔ ɖem o.
• Wò ʋu ƒe pH mesɔ o (eɖanye acid akpa alo alkaline akpa).

ABG dodokpɔ ate ŋu akpe ɖe ame ŋu wòanya dɔléle aɖewo. Ne wò dɔwɔwɔ me tsonu mesɔ o la, wò ɖɔkta ate ŋu aɖe gbe be woagawɔ dodokpɔ bubuwo (abe ʋudodokpɔ bubuwo kple/alo ʋudodokpɔ ene) atsɔ aɖo kpe dɔlélea dzi alo agbee.

Nukae nye asixɔxɔ siwo sɔ na ABG dodokpɔ?

Dometsotso siwo sɔ ate ŋu ato vovo vie tso dodokpɔxɔ ɖeka me yi bubu gbɔ. Ne èxɔ wò ʋudodokpɔ me tsonu la, woatsɔ nyatakaka siwo afia nusiwo ƒe didime sɔ na dzidzenu ɖesiaɖe tso dodokpɔxɔ ma me la ade eme. Ne nya aɖe le asiwò ku ɖe wò dɔwɔwɔ me tsonu ŋu la, kpɔ egbɔ be yebia wò ɖɔkta .

Zi geɖe la, asixɔxɔ siwo le atsiaƒu ƒe kɔkɔme le mama dedie nue nye esiawo:

• pH : 7.35-7.45 ƒe agbɔsɔsɔme
• Oxygen ƒe akpa aɖe ƒe nyaƒoɖeamenu (`PaO2`) : Mercury milimeta 75 va ɖo 100 (mmHg) .
• Carbon dioxide ƒe akpa aɖe ƒe nyaƒoɖeamenu (`PaCO2`) : 35 va ɖo 45 mmHg
• Bicarbonate (`HCO3`) : miliequivalent 22 va ɖo 26 le lita ɖeka me (mEq/L) .
• Oxygen ƒe agbɔsɔsɔ (`O2Sat` alo `SaO2`) : 95% va ɖo 100% .

Le teƒe siwo kɔkɔ afɔ 3,000 (meta 900) kple esi wu nenema la, oxygen ƒe agbɔsɔsɔ le mama dedie nu ɖiɖina kura.

Ɣekaɣie wòle be makpɔ nye ɖɔkta?

Ne aɖuɖɔtoedɔléle si nɔa anyi didi abe COPD alo asrã ene le ŋuwò la, anɔ eme be ahiã be nàyi ɖɔkta gbɔ edziedzi eye woado ABG dodokpɔwo na wò be nàka ɖe edzi be wò atikewɔwɔa le dɔ wɔm nyuie hã. Ne dzesi aɖe si ɖea fu na wò si do ƒome kple wò lãkusidɔ dzea dziwò la, ƒo nu kple wò ɖɔkta kaba ale si nàte ŋui.

Mlɔeba la, nu siwo dzi wòle be woaɖo ŋkui

ABG dodokpɔ nye dɔwɔnu nyui aɖe si wozãna tsɔ dia dɔlélewoe , vevietɔ le nɔnɔme kpata aɖewo me. Ðɔktawo hã zãa dodokpɔ sia tsɔ léa ŋku ɖe lãmesẽkuxi aɖewo ŋu. Ne èle ABG dodokpɔ wɔm la, nenɔ susu me na wò be enye dɔdamɔnu si to vovo vie tso ʋudodokpɔ edziedzi gbɔ, eye ate ŋu ave wò vie wu. Ne nya aɖe le asiwò ku ɖe dɔdamɔnua alo nusi nàkpɔ mɔ na ŋu la, mègahe ɖe megbe le wò ɖɔkta biabia me o . Wole afisia be yewoakpe ɖe ŋuwò.

` Ʋu ƒe gas dodokpɔ, ʋuka me ʋu ƒe gas, oxygen, carbon dioxide, pH ƒe asixɔxɔ, gbɔgbɔtsixe ƒe ɖoɖo, atikewɔwɔ me dodokpɔwo