E aʻo kākou e pili ana i ka Malignant Hyperthermia, kahi hopena weliweli i ka anesthesia i ka wā o ke ʻoki ʻana.

Inā pono ʻoe a i ʻole kekahi o kou ʻohana e hana ʻia ke ʻoki kino, e hāʻawi ʻia ʻoe i ka anesthesia ma mua, ʻeā? I ka ʻōlelo maʻalahi, hoʻohiamoe loa ia iā mākou. Akā no kekahi poʻe, hiki i kekahi o nā lāʻau lapaʻau i hoʻohana ʻia no kēia anesthesia ke hana i kahi hopena koʻikoʻi loa, a hiki ke hoʻoweliweli i ke ola. I kēia lā ke kamaʻilio nei mākou e pili ana i ka malignant hyperthermia , kahi maʻi weliweli akā hiki ke mālama ʻia inā ʻike mua ʻia.

He aha ka Malignant Hyperthermia?

I ka ʻōlelo maʻalahi, he maʻi genetic ka Malignant Hyperthermia. ʻO ia hoʻi, ua hoʻoilina ʻia. Ke hōʻike ʻia kekahi kanaka me kēia maʻi i kekahi mau ʻano anesthesia i ka wā o ke ʻoki ʻana, pane koʻikoʻi ko lākou kino. He pilikia weliweli kēia e ola ai. Akā ʻo ka mea nui loa ma ʻaneʻi, ʻaʻole kēia e hana me nā lāʻau lapaʻau a pau i hoʻohana ʻia no ka anesthesia i ka wā o ke ʻoki ʻana. He palena wale nō ka nui o nā lāʻau lapaʻau e hoʻoulu ai i kēia hopena. Eia kekahi, inā ʻike ʻia, hiki ke mālama koke ʻia. ʻO ka hapa nui o ka manawa, ʻaʻole ʻike ke kanaka he mutation gene ko lākou e pili ana i kēia i loko o ko lākou kino. No ka mea, ʻaʻole lākou e hōʻike i kekahi mau hōʻailona i ke ola maʻamau. Kū mai ka pilikia ke komo kēlā lāʻau anesthetic i loko o ke kino.

ʻO wai ka mea i ʻoi aku ka pilikia?

Loaʻa kēia pilikia inā loaʻa kēia maʻi i kekahi o ka ʻohana.

• Moʻolelo ʻohana: Inā ua loaʻa i kahi ʻohana pili loa ou - he makuahine, he makuakāne, he kaikunāne, he kaikuahine, a he keiki paha - ka hyperthermia malignant, ua piʻi aʻe kou pilikia. No laila, inā hana ʻia ʻoe i ke ʻoki kino, he mea nui e haʻi aku i ka anesthesiologist e pili ana i kēia moʻolelo ʻohana .
• Kekahi mau maʻi ʻiʻo : ʻOiai inā ʻaʻohe mea o kou ʻohana i loaʻa i kēia pilikia, ʻoi aku ka nui o ka pilikia o ka poʻe me kekahi mau maʻi ʻiʻo kakaikahi. Eia kekahi laʻana:
• Maʻi kikowaena waena
• Maʻi Multiminicore
• ʻO ka maʻi King-Denborough
• Ka maʻi STAC3

He mau maʻi kakaikahi loa kēia, akā inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana kekahi, he mea nui e hoʻomaopopo i kāu kauka.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole kēia he maʻi maʻamau loa. Wahi a nā helu helu, ʻike ʻia kēia maʻi ma kahi o hoʻokahi i loko o 100,000 mau ʻoki kino i nā pākeke. Ma waena o nā keiki ʻōpio, ʻoi aku ka kiʻekiʻe o kēia helu, ʻo ia hoʻi, hoʻokahi i loko o 30,000 mau ʻoki kino. He mea kūpono hoʻi ke ʻike ʻia ʻo ka hapalua o nā maʻi i ʻike ʻia ma lalo o 19 makahiki. Eia nō naʻe, manaʻo nā kānaka ʻepekema he ʻoi aku ka maʻamau o ka poʻe me kahi predisposition genetic i kēia i loko o ke kaiāulu. ʻO kēia no ka mea, ʻoiai inā loaʻa iā lākou ka gene, inā ʻaʻole lākou i ʻike ʻia i nā lāʻau anesthetic e hoʻoulu ai i kēlā hopena i ko lākou ola a pau, ʻaʻole loa e kū mai kēia maʻi.

He aha nā hōʻailona o kēia?

Hiki ke ʻike ʻia kēia mau hōʻailona i ka wā o ke ʻoki ʻana a i ʻole ma hope koke iho o ke ʻoki ʻana i kou wā e hoʻōla ana. Inā loaʻa iā ʻoe kēia mau hōʻailona i kou wā hiamoe a ma lalo o ka anesthesia, ʻaʻole ʻoe e ʻike iā lākou. Akā e ʻike kāu anesthesiologist iā lākou. E nānā pono lākou i kāu mau hōʻailona koʻikoʻi i ka wā o ke ʻoki ʻana. No laila e hoʻomaka lākou i ka lāʻau lapaʻau i ka wā e ʻike ai lākou i kēia mau hōʻailona.

No ke aha lā kēia e hana nei? He aha ke kumu?

ʻO ka poʻe i maʻalahi i ka Malignant Hyperthermia, he loli genetic ko lākou, ʻo ia hoʻi, he mutation genetic, i loko o kekahi mau protein i loko o ko lākou mau cell muscle. E noʻonoʻo i ka loaʻa ʻana o ka calcium i loko o kā mākou mau cell muscle. Hoʻokele ʻia ka hoʻokuʻu ʻia ʻana o kēia calcium e kahi mea e like me ka puka. Ke hāʻawi ʻia i kahi kanaka maʻamau i nā lāʻau anesthetic, hana kēia puka ma ke ʻano i kāohi ʻia. ʻO kēia ke kumu o ka ʻūmiʻi a me ka paʻa ʻana o nā ʻiʻo, hoʻomaka ka metabolism o ke kino e wikiwiki, a piʻi nui ka mahana o ke kino. I ka hopena, make nā hunaola ʻiʻo, a hōʻiliʻili ka nui o nā mea e like me ka potassium i loko o ke koko. Loaʻa nā hōʻailona koʻikoʻi ʻē aʻe ma muli o kēia mau kumu.

He aha nā lāʻau lapaʻau e hoʻoulu ai i kēia hopena?

ʻO ke kumu nui o kēia kūlana ʻo ia nā hui ʻelua o nā lāʻau lapaʻau.

• Nā lāʻau hoʻomaha hanu ʻia:
• Halothane
• ʻO ka Desflurane
• ʻO Sevoflurane
• ʻIsoflurane
• Nā lāʻau lapaʻau intravenous:
• ʻO Succinylcholine (he mea hoʻomaha wikiwiki kēia i nā uaua)

Pehea ʻoe e ʻike ai a hōʻoia i kēia?

Ka ʻike ʻana i ka wā o ke ʻoki kino

Hoʻomaopopo pinepine ʻia i ka wā o ke ʻoki kino. Inā ʻaʻole ʻoe i ʻike he maʻi kou, ʻaʻole hoʻi kāu kauka anesthesiology. Akā e nānā pono ʻo ia iā ʻoe i ka wā o ke ʻoki kino a manaʻo paha he hyperthermia malignant inā ʻike lākou i nā loli aʻe:

• Hoʻonui ʻia ka helu o ka puʻuwai no ke kumu ʻole.
• Piʻi wikiwiki o ka mahana o ke kino .
• Ua hoʻonui ʻia ka nui o ke kalapona ʻokikene i hoʻokuʻu ʻia.
• ʻOʻoleʻa o nā ʻiʻo.

Ua hoʻomaʻamaʻa ʻia nā anesthesiologists e ʻike koke i kēia mau loli, i hiki iā lākou ke hoʻomaka koke i ka mālama ʻana.

Hiki ke ʻike mua inā he pilikia?

Inā kānalua ʻoe he pilikia kēia ma muli o kou mōʻaukala ʻohana, aia kekahi mau hoʻokolohua kūikawā e hōʻoia i ia.

• Hoʻāʻo ʻaelike Caffeine Halothane (CHCT): Pili kēia i ka lawe ʻana i kahi ʻāpana liʻiliʻi loa o kou ʻiʻo (biopsy ʻiʻo) a hōʻike iā ia i ke kinoea halothane a me ka caffeine i loko o kahi keʻena hoʻokolohua. Hiki ke hoʻohana ʻia ke ʻano o ka pane ʻana o ka ʻāpana ʻiʻo e hoʻoholo ai inā ua maʻi ʻoe i kēia maʻi.
• Ka hoʻāʻo ʻana i ka hoʻoilina: ʻO kēia hoʻāʻo, e pili ana i ka lawe ʻana i kahi hāpana koko, hiki ke ʻike i nā hoʻololi hoʻoilina (e.g., RYR1, STAC3, CACNA1S) e pili ana me ka Malignant Hyperthermia.

Akā, he pipiʻi iki kēia mau hoʻāʻo, a ʻaʻole loaʻa ma nā wahi āpau ma Sri Lanka. No laila, inā pono ʻoe e hana i kahi ʻoki kino ulia pōpilikia a loaʻa i kekahi o kou ʻohana kēia maʻi, ʻaʻole e kali nā kauka no nā hoʻāʻo a e hoʻohana wale i nā anesthetics palekana ʻaʻole e hoʻoulu i kēia hopena iā ʻoe.

Pehea e mālama ʻia ai?

ʻO ka lāʻau lapaʻau nui a hoʻōla ola i hāʻawi ʻia i ka wā o ka hyperthermia malignant ʻo dantrolene . I ka manawa e kānalua ai ka anesthesiologist i kēia kūlana, hāʻawi koke lākou i kēia lāʻau lapaʻau ma ke ʻano intravenous. I ka manawa like,

• Hoʻōki koke ʻia ka lāʻau hoʻomake i hoʻokumu i ka hopena.
• E hoʻomaopopo ʻia ke kauka ʻoki a e hoʻopau ʻia ke ʻoki ʻana i ka hikiwawe loa.
• No ka hoʻēmi ʻana i ke kiʻekiʻe o ke kino , hāʻawi ʻia nā wai anuanu IV i loko o nā aa koko, a hoʻomaʻalili ʻia ke kino me nā mea e like me nā ʻeke hau.
• Hāʻawi i ka oxygen.
• Hoʻōla i nā maʻi o ka puʻuwai.

Ke hoʻomalu ʻia ke kūlana, e mālama ʻia ʻoe i loko o ka ʻāpana mālama koʻikoʻi (ICU) no hoʻokahi lā ma ka liʻiliʻi, kahi e nānā ai ke kime lapaʻau iā ʻoe. I loko o kēia manawa, e hana lākou i nā hoʻokolohua koko hou aʻe a hāʻawi i ka lāʻau lapaʻau hou e like me ka mea e pono ai.

Pehea lā ke ʻano o ke kūlana? He aha nā pilikia?

Inā ʻike koke ke kime lapaʻau i kēia maʻi a mālama pono iā ia, hiki ke ho'ōla piha ʻia. ʻO nā pilikia e hiki ke kū mai i kēia:

• Ka hōʻino ʻana o nā ʻiʻo.
• Ka hāʻule ʻana o nā puʻupaʻa.
• Ka hemahema o ke akepaʻa.
• Ke kahe ʻana o ke koko.
• Paʻa ka puʻuwai.
• Nā ʻōʻili.
• Ke komo nei i loko o ka coma.
• Ka make.

ʻO ka Malignant Hyperthermia kahi maʻi e make pinepine ai inā ʻaʻole mālama ʻia. ʻOiai me ka mālama kūpono, aia ka nui o ka make ma waena o 3% a me 5%.

Hiki ke pale ʻia kēia?

ʻAe, hiki ke pale ʻia! ʻO ke ala maikaʻi loa e hana ai i kēia, ʻo ia ka makaʻala i kou pilikia iā ʻoe iho a me kāu kauka. Inā ʻike ʻoe he loli genetic kou e pili ana i kēia, a inā ʻike ʻoe he maʻi ko kekahi o kou ʻohana, pono ʻoe e haʻi i ke kauka anesthesiologist ma mua o ke ʻoki ʻana. A laila ke hāʻawi ʻo ia iā ʻoe i ka anesthesia, e hoʻohana ʻo ia i nā lāʻau palekana loa ma kahi o kēlā mau lāʻau weliweli. A laila ʻaʻole e hana ʻia kēlā hopena weliweli. ʻIke ka poʻe he nui he pilikia ko lākou ma hope o ka hiki ʻana iā lākou. ʻO ia ke kumu he mea nui e ʻike i ka mōʻaukala olakino o kou ʻohana. ʻO ka Hyperthermia Malignant, anesthesia, ʻoki kino, anesthesia reaction, maʻi genetic, dantrolene, mōʻaukala ʻohana, palekana ʻoki kino, nā pilikia anesthesia, nā maʻi genetic