Ðe gbɔgbɔ le sesẽm na wò lãkusiwoa? Mina míasrɔ̃ nu tso ARDS (Acute Respiratory Distress Syndrome) sia si me afɔku le ŋu!

Ðe gbɔgbɔ sesẽ na wò ŋutɔ zi ɖeka, eye nèse le ɖokuiwò me abe ɖe wò akɔta xaxa ene kpɔa? Alo ɖe nèɖo ŋku ɣeyiɣi aɖe si me ame aɖe si nènya la dze dɔ vevie kasia, mete ŋu nɔ gbɔgbɔm nyuie o eye woxɔe ɖe kɔdzi ƒe dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ vevie (ICU) dzia? Ðewohĩ nusi gbɔ wòtsoe nye dɔléle aɖe si woyɔna be ARDS (Acute Respiratory Distress Syndrome) . Esia nye nya vevi aɖe vie, gake ne wona nyanya wò nyuie la, anɔ bɔbɔe be nàse nu geɖe gɔme. Mina míaƒo nu tso esia ŋu tsitotsito, alo?

Nukae nye ARDS? Mina míase egɔme bɔbɔe.

Kpuie ko la, ARDS nye dɔléle sesẽ aɖe si gblẽa nu le míaƒe lãkusiwo ŋu. Bu eŋu ale: Ya kotoku suesuesuewo (siwo woyɔna be alveoli) le míaƒe lãkusiwo me. Wole abe weintsetse sue siwo le weinka dzi ene. Ne míele gbɔgbɔm la, yakotoku siawo xɔa ɔksidzin tso ya me heɖea asi le eŋu yia ʋua me. Gake ne ARDS dzɔ la, tsi yɔa yakotoku siawo me fũ. Ele abe ʋuƒo si me tsi le ene. Ekema ya mete ŋu yɔa lãkusia me nyuie o, eye ɔksidzin agbɔsɔsɔme si yia ʋua me dzi ɖena kpɔtɔna ŋutɔ. Míeyɔa esia be hypoxia. Zi geɖe la, ɖɔktawo bua ARDS be enye esi mesẽ o, esi mesẽ o, alo esi nu sẽ . Wokpɔnɛ to oxygen ƒe agbɔsɔsɔ si le ʋua me tsɔtsɔ sɔ kple oxygen agbɔsɔsɔme si wòle be woatsɔ ayi agbɔsɔsɔ ma gbɔ me. ARDS ate ŋu ana ŋutinu vevi bubuwo abe míaƒe ahɔhɔ̃, dzi, ayiku, kple dɔgbowo ene hã nagakpɔ ɔksidzin si wohiã o. Eyata ARDS nye nɔnɔme si me afɔku le si ate ŋu ade ame ƒe agbe afɔku me gɔ̃ hã. Zi geɖe la, ARDS dzɔna ne wole atike wɔm na ame aɖe le kɔdzi le dɔlékui bubu, dɔléle, alo afɔku bubu ta. Gake ne dzesi siawo dze le ŋuwò le aƒeme la, ele vevie be nàyi atikewɔƒe enumake.

Ðe ARDS ƒe akpa etɔ̃ li?

Ɣeaɖewoɣi la, ɖɔktawo maa ARDS ɖe akpa etɔ̃ me: Exudative, Proliferative, kple Fibrotic. Esia fia alesi gbegbe aɖuɖɔtoewo vuvu eye tsi ƒoa ƒu ɖe lãkusiwo me, eye emegbe alesi lãkusiwo dzea hayahaya gɔmee koŋ. Menye amesiamee yia ŋgɔ va ɖoa Afɔɖeɖe 3. Akpa sia lɔ abi le lãkusiwo ŋu (`(Aɖuɖɔtoe me fibrosis)`) kple alesi wòhiã be woayi edzi atsɔ mɔ̃ awɔ yae.

Aleke gbegbee ARDS bɔe?

Esia nye nɔnɔme sesẽ aɖe. Edzea ame siwo ade 200,000 dzi ƒe sia ƒe le United States ɖeɖe dzaa. Le xexeame katã la, edzea ame abe miliɔn 3 ene dzi ƒe sia ƒe. ARDS ye kpɔa amesiwo katã woxɔna ɖe dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ le vevie (ICU) ƒe 10% lɔƒo. Ekpɔa amesiwo katã woxɔna ɖe kɔdzi hena mɔ̃wo ƒe yaƒoƒo ƒe akpa si ade 25% hã.

Nukawoe nye ARDS ƒe dzesiwo? Aleke nèwɔ dea dzesii?

ARDS ƒe dzesiwo ate ŋu ato vovo le nusi gbɔ wòtso, alesi dɔlélea nu sẽe, kple lãkusi alo dzidɔ ɖesiaɖe si nɔ ŋuwò do ŋgɔ nu. Dzesi vevitɔwoe nye:

• Yagbɔgbɔ sesẽna vevie :Ewɔna nam abe ɖe mète ŋu le gbɔgbɔm o ene, abe ɖe nèle gbɔgbɔm ene.
• Gbɔgbɔ kabakaba kple kutrikuku : Gbɔgbɔ kple agbagbadzedze geɖe, abe ɖe wole gbɔgbɔm be yeagbɔ ene.
• Dzi ƒe tsotso dzina ɖe edzi.
• Aɖabɛwo kple nuyiwo ƒe amadede si trɔna blɔ: Esia tsoa oxygen ƒe agbɔsɔsɔ si medea ʋua me o gbɔ.

Bu eŋu kpɔ, asrã sesẽ kple kɔdzidɔ nɔ Aƒetɔ Nalin ŋu ŋkeke eve sɔŋ. Kasia, gbɔgbɔ sesẽ nɛ, eƒe akɔta nɔ ƒoƒom. Srɔ̃a de dzesii be eƒe ɖawo nɔ blɔ. Esi wowɔ kaba yi kɔdzi la, ɖɔktawo gblɔ be ate ŋu anye ARDS .

ARDS ate ŋu adze egɔme le gaƒoƒo aɖewo va ɖo ŋkeke geɖe me tso esime nudzɔdzɔ si he dɔlélea vɛ, eye ate ŋu agblẽ ɖe edzi kabakaba ŋutɔ hã.

Nukawoe hea ARDS vɛ?

Nu geɖe li siwo ate ŋu ahe ARDS vɛ. Mina míalé ŋku ɖe wo dometɔ vevitɔwo ŋu:

• Sepsis : Nu vevitɔ si gbɔ ARDS tsonae nye dɔléle aɖe si woyɔna be sepsis. Nɔnɔme sia ate ŋu ado mo ɖa ne dɔlékui sesẽ aɖe le wò lãkusi me (abe aklãdɔ ene ) alo dɔlékui aɖe si le ŋutinu bubu aɖe me kaka ɖe wò ŋutilã katã me, si ana nàvuvu vevie.
• Aspiration pneumonia: Ne nusiwo le dɔgboa me (nuɖuɖu, tsi) yi ɖe lãkusi me la, ate ŋu agblẽ nu le lãkusi ŋu vevie eye wòana ARDS. Esia dzɔna ne nane si míeɖuna alo nona yi ɖe yaƒoƒomɔ̃wo me. Esia ate ŋu adzɔ ɖe ame aɖe si menya naneke o alo ame tsitsi dzi koŋ.
• Ʋudodo: Afɔku le ARDS ŋu ne wona ʋu si wu unit 15 wò le ɣeyiɣi kpui aɖe me.
• Covid-19 `( COVID-19 )`: Covid-19 dɔlékui ate ŋu ahe ARDS sesẽ vɛ.
• Dɔdzẽ : Dɔdzẽ sesẽ aɖe si le dɔgboa me.
• Afɔku gãwo alo dzobibi: Afɔku kple anyidzedze ate ŋu agblẽ nu le lãkusiwo ŋu tẽ, alo ate ŋu agblẽ nu le ŋutinu bubuwo ŋu le ŋutilãa me eye wòana lãkusiwo navuvu vevie.
• Nuveviwɔame le gbɔgbɔ me: Atikewo ƒe dzudzɔ alo dzudzɔ si me wodea amii ŋutɔ gbɔgbɔ.
• Atike vɔ̃ɖiwo zazã fũu akpa : Atike vɔ̃ɖi aɖe, abe cocaine alo opioid ene, nono fũ akpa.
• Nyrɔ alo tsi me nɔnɔ kloe: Ne ènyrɔ la, tsi gena ɖe wò lãkusi me hegblẽa nu le wo ŋu.

Amekawoe le afɔku gã aɖe me be woaxɔ ARDS?

Zi geɖe la, ARDS dzea ame siwo woxɔ ɖe kɔdzi xoxo le afɔku alo dɔléle aɖe ta la dzi. Ke hã, mefia kokoko be àxɔe le esi nèle kɔdzi ta ko o. Nu geɖe li siwo nana wò afɔkua dzina ɖe edzi:

• Ƒe 65 kple edzivɔ xɔxɔ.
• Atamazazã (sigaretnono).
• Atike vɔ̃ɖiwo zazã.
• Aɖuɖɔtoedɔléle aɖe si nɔ ame ŋu do ŋgɔ.

Kuxi kawoe ate ŋu ado tso ARDS me?

ARDS ate ŋu ahe kuxi vovovowo vɛ, ne èle kɔdzi kple ne èyi aƒeme vɔ siaa. Wo dometɔ aɖewoe nye:

• Ʋu ƒe sisi alo deep vein thrombosis (DVT).
• Pneumothorax: Esia ate ŋu adzɔ le nyaƒoɖeamenu si yagbɔgbɔmɔ̃a wɔna ɖe lãkusi si gblẽ eye wòsesẽ dzi ta.
• Delirium: Ame ƒe susu ƒe tɔtɔ.
• Ŋutinu geɖe ƒe dɔmawɔmawɔ nyuie .
• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ.
• Aklã ƒe abi alo fibrosis.
• Nuteɖeamedzi le Nuveviwɔame megbe (PTSD) .
• Susu ƒe lãmesẽkuxiwo abe dzimaɖitsitsi kple blanuiléle ene .

Aleke nèwɔna dea dzesi ARDS? (Dɔléle ƒe dzesi) .

Ðɔktawo nɔa te ɖe ŋutilã dodokpɔ kple dodokpɔ geɖe me tsonu dzi dea dzesi ARDS. Esi wònye be ARDS ƒe dzesiwo sɔ kple lãkusi alo dzidɔ si nɔa anyi didi ta la, ele be ɖɔktaa naɖe nu bubu siwo gbɔ wòtso hã ɖa. Ðɔkta ate ŋu abia be woawɔ dodokpɔ vovovowo, abe:

• Akɔta ƒe X-ray: Be woakpɔ tsi agbɔsɔsɔme si le lãkusiwo me.
• Ʋudodokpɔ: Edzidzea oxygen ƒe agbɔsɔsɔ le ʋua me eye wòkpɔa alesi ARDS ƒe sesẽme le.
• Echocardiogram (dzia ƒe gbeɖiɖi sesẽ dodokpɔ): Kpɔ alesi dzia le dɔ wɔme ɖa.
• Electrocardiogram (EKG): Edzidzea dzia ƒe elektrikŋusẽ ƒe dɔwɔwɔ.
• Asibidɛ ƒe nugbɔ ƒe sensor `(Pulse oximetry)`: Lé ŋku ɖe oxygen ƒe agbɔsɔsɔ ŋu ɣesiaɣi.
• CT scan (Computed Tomography - CT scan): Xɔ nyatakaka tsitotsito tso lãkusiwo ŋu.
• Nusiwo dona le gbɔgbɔtsixe me ƒe kpɔɖeŋu aɖe ɖeɖe: Di nusi gbɔ dɔlélea tso.

Nukawoe nye atike siwo wozãna na ARDS?

Taɖodzinu vevitɔ si le ARDS dada ŋue nye be woana oxygen ƒe agbɔsɔsɔ si le ʋua me nadzi ɖe edzi eye woaxe mɔ ɖe ŋutinuwo ƒe dɔmawɔmawɔ nyuie nu. Amesiwo ŋu ARDS le ate ŋu ahiã yagbɔgbɔmɔ̃ si wotsɔ mɔ̃ wɔe kple/alo oxygen-dɔdamɔnu be woadzi oxygen ƒe agbɔsɔsɔ ɖe edzi le ʋua me. Woate ŋu ahiã kpekpeɖeŋu hã be woaʋu yaƒoƒomɔ̃ siwo nu gblẽ le wo ŋu. Wò ɖɔkta ate ŋu aɖe afɔ aɖewo atsɔ aɖe ARDS ƒe kuxiwo dzi akpɔtɔ, abe:

• Alɔ̃dɔdɔtike (sedation) nana be wòakpe ɖe ame ŋu wòaɖu vevesese dzi eye wòanɔ anyi kpoo.
• Le esi teƒe be nàtrɔ wò ɖe megbe la, da ɖokuiwò ɖe teƒe si nàbɔbɔ nɔ anyi. Esia nana oxygen ƒe sisi nyona ɖe edzi.
• Wɔ gbɔgbɔ dodokpɔwo eye nànya ɣeyiɣi si sɔ be nàɖe mɔ̃a kple yagbɔgbɔmɔ̃a ɖa.
• Ʋumenugbagbeviɣitikewo nana be ʋu nagaxe o.
• Atike siwo naa tsinyegoe me tsi si sɔ gbɔ ɖe ŋutilãa me.
• Atike nana be wòaɖe tsi ƒe ƒoƒo ɖe lãkusi me dzi akpɔtɔ.
• Wona dɔlékuiwutikewo be woatsɔ axe mɔ ɖe dɔlékuiwo xɔxɔ nu alo atsɔ ada dɔlékui siwo li xoxo.
• Na ʋuʋu vevie kple kamedede be woaxe mɔ ɖe lãmekawo ƒe gbɔdzɔgbɔdzɔ nu.
• Woaɖoe ɖe aklã ƒe ɖɔɖɔɖo ƒe ɖoɖowo me be woado ŋusẽ aklãa eye woadzi aklã ƒe ŋutete ɖe edzi.

Ɣeyiɣi didi kae wòxɔna hafi wohayana tso ARDS me? Nukae nye alesi wohayanae?

Enɔ te ɖe alesi dɔlélea nu sẽe kple ɣeyiɣi didi si wòxɔna hafi ame ƒe lãkusiwo haya dzi. Numekuku akpa gãtɔ ɖee fia be zi geɖe la, exɔa ɣleti ade va ɖo ƒe ɖeka hafi lãkusi ƒe dɔwɔwɔ nyuie gatrɔna le ARDS megbe. Ke hã, ame aɖewo mehayana keŋkeŋ gbeɖe o. Agbetsitsi ƒe agbɔsɔsɔme na ARDS anɔ abe 55% va ɖo 70% , ne wodae kaba. Agbetsitsi dzi ɖena kpɔtɔna ne wohe atikewɔwɔa ɖe megbe alo ne ŋutinu bubuwo te kpododonu. Nuwo abe wò atikewɔwɔ me nɔnɔme siwo gbɔ wòtso, atikewɔwɔ ŋutinya, kple alesi gbegbe wò gbɔgbɔtsixe tsia ƒowòe enee fiaa wò ŋgɔdonya. Wò ɖɔkta adzro nya sia me kpli wò.

Ðe woate ŋu axe mɔ ɖe ARDS nua?

Mɔ aɖeke meli koŋ si dzi woato axe mɔ ɖe ARDS nu o. Gake ne gbɔgbɔtsixetsixe ƒe dzesiwo le ŋuwò, alo ne wò lãkusi gblẽ alo nɔnɔme bubu aɖe le ŋuwò la, atikewɔla didi enumake ate ŋu akpe ɖe ŋuwò be nɔnɔmea nagagblẽ ɖe edzi o. Ƒo asa na atamanono kple ahanono dzi ɖeɖe kpɔtɔ ate ŋu aɖe afɔku si le ARDS sesẽ xɔxɔ me dzi akpɔtɔ.

Aleke agbe le le ARDS megbe? Nuka ŋue wòle be míanɔ ŋudzɔ ɖo?

ARDS ate ŋu ade ame ƒe agbe afɔku me eye wòado vɔvɔ̃ na ame. Gake esi wowɔ atikewɔwɔ siwo nyo wu kple yaƒoƒo ƒe kpekpeɖeŋu (vevietɔ wotrɔ dɔnɔwo ɖe woƒe dɔgbo dzi be woana oxygen nanyo ɖe edzi) ta la, ame geɖe wu le agbe fifia, eye ARDS ƒe kuxiwo dzi le ɖeɖem kpɔtɔ. Zi geɖe la, amesiwo mexɔ ƒe 65 haɖe o kple amesiwo xɔ ARDS le afɔku alo ʋudodo vɔ megbe ƒe ŋgɔdonya nyona wu. ARDS ƒe hayahaya ate ŋu axɔ ɣeyiɣi didi. Ame geɖe siwo woɖe le yagbɔgbɔmɔ̃a me la te ŋu gbɔa ya faa. Wo dometɔ aɖewo hayana keŋkeŋ, gake ame bubuwo ya ate ŋu adze lãkusi me kuxi siwo nɔa anyi didi. Wohiã na lãkusiŋutinunyala bibi (aklãdɔdala) ƒe beléle.

"Dada xɔ ARDS eye wònɔ kɔdzi ɣleti geɖe. Esi wògbɔ va aƒeme gɔ̃ hã la, ɖeɖi te eŋu ŋutɔ. Dɔ suetɔ kekeake gɔ̃ hã mete ŋu wɔna kura o. Gake esi wòwɔ ɖe ɖɔktawo ƒe mɔfiamewo dzi eye wòwɔ kamedede vɔ la, eƒe lãme le sesẽm vivivi. Le ɣeyiɣi sia me la, eƒe ƒomea ƒe kpekpeɖeŋu kple lɔlɔ̃ xɔ asi ŋutɔ."

Agbenɔnɔ le ARDS megbe ate ŋu asesẽ. Gbɔ dzi ɖi eye nàdi kpekpeɖeŋu tso ƒometɔwo kple xɔlɔ̃wo gbɔ ne èle hayahayam. Àte ŋu ahiã kpekpeɖeŋu le gbesiagbedɔwo hã me vaseɖe esime wò lãkusiwo nahaya. Ƒo nu kple wò ɖɔkta tso kpekpeɖeŋunahawo alo dɔwɔnu bubu siwo ate ŋu akpe ɖe ŋuwò nàgakpɔ ŋusẽ ake ŋu.

Kadodo kae le COVID-19 kple ARDS dome?

Esiawo menye nu ɖeka o. Ame si ŋu COVID-19 le ate ŋu axɔ ARDS ne dɔlékuia ɖo lãkusi me. Numekulawo gblɔ be agbetsitsi ƒe agbɔsɔsɔme na amesi ŋu COVID-19 kple ARDS siaa le la anɔ abe 50% va ɖo 60% ene. Gake esia nɔ te ɖe nu geɖe hã dzi, abe lãmesẽ ŋutinya kple atikewɔwɔ ƒe nɔnɔme bubuwo ene. Ɣeyiɣi zazã le dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ le vevie (ICU) ate ŋu anye nuteƒekpɔkpɔ dziŋɔ aɖe si sesẽ. Ðewohĩ amesiwo le hayahayam tso ARDS me mate ŋu atrɔ ayi woƒe agbenɔnɔ si sɔ me kaba o, eyata èhiã kpekpeɖeŋu godoo. Ele vevie be nàxɔ kpekpeɖeŋu kple aɖaŋuɖoɖo tso dɔnyala bibiwo gbɔ le wò hayahaya tso ARDS me. Bia wò atikewɔlawo ƒe ƒuƒoƒoa tso beléle sesẽwo megbe hayahaya ƒe ɖoɖowo kple Internet dzi kpekpeɖeŋunaha siwo le miaƒe nutoa me ŋu.

Vevietɔ Wu: Nusiwo Dzi Nàɖo Ðo (Take-Home Message) .

Enyo, eyata nu ʋɛ aɖewo siwo dzi wòle be nàɖo ŋkui tso nusiwo ŋu míeƒo nu tsoe me lae nye esi:

• ARDS nye dɔléle sesẽ aɖe si gblẽa nu le lãkusiwo ŋu. Tsi yɔa ya kotoku siwo le lãkusia me, si wɔnɛ be oxygen si ate ŋu aɖo ʋua me dzi ɖena kpɔtɔna.
• Ne èkpɔ dzesiwo abe gbɔgbɔ sesẽ ŋutɔ, gbɔgbɔ kabakaba, alo ɖa/nuyi blɔ ene la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
• Nu geɖe ate ŋu ahe ARDS vɛ. Dɔlékuiwutikewo, aklãdɔ, COVID-19, kple afɔku sesẽwo nye wo dometɔ ʋɛ aɖewo ko.
• Dɔdamɔnua lɔ ɔksidzin, yagbɔgbɔmɔ̃ ƒe kpekpeɖeŋu, kple kuxiwo gbɔ kpɔkpɔ koŋ ɖe eme .
• Exɔa ɣeyiɣi hafi wohayana, eye ame aɖewo ate ŋu adze aɖuɖɔtoemedɔléle siwo nɔa anyi didi.
• Atikewɔwɔ kaba kple atikewɔwɔ nyuie le vevie ŋutɔ be woaɖe amewo ƒe agbe eye woaɖe kuxiwo dzi akpɔtɔ.
• Kpekpeɖeŋu tso ƒometɔwo kple hadomegbenɔnɔ gbɔ le vevie na amesi le hayahayam tso ARDS me.

Ðo ŋku edzi be ele vevie be nànya nɔnɔme sia. Ne wò ŋutɔ alo ame aɖe si nènya kpɔ dzesi siawo dometɔ aɖe la, mègatsi dzodzodzoe alo atsi dzodzodzoe o, ke boŋ yi ɖɔkta gbɔ enumake. To mɔ sia dzi la, àte ŋu adze atikewɔwɔ si hiã la gɔme kaba ale si nàte ŋui.