Ke manaʻo nei ʻoe i kekahi manawa he pōkole ka hanu, ua paʻa kou umauma, a ua poniuniu paha ʻoe ma hope o ka hele wāwae ʻana i kahi mamao pōkole? A i ʻole loaʻa pinepine iā ʻoe ka ʻeha poʻo? ʻO kekahi kumu ma hope o kēia, ʻo ia ka emi ʻana o ka pae oxygen i loko o kou koko. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia he hypoxemia . No ka mea, he maʻi koʻikoʻi kēia, e ʻike kākou i ke kumu o ia mea me ka maʻalahi a me ka maopopo.
ʻĀ, he aha kēia Hypoxemia?
I ka ʻōlelo maʻalahi, ʻo Hypoxemia kahi kūlana kahi i emi ai ka nui o ka oxygen ma kou koko ma mua o ka nui maʻamau. He mea nui ka oxygen no kēlā me kēia cell a me nā ʻōkana i loko o ko mākou kino e hana pono ai, e like me ka pono o ke kaʻa i ka ʻaila e holo ai.
E noʻonoʻo i kēia ʻano. Ke hanu kākou, hele ka oxygen i ka lewa i loko o ko kākou mau māmā. Aia i loko o nā māmā kahi pūnaewele o nā ʻeke ea liʻiliʻi i kapa ʻia ʻo alveoli. Ua hoʻopuni ʻia kēia mau ʻeke ea e nā kīʻaha koko maikaʻi loa (capillaries). Ke hanu kākou, ua omo ʻia ka oxygen e komo ana i loko o nā māmā ma o kēia mau ʻeke ea i loko o nā kīʻaha koko. A laila lawe ke koko i kēia oxygen a hāʻawi iā ia i nā ʻiʻo ma ke kino holoʻokoʻa.
Hiki mai ka hypoxemia ke hewa kekahi mea me kēia kaʻina hana. ʻAʻole hiki iā ʻoe ke hanu i ka oxygen lawa , a i ʻole ʻaʻole hiki ke komo pono ka oxygen āu e hanu ai i loko o kou koko . ʻO ia ke kumu e ʻoi aku ai ka pilikia o ka poʻe me ka maʻi māmā a me ka maʻi puʻuwai no kēia maʻi.
He ʻelua mau mea like ʻole ʻo Hypoxemia a me Hypoxia?
ʻAe, ʻoiai he nui ka poʻe e huikau nei i kēia mau huaʻōlelo ʻelua, aia kahi ʻokoʻa iki. He mea nui e ʻike i kēlā.
- ʻO ka Hypoxemia ka emi ʻana o nā pae oxygen i loko o ke koko .
- ʻO ka Hypoxia ka emi ʻana o ka nui o ka oxygen e hiki ana i nā ʻiʻo o ke kino .
E noʻonoʻo i ke koko e like me kahi 'kalaka lawe' e lawe ana i ka oxygen. ʻO nā ʻiʻo he 'mea kūʻai aku' e kali ana i ka oxygen. ʻO ka Hypoxemia ka wā e haʻahaʻa ai ka ukana o ke kalaka (oxygen). No laila, ʻo ka Hypoxia ka wā ʻaʻole i loaʻa i ka mea kūʻai aku ka ukana. I ka manawa pinepine, i ka wā e haʻahaʻa ai ka oxygen i loko o ke koko (Hypoxemia), nele pū nā ʻiʻo i ka oxygen (Hypoxia). Akā, ʻaʻole ia e hana mau.
He aha nā hōʻailona o kēia maʻi?
Hiki ke ʻokoʻa nā hōʻailona o ka hypoxemia ma muli o kona koʻikoʻi a me ke kumu. Aia kekahi mau hōʻailona maʻamau i helu ʻia ma ka papa ma lalo nei.
| Hōʻailona | Wehewehena |
|---|---|
| Paʻakikī ka hanu ʻana | Manaʻo o ka ʻūmiʻi ʻana, pilikia ka hanu ʻana (dyspnea). |
| ʻEha poʻo | ʻEha poʻo, ʻoi aku hoʻi i ke kakahiaka. |
| Nā palpitations o ka puʻuwai | Hoʻonui ʻia ka helu o ka puʻuwai (tachycardia). |
| Kuke a me ke kani o ka umauma | ʻUmi pinepine a me ka wheezing i ka wā e hanu ana. |
| Ka huikau | Hiki mai ka huikau a me ka hoʻonāukiuki ke nele ka lolo i ka oxygen. |
| Polū (Cyanosis) | He pilikia kēia! ʻO ke kala polū o ka ʻili, nā lehelehe, a me nā kui. |
No ke aha e hana ai kēia? He aha nā kumu o ka hypoxemia?
Nui nā kumu no kēia. ʻO ke kumu nui he maʻi olakino e pili ana i ke kaʻina hana hanu a i ʻole ke kahe koko. No ka laʻana, ke hele ʻoe i kahi kiʻekiʻe, e like me kahi mauna, hiki ke loaʻa kēia maʻi no kekahi manawa ma muli o ka nele o ka oxygen i ke kaiapuni.
Aia ma lalo iho kekahi o nā pilikia olakino nui e hiki ai ke hoʻoulu i ka hypoxemia.
- Asthma
- Pneumonia
- COPD (Maʻi Puʻuwai Pale Mau)
- Ka hāʻule ʻana o ka puʻuwai paʻa
- ʻO ka Embolism Pulmonary
- ʻEdema Pulmonary
- ʻAneʻane hiamoe
- Anemia
- Nā kīnā puʻuwai hānau
- Nā maʻi hanu koʻikoʻi e like me COVID-19
5 mau ʻano hana nui e kōkua ai i ka hoʻopau ʻana o ka oxygen
Mai kahi kuanaʻike lapaʻau, aia he 5 mau ʻano hana nui e kōkua ai i ka nele o ka oxygen i loko o ke koko. He mea paʻakikī iki kēia, akā e mālama kākou i ka maʻalahi.
1.ʻAʻohe kūlike o ka ea a me ka hoʻokahe ʻana (V/Q): E noʻonoʻo i nā māmā e like me ke kahua kaʻa. ʻO ka ea (oxygen) nā mea holo. ʻO ke koko ke kaʻa. I kekahi manawa ua piha ke kahua i nā mea holo, akā ʻaʻohe kaʻa (kahe haʻahaʻa o ke koko). A i ʻole he nui nā kaʻa, akā ʻaʻohe mea holo (kahe haʻahaʻa o ka ea). ʻO kēia kūlike ʻole ma waena o ke kahe o ka ea a me ke kahe o ke koko ua kapa ʻia ʻo V/Q mismatch.
2. Ka Hoʻopilikia ʻana o ka Hoʻolaha: I kēia manawa, e noʻonoʻo ʻoe aia nā ohua (oxygen) ma ke kahua kū, a ke neʻe nei ke kaʻa (koko). Akā, aia kahi mea keakea no nā ohua e kau i luna o ke kaʻa. ʻO kēia ke keakea i ka oxygen mai nā māmā i ke koko . Hiki ke hana ʻia kēia ma muli o nā mea e like me ka mānoanoa o nā paia o nā māmā.
3. Hypoventilation: I ka ʻōlelo maʻalahi , ka hanu mālie a i ʻole ka hanu hohonu ʻole , ʻo ia ka hopena i ka lawa ʻole o ka oxygen e hiki ana i nā māmā.
4. Haʻahaʻa ka Oxygen Kaiapuni: He mea maopopo kēia. Inā haʻahaʻa ka oxygen i ke kaiapuni a mākou e noho nei , no ka laʻana, ke piʻi mākou i ka piko o ka mauna, ʻaʻole hiki iā mākou ke lawe i ka oxygen lawa.
5. Ka Hoʻololi ʻĀkau-a-Hema: He koko haʻahaʻa ka oxygen (koko polū) ko ko kākou puʻuwai ma ka ʻaoʻao ʻākau a me ke koko kiʻekiʻe ka oxygen (koko ʻulaʻula) ma ka ʻaoʻao hema. ʻAʻole hui pū kēia mau mea ʻelua. Akā i kekahi mau maʻi puʻuwai, ma kahi o ka hele ʻana i nā māmā e loaʻa ai ka oxygen, lele pololei kekahi o ke koko haʻahaʻa ka oxygen i ka ʻaoʻao hema a hele i ke kino . He kumu nō hoʻi kēia o ka Hypoxemia.
Pehea e ʻike ai ke kauka i kēia?
Ma hope o ka hoʻolohe ʻana i kāu mau hōʻailona, e nānā ke kauka iā ʻoe. Hoʻokomo pū kēia i ka hoʻolohe ʻana i kou puʻuwai a me kou mau māmā, ka nānā ʻana i ke kala o kou ʻili, a me ka hana ʻana i kekahi mau hoʻokolohua e hoʻoholo ai i kāu mau pae oxygen.
- ʻO ka Pulse Oximetry: Ua ʻike paha ʻoe i kēia. He mea hana ia e kau ana ma kou manamana lima a ana i kou pae oxygen. ʻAʻohe ʻeha a maʻalahi loa. Pono ka pulse o ke kanaka olakino he 95% a ʻoi aku paha.
- Hoʻāʻo Kinoea Koko Arterial (ABG): ʻO kēia ka hoʻāʻo pololei loa. Lawe ʻia kahi hāpana koko liʻiliʻi mai kahi aʻa ma ka pulima lima, ke kūlou o ke kuʻekuʻe lima, a i ʻole ka ʻūhā, a ana ʻia nā pae o ka oxygen, ke kalapona ʻokikene, a me ka waikawa (pH) o ke koko.
- Hoʻāʻo Hele Waewae ʻEono Minuke (6MWT): He hoʻāʻo e ana i ka mamao o kou hiki ke hele ma ka ʻāina pālahalaha i loko o 6 mau minuke, a pehea e loli ai kāu pae oxygen me ka hoʻoikaika kino.
Pehea e mālama ʻia ai?
ʻO ka mea nui i ka wā e mālama ai i ka hypoxemia, ʻo ia ka mālama ʻana i ke kumu kumu . Eia kekahi, hoʻohana ʻia ka lāʻau lapaʻau e hoʻihoʻi koke i nā pae oxygen koko i ka maʻamau.
ʻO ka mea nui loa, ʻo ia ka hoʻonui ʻana i ka pae oxygen i loko o ke koko. No kēia, hāʻawi ʻia ka oxygen hoʻohui .
ʻEkolu mau ʻano lapaʻau:
- Oxygen: Hāʻawi ʻia ka oxygen ma o kahi cannula ihu a i ʻole kahi pale maka. Ua kuhikuhi ʻia kekahi poʻe i nā mea hoʻohui oxygen hiki ke hoʻohana ʻia ma ka home.
- Nā mea hanu: Hāʻawi ʻia nā mea hanu i nā poʻe me nā maʻi e like me ka hānō a i ʻole COPD i nā mea hanu e hoʻonui i nā alaloa ea (bronchodilators) a hōʻemi paha i ka pehu (steroids).
- Nā mīkini CPAP: Hāʻawi ʻia kēia mīkini i ka poʻe e loaʻa ana i ka apnea hiamoe e hoʻohana i ka pō.
- Mea Hoʻōla hanu: Inā koʻikoʻi loa ke kūlana o ka mea maʻi, ʻo ia hoʻi he paʻakikī iā lākou ke hanu iā lākou iho, ua hoʻopili ʻia lākou i kahi mīkini hanu hana (ventilator) ma ka ʻāpana mālama koʻikoʻi o ka haukapila.
- Nā lāʻau lapaʻau ʻē aʻe: Inā piha nā māmā i ka wai, hāʻawi ʻia nā lāʻau lapaʻau (diuretics) e wehe i ka wai keu.
He aha kā mākou e hana ai e mālama i nā pae oxygen maikaʻi?
Inā loaʻa iā ʻoe ka maʻi puʻuwai a i ʻole ka maʻi māmā, he mea nui kēia mau mea e hōʻemi ai i ka pilikia o ka hypoxemia.
- E hoʻokele pono i kou kūlana: E hoʻohana i ka lāʻau lapaʻau a me ka inhaler i kuhikuhi ʻia e kāu kauka i ka manawa kūpono. E hōʻoia e hele i nā keʻena lapaʻau.
- E pale loa i ka puhipaka: He mea ʻino loa ka puhipaka i nā māmā. ʻO ka haʻalele ʻana i ka puhipaka e kōkua i ka hoʻonui ʻana i nā pae oxygen.
- Hana i nā hoʻomaʻamaʻa hanu: E nīnau i kāu kauka e pili ana i nā mea e like me ka hanu hohonu a me ka hoʻohana ʻana i nā mea hana e like me ka Incentive Spirometer.
- E makaʻala i nā hōʻailona hou: Inā loaʻa iā ʻoe ka pōkole o ka hanu a i ʻole ka ʻeha o ka umauma, mai hoʻowahāwahā iā ia.
- E makaʻala i ka wā e hele ai i nā wahi kiʻekiʻe: Inā he maʻi puʻuwai a māmā paha kou, e kamaʻilio me kāu kauka a e kiʻi i ka ʻōlelo aʻoaʻo e pono ai ma mua o ka hele ʻana i kahi mauna.
Āhea mākou e ʻike koke ai i ke kauka? (I ka manawa hea e hele ai i ka ETU)
He kūlana hoʻoweliweli ola ka hypoxemia. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, e hele koke i ka Emergency Department (ETU) o ka haukapila.
- Ka hanu pōkole loa koke.
- Ka loli ʻana o ke ʻano polū o nā lehelehe, nā kui lima, a i ʻole ka ʻili (Cyanosis).
- ʻEha nui o ka umauma.
- Ka huikau, ka hoʻonāukiuki, a i ʻole ka nalowale o ka ʻike.
- Inā loaʻa iā ʻoe kahi maʻi, e ʻoi koke aʻe paha kona mau hōʻailona maʻamau.
Leka Lawe-Home
- ʻO ka hypoxemia kahi pae haʻahaʻa loa o ka oxygen i loko o ke koko. Hiki i kēia ke hōʻino i nā ʻōkana o ko mākou kino.
- ʻO nā hōʻailona nui ka paʻakikī o ka hanu ʻana, ka ʻeha poʻo, ka piʻi ʻana o ka puʻuwai, a me ka ʻili polū.
- ʻO nā maʻi māmā (asthma, COPD) a me ka maʻi puʻuwai nā kumu nui.
- Hiki i kahi pulse oximeter i kau ʻia ma ka manamana lima ke hāʻawi i kahi manaʻo maʻamau o nā pae oxygen, akā pono nā hoʻokolohua lapaʻau no kahi hōʻoia pololei.
- ʻO nā ʻano lapaʻau nui, ʻo ia ka mālama ʻana i ka maʻi kumu a me ka hāʻawi ʻana i ka oxygen mai waho inā pono.
- Inā pilikia nui kou hanu ʻana a i ʻole ka ʻili polū, he pilikia ia. E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU).
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo