Èkpɔ ame aɖe le dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ le vevie (ICU) alo ame aɖe si wokplɔ va xɔ si me wokpɔa dɔnɔwo gbɔ le kpata (ETU) me kple gbɔgbɔtsixe sesẽ, eye ɖɔktawo ƒu du gblɔ na wo be "woawɔ ABG" kpɔa? Esia nye ʋudodokpɔ vevi aɖe ŋutɔ eye wòto vovo vie. Egbea, míaƒo nu tso eŋu bɔbɔe, le mɔ si gɔme nàte ŋu ase nu.
Kpuie ko la, nukae nye ABG dodokpɔ sia?
ABG (Arterial Blood Gas) nye dodokpɔ si me woɖea ʋu sue aɖe tso ʋuka aɖe si le míaƒe ŋutilã me me. Fifia ɖewohĩ ànɔ eŋu bum be, "Ʋudodokpɔ bubuwo xɔa ʋu tso ʋuka aɖe me, vovototo kae le eme?"
Bu eŋu ale. Míaƒe ŋutilã le abe du ene.
- Ʋukawo le abe mɔ gã siwo tsɔa nu veviwo abe ɔksidzin kple nunyiame ene vaa du aɖe me ene.
- Veinwo le abe mɔ xoxo siwo le dua me siwo tsɔa gbeɖuɖɔwo abe ya si woyɔna be carbon dioxide ene trɔna yia dua me.
Eyata ne míedi be míanya oxygen agbɔsɔsɔme si tututu le gegem ɖe míaƒe ŋutilã ƒe ŋutinuwo me, vevietɔ ahɔhɔ̃ kple dzi la, ele be míado ʋu si le "mɔ gã" ma dzi la kpɔ, alo? Esia tae woɖea ʋu tso ʋuka aɖe me hena ABG dodokpɔa.
Dodokpɔ sia koŋue dzidzea oxygen kple carbon dioxide ƒe agbɔsɔsɔ si le wò ʋu me. Edzidzea wò ʋu ƒe acid-base ƒe dadasɔ, alo pH hã. Dadasɔ sia le vevie na nusiwo katã yia edzi le míaƒe ŋutilã me.
Nuka tututue ABG dodokpɔ dzidzena?
Ne èlé ŋku ɖe ABG ƒe nyatakaka aɖe ŋu la, àkpɔ lɛta aɖewo siwo gɔmesese sesẽ vie. Gake gɔmesesea le bɔbɔe ŋutɔ. Na míakpɔ nusi dzidzenu mawo dometɔ ɖesiaɖe fia ɖa.
| Dzidzedzekpɔkpɔ | Gɔmesese bɔbɔe |
|---|---|
| pH | Esia na nènya alesi gbegbe wò ʋu me acid le. Ele be asixɔxɔ sia nanɔ 7.35 kple 7.45 dome. Nusianu si bɔbɔ wu ema fia be wò ʋu nye acid, eye nusianu si lolo wu fia be alkaline le eme. |
| PaO2 (Oxygen ƒe nyaƒoɖeamenu ƒe akpa aɖe) . | Oxygen agbɔsɔsɔme si le ʋua me. Esia ɖe alesi oxygen le gegem ɖe ʋua me nyuie tso wò lãkusi me fia. |
| PaCO2 (Carbon dioxide ƒe nyaƒoɖeamenu ƒe akpa aɖe) . | Carbon dioxide ƒe agbɔsɔsɔ si le wò ʋu me. Esia ɖe alesi wò ŋutilã le ya si woyɔna be carbon dioxide ɖem ɖa nyuie la fia. |
| HCO3 (Bicarbonate) ƒe ƒuƒoƒo . | Esia nye gɔmeɖoanyi le míaƒe ʋu me. Ayikuwoe kpɔa edzi. Ele vevie ŋutɔ na ʋua ƒe pH ƒe dadasɔ. |
| O2Sat (Oxygen ƒe agbɔsɔsɔ) . | Eɖea protein si nye hemoglobin si le ʋua me ƒe agbɔsɔsɔme si le oxygen tsɔm fiana, abe alafa memamã ene. Pulse oximeter si nèdea asibidɛ dzi la dzidzea asixɔxɔ ma ke. |
Ɣekaɣie wòhiã be woawɔ ABG dodokpɔ?
Esia menye dodokpɔ si wowɔna hena dodokpɔ edziedzi o. Zi geɖe la, wowɔa esia le nɔnɔme kpatawo me kple be woalé ŋku ɖe dɔnɔ siwo woxɔ ɖe kɔdzi xoxo ƒe nɔnɔme ŋu . Susu vevi siwo ta ɖɔkta ate ŋu aɖe gbe be woawɔ dodokpɔ sia ɖo dometɔ aɖewoe nye esi:
- Yagbɔgbɔ sesẽ sesẽwo: Le nɔnɔmewo abe asrã ƒe sesẽ kple tsi ƒe ƒoƒo ɖe lãkusi me (yagbɔgbɔ ƒe dɔmawɔmawɔ nyuie) ene me.
- Dɔlékui ƒe nɔnɔme sesẽwo: Le dɔlékui siwo ate ŋu ade ame ƒe agbe afɔku me abe sepsis alo septic shock ene me.
- Kuxi siwo do ƒome kple suklidɔ: Le nɔnɔme siwo me ʋua va zua acid, abe suklidɔ ƒe ketoacidosis (DKA) ene.
- Dzidɔ alo dzidɔ: Ne dzia dzudzɔ dɔwɔwɔ zi ɖeka (Acute heart failure) alo ne dzia tɔ (Cardiac arrest).
- Ayikuwo ƒe dɔmawɔmawɔ nyuie: Ne ayikuawo mete ŋu ɖea aɖi le ʋua me nyuie o la, ʋua va zua acid. Srɔ̃ nu tso nɔnɔme sia ŋu.
- Aɖi: Ne woɖu aɖi aɖewo la, ʋua ƒe pH trɔna.
- Do ŋgɔ na amekoko gãwo kple emegbe: Lé ŋku ɖe dɔnɔa ƒe gbɔgbɔtsixe ƒe nɔnɔme ŋu le atike si wua alɔ̃dɔdɔ me kple le amekoko vɔ megbe.
- Aɖuɖɔtoedɔléle siwo nɔa anyi didi: Kpɔe ɖa be atikewɔwɔ kpɔa dzidzedze na amesiwo ŋu dɔlélewo abe COPD (Chronic obstructive pulmonary disease) le hã.
Aleke wowɔa dodokpɔ siae? Ðe wòvea amea?
ABG dodokpɔ wɔwɔ to vovo vie tso ʋudodokpɔ edziedzi gbɔ.
Hafi dodokpɔa nadze egɔme
Ɣeaɖewoɣi la, ne wole oxygen kpeɖeŋutɔ nam wò la, woate ŋu adzudzɔe abe miniti 20 ene do ŋgɔ na dodokpɔa. Esia nye be nàkpɔ alesi wò ŋutilã wɔa dɔe oxygen manɔmee. Gake ne màte ŋu awɔe kura o oxygen manɔmee la, ɖewohĩ màte ŋu awɔe o. Ne wole ʋu ɖem tso wò asibidɛ me la, ɖɔkta alo dɔwɔla si wona hehee ate ŋu awɔ dodokpɔ bɔbɔe aɖe si woyɔna be ‘Allen dodokpɔ’ atsɔ akpɔe ɖa be ʋu le sisim nyuie le wò alɔnu hã.
Esime wole dodokpɔa wɔm
1. Ðɔkta alo dɔwɔla bibi aɖe si wona hehee akpɔ ʋuka aɖe le wò asibidɛ ƒe eme (radial artery), le wò abɔta gbɔ (brachial artery), alo le wò akɔta (femoral artery).
2. Klɔ teƒea nyuie eye nàtsɔ dɔlékuiwutike asisi ɖe eŋu.
3. Emegbe, wotsɔa aŋe sue aɖe ŋutɔ dea ʋukaa me eye woɖea ʋu sue aɖe dea atikekui me.
4. Ne míagblɔe tututu la , esia ate ŋu ase veve vie wu ʋuɖeɖe tso ʋuka me. Esia le alea elabena ʋukaa le míaƒe ŋutigbalẽ te goglo vie eye lãmeka geɖe le eŋu ƒo xlãe. Gake ɣeyiɣi si me wotsɔ aŋea de eme ko hafi vevesesea dzɔna.
5. Ne èfɔ ʋu agbɔsɔsɔme si hiã vɔ la, ɖe aŋea ɖa eye nàtsɔ kotoku alo gaze aɖe aƒoe ɖe teƒea be ʋua natɔ te abe miniti 5 va ɖo 10 ene . Ne èle atike siwo nana ʋu mekɔna o zãm la, ɖewohĩ ahiã be nàzi edzi ɣeyiɣi didi wu.
Le dodokpɔa megbe
Teƒe si wotsɔ aŋea de la ate ŋu aƒo vie alo azu blɔ. Esia sɔ. Wò ɖɔkta agblɔ na wò be nàƒo asa na nu kpekpewo kɔklɔ kple alɔ ma gaƒoƒo 24 le ʋuɖeɖe vɔ megbe.
ABG dodokpɔa me tsonuawo nɔa anyi kaba ŋutɔ, zi geɖe le miniti 10-15 me, elabena emetsonu siawo le vevie ŋutɔ na nyametsotso wɔwɔ kabakaba le nɔnɔme kpatawo me.
Aleke asixɔxɔ siwo le nyatakakaa me le mama dedie nu le?
Asixɔxɔ siawo ate ŋu ato vovo vie tso dodokpɔxɔ ɖesiaɖe me, gake esiawoe nye asixɔxɔ siwo le mamã dedie nu na ame tsitsi si le lãmesẽ me le atsiaƒu ƒe sɔsɔme. Anyo wu be nàbia wò ɖɔkta be wòaɖe asixɔxɔ siwo le wò nyatakakaa me la me bliboe .
| Dzidzedzekpɔkpɔ | Normal Range ƒe didime |
|---|---|
| pH | 7.35 - 7.45 ƒe ɣeyiɣiwo |
| PaO2 | 75 - 100 mmHg ƒe kpekpeme |
| PaCO2 | 35 - 45 mmHg ƒe kpekpeme |
| HCO3 | 22 - 26 mEq/L ƒe kpekpeme |
| O2Sat | 95% - 100% . |
Ne dzidzenu siawo mele agbɔsɔsɔ si sɔ me o la, ate ŋu afia be wò ŋutilã mele oxygen si sɔ xɔm o , alo be carbon dioxide mele dodom le wò lãmenugbagbeviwo me nyuie o , alo be wò ʋu ƒe acid/base ƒe dadasɔ megada sɔ o . Wò ɖɔkta azã nyatakaka sia, wò dzesiwo, kple dodokpɔ bubuwo atsɔ anya nusi tututu gblẽ le ŋuwò.
Gbedasi si Wotsɔ Yi Aƒeme
- ABG menye ʋudodokpɔ si wowɔna edziedzi tso ʋuka me o, ke boŋ enye dodokpɔ tɔxɛ aɖe si wowɔna tso ʋuka, si nye ʋuka gã aɖe si naa oxygen ŋutilãa me.
- Esia koŋ dzidzea oxygen, carbon dioxide, kple acidity (pH) si le ʋua me.
- Esia le vevie ŋutɔ be woate ŋu ade dzesi atikewɔwɔ ƒe nɔnɔmewo kaba le nɔnɔme kpatawo kple nɔnɔme sesẽwo abe gbɔgbɔtsixetsixe, dɔlékui sesẽwo, kple dzidɔ ene me.
- Togbɔ be ate ŋu ase veve vie wu ʋudodokpɔ edziedzi hã la, nyatakaka siwo wòna ate ŋu akpe ɖe ame ŋu wòaɖe ame ƒe agbe.
- Ƒo nu kple wò ɖɔkta si le dɔ wɔm na wò ɣesiaɣi tso wò ABG dodokpɔa me tsonu kple nusi wofia ŋu.
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