He pāpaʻu loa anei kou hanu ʻana? (Respiratory Depression/Hypoventilation) - E kamaʻilio kākou e pili ana i kēia!

Ua manaʻo paha ʻoe e like me ka paʻakikī o ka hanu ʻana, a i ʻole ua pōkole loa kou hanu? Malia paha ua manaʻo ʻoe i ka poniuniu a luhi paha. ʻO kekahi kumu paha ma hope o kēia mau mea, ʻo ia ka emi ʻana o ka hanu ʻana, ʻo ia ka mea a mākou e kapa nei ma ke ʻano lapaʻau (Respiratory Depression) a i ʻole (Hypoventilation) .

He aha ka hoʻohaʻahaʻa hanu?

I ka ʻōlelo maʻalahi, ʻo ke kaumaha o ka hanu ( a i ʻole hypoventilation) ka wā e lohi loa ai kou hanu ʻana, a i ʻole ʻoe e hanu pāpaʻu loa. Ke hana ʻia kēia, ʻaʻole hana pono ka hoʻololi ʻana o ka ea i loko o kou mau māmā. E noʻonoʻo e pili ana i ia mea, ke hanu mākou, hele ka oxygen i loko o ka ea hou i loko o ke koko ma o nā ʻeke ea liʻiliʻi (alveoli) i loko o ko mākou mau māmā. Eia kekahi, ʻo ke kalapona ʻokikene (CO2) , he huahana ʻōpala no ko mākou kino, hoʻi i loko o nā māmā mai ke koko a hoʻokuʻu ʻia i waho. ʻO kēia ka mea a mākou e kapa nei he hoʻololi kinoea .

I kēia manawa, ma ke ʻano o (Hypoventilation) , ʻo ka mea e hana ʻia ana, no ka mea ʻaʻole ʻoe e hanu pono ana, ʻaʻole e haʻalele ke kinoea kalapona ʻokikene (CO2) i ke kino a hōʻiliʻili i loko o ke koko. Kāhea mākou i kēia (Hypercapnia) . ʻAʻole wale ia, i kekahi manawa ʻaʻole paha e loaʻa i nā māmā ka oxygen lawa. A laila emi ka pae oxygen i loko o ke koko, i kapa ʻia ʻo (Hypoxemia) . Maopopo iā ʻoe?

He aha nā hōʻailona?

Ke emi kou hanu ʻana (hypoventilation) , hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka luaʻi a me ka luaʻi.
• ʻEha poʻo.
• Manaʻo luhi, hiamoe , a palaualelo paha i nā manawa a pau.
• Ka huikau, ka huikau , a i ʻole ka loli o ke kūlana noʻonoʻo.
• Piʻi ka helu o ka puʻuwai.
• Pōʻaiʻī.
• Lohi, pāpaʻu, a luhi paha ka hanu ʻana.
• ʻO ke kala polū o ka ʻili, nā lehelehe, a i ʻole nā ​​​​kui lima (cyanosis) . He hōʻailona koʻikoʻi kēia.

He aha ke kumu o kēia?

ʻO nā kumu nui o ka pōkole o ka hanu ʻana, ʻo ia ka hoʻohana pono ʻole ʻana i kekahi mau lāʻau lapaʻau, ka overdose , a i ʻole kahi hopena i manaʻo ʻole ʻia i kekahi waiʻona a lāʻau lapaʻau paha. E noʻonoʻo i kēia mau mea:

• ʻO nā Opioids: Ua kapa ʻia kēia mau mea he narcotics . ʻO nā laʻana e komo pū me ka morphine , tramadol, oxycodone (OxyContin®) , a me ka fentanyl . Hoʻohana hewa kekahi poʻe i kēia mau lāʻau.
• Nā Benzodiazepines:ʻO kēia mau mea he mau lāʻau hoʻomaha a me nā lāʻau hiamoe. ʻO nā laʻana e like me ka lorazepam (Ativan®) , alprazolam (Xanax®) , a me diazepam (Valium®) .
• Barbiturates: Hāʻawi ʻia kēia mau lāʻau lapaʻau i kekahi manawa no ka hopu ʻana a i ʻole migraines .
• Nā lāʻau lapaʻau kū ʻole i ke kānāwai: Nā mea e like me ka heroin a me ka gamma hydroxybutyrate (GHB) .
• Nā lāʻau hiamoe: Nā lāʻau lapaʻau i kauoha ʻia e like me zolpidem (Ambien®) .
• Anesthesia: Hiki ke hana ʻia e ka lāʻau lapaʻau i hāʻawi ʻia e hoʻohiamoe iā ʻoe ma mua o ke ʻoki ʻana.

Ma waho aʻe o kēia mau lāʻau lapaʻau a me nā lāʻau lapaʻau, hiki i nā maʻi a me nā kūlana ʻē aʻe ke hana i ka hypoventilation :

• Momona: Ua kapa ʻia kēia ʻo Obesity Hypoventilation Syndrome (OHS) . ʻO ia hoʻi, lilo ka hanu ʻana i mea paʻakikī ma muli o ka momona.
• Nā kūlana e pilikia ai ka hanu ʻana: No ka laʻana, ka maʻi pulmonary obstructive mau loa (COPD) a me ka obstructive sleep apnea .
• Nā kūlana e hōʻemi ai i ka holo ʻana o ka hanu: No ka laʻana , ka hahau ʻana a me ka hypothyroidism .
• Nā kūlana e hoʻopilikia ai i ka iwi kuamoʻo, nā aʻalolo, a i ʻole ka kaohi ʻana o nā ʻiʻo: ʻO nā laʻana e pili ana i ka muscular dystrophy, nā maʻi aʻalolo a i ʻole ke kaula spinal, ka multiple sclerosis (MS) , a me ka amyotrophic lateral sclerosis (ALS) .
• Nā loli i ke ʻano o ka umauma a i ʻole ka iwi kuamoʻo: Nā kūlana e like me ka scoliosis ( curvature o ka iwi kuamoʻo), ankylosing spondylitis, a me ka flail chest .
• Nā mea ʻawahia a lāʻau make paha: Nā mea e like me ka tetanus , ka lāʻau ʻawahia ciguatera, a me ka botulism .

He aha nā mea e hoʻonui ai i ka pilikia?

Hiki ke piʻi aʻe ka pilikia o ka hanu pōkole ma muli o nā kumu i lalo:

• Hoʻohana pono ʻole ʻia nā lāʻau lapaʻau e like me opioids a i ʻole benzodiazepines .
• Inā ua hana ʻia ʻoe i ke ʻoki kino i hala koke nei (ma muli o ka anesthesia).
• Inā he mau maʻi o ka māmā, nā ʻiʻo, a me ka ʻōnaehana nerve (lolo a me ke kaula kuamoʻo), e like me kā mākou i kūkākūkā ai ma luna.

He aha nā pilikia e hiki ai i kēia ke hana?

ʻO ke kalapona ʻokikene i loko o kou kokoInā piʻi nui nā pae CO2, hiki iā ia ke hana i nā pilikia weliweli, a hiki ke hoʻoweliweli i ke ola. E nānā:

• ʻAcidosis hanu: ʻO ke ʻano kēia ua ʻoi aku ka waikawa o kou koko ma mua o ka mea e pono ai.
• Ka Holo ʻole o ka Hanu: ʻO kēia ka manawa ʻaʻole lawa ka oxygen i nā ʻiʻo o kou kino.
• Ka hopu ʻana o ka puʻuwai: Ke kū koke ʻana o ka puʻuwai.
• Koma.
• Ke koko kiʻekiʻe o ka puʻuwai: Hoʻonui ʻia ke kaomi i loko o nā kīʻaha koko e pili ana i nā māmā.

Pehea ʻoe e ʻike ai i kēia?

No ka ʻike ʻana i ke kaumaha o ka hanu ʻana , e nīnau mua ke kauka iā ʻoe e pili ana i kāu mau hōʻailona, ​​​​kou mōʻaukala olakino, a me nā lāʻau lapaʻau āu e lawe nei. A laila, hiki iā lākou ke kauoha i nā hoʻokolohua koko kūikawā e ana i ka nui o ke kalapona ʻokikene (CO2) i loko o kou koko. Hiki iā lākou ke kauoha i nā hoʻokolohua ʻē aʻe e ʻike pono i ke kumu o ka hypoventilation .

He aha ke ʻano o nā hoʻokolohua e hana ʻia?

Hiki ke hana i nā hoʻokolohua ma lalo nei e ʻike ai i ke kumu o ka pōkole o ka hanu:

• Hoʻāʻo Kinoea Koko Arterial: Nānā kēia i ka nui o ka oxygen, carbon dioxide, a me ka acidity i loko o ke koko.
• Nā Hoʻāʻo Hana Puʻuwai: He mau hoʻāʻo kēia e nānā i ka hana maikaʻi o kou mau māmā.
• ʻO ka Pulse Oximetry: He mea hana e ana i ka nui o ka oxygen i loko o kou koko ma ke kau ʻana i kahi clip liʻiliʻi i kou manamana lima. Ua ʻike paha ʻoe i kēia.
• Nā Hoʻāʻo Koko: Nui nā hoʻāʻo koko ʻē aʻe e hiki ke kōkua i ka ʻike ʻana i kēia kūlana a i ʻole kona mau kumu. ʻO nā laʻana e komo pū me ka Complete Blood Count (CBC) , Basic Metabolic Panel (BMP) , Toxicology Screen (e nānā i nā mea e like me nā lāʻau lapaʻau), Carbon Dioxide (CO2) blood test, a me Thyroid Function Tests.
• Kiʻi: Hiki i ke kauka ke kauoha i nā X-ray o kou umauma, nā scan CT (Computed Tomography scans) o kou umauma a i ʻole ke poʻo e nānā i nā kūlana ʻē aʻe.
• Haʻawina Hiamoe / Polysomnography: Kōkua kēia hoʻāʻo i ka ʻike ʻana i nā kūlana e like me ka apnea hiamoe a me ka maʻi momona hypoventilation syndrome .

Pehea e mālama ʻia ai?

ʻO ka mālama ʻana no ka pōkole o ka hanu e pili ana i ke kumu a me ke koʻikoʻi o ke kūlana. Hiki i nā mea lawelawe olakino ke hāʻawi iā ʻoe i nā lāʻau lapaʻau e like me:

• ʻO ka hoʻoulu ʻana i ka ea ʻaʻole i komo i loko o ka ʻōnaehana hanu: Pili kēia i ka hoʻohana ʻana i kahi mīkini e kōkua iā ʻoe e hanu ma o kahi pale maka e kūpono ana ma luna o kou maka. No ka laʻana, kahi mīkini Continuous Positive Airway Pressure (CPAP) a i ʻole kahi mīkini Bilevel Positive Airway Pressure (BiPAP®) . Ua lohe paha ʻoe i kēia mau mea.
• Nā Lāʻau Hoʻoulu Hanu: I kekahi manawa, inā hana ʻia kēia kūlana e ka overdose a i ʻole he hopena ʻaoʻao o ka lāʻau lapaʻau, hiki ke hāʻawi ʻia nā lāʻau lapaʻau reversal agent . No ka laʻana, inā hana ʻia kēia kūlana e nā opioids , hiki ke hoʻemi ʻia nā hopena ma ka hāʻawi ʻana i kahi lāʻau i kapa ʻia ʻo Naloxone/Narcan® .
• Lapaʻau Oxygen: Hiki ke hāʻawi ʻia ka oxygen inā pono.
• Ka Hoʻoulu ʻEa Mekanika: Inā koʻikoʻi loa ke kūlana, pono paha e hoʻomaha ʻia ke kanaka, e hoʻokomo i loko o kahi ʻōmole, a e hanu ka mīkini.

He aha ke ʻano o ke kūlana e hiki ke manaʻo ʻia i ka wā e hiki mai ana? (Outlook)

ʻO ka wānana no ka pōkole o ka hanu e pili ana i ke kumu. ʻO kahi pilikia, e like me ka overdose opioid , hiki ke make inā ʻaʻole mālama koke ʻia. Eia nō naʻe, inā ua hoʻokumu ʻia ke kūlana e ka apnea hiamoe, ka obstructive sleep apnea syndrome ( OHS ) e pili ana i ka momona, a i ʻole nā ​​​​​​kūlana lōʻihi ʻē aʻe, pono ia e mālama mau ʻia a e hoʻomaikaʻi mālie.

Hiki ke pale ʻia?

ʻO ke ala maikaʻi loa e pale aku ai i ka hanu pōkole, ʻo ia ka lawe ʻana i kāu mau lāʻau lapaʻau e like me ke kauoha a me ka mālama ʻana i nā kūlana olakino ma lalo. E hōʻoia e nīnau i kāu kauka a kauka lāʻau paha ma mua o ka lawe ʻana i ʻelua a ʻoi aku paha mau lāʻau lapaʻau, ʻoiai nā opioids a me nā benzodiazepines, e hoʻohaʻahaʻa i kou noʻonoʻo a hoʻohiamoe paha iā ʻoe. Eia kekahi , e makaʻala i nā hopena maikaʻi ʻole e hiki ke hana ʻia ke lawe ʻia kēia mau lāʻau lapaʻau me ka waiʻona.

"He hoaaloha ka lāʻau lapaʻau inā hoʻohana pono ʻia, akā, he ʻenemi inā hoʻohana hewa ʻia."

Āhea wau e ʻike ai i ke kauka?

E kamaʻilio me kāu kauka ma kēia mau hihia:

• Inā he mau nīnau a kānalua paha kāu e pili ana i kahi maʻi āu e loaʻa nei.
• Inā he mau nīnau a kānalua paha kāu e pili ana i kahi lāʻau i kauoha ʻia e ke kauka.
• Inā loaʻa iā ʻoe nā hōʻailona o ka pōkole o ka hanu, ʻoiai inā he mau pilikia olakino ʻē aʻe kāu e hoʻonui ai i kou pilikia.

I ka manawa hea ʻoe e hele ai i kahi Emergency Treatment Unit (ETU) ?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona koʻikoʻi , e hele koke i ka lumi pilikia kokoke loa:

• Inā loaʻa iā ʻoe nā ʻōʻili .
• Inā ua loli ke kūlana noʻonoʻo a aia ka huikau .
• Inā ʻoe e hiamoe loa a hiki ʻole iā ʻoe ke ala.
• Inā he huikau kou e pili ana i kou wahi a me kou manawa.
• Inā loaʻa iā ʻoe ka makaʻu a i ʻole ke kānalua kūikawā (paranoia) .
• Inā polū ka ʻili, nā kui, a i ʻole nā ​​lehelehe.

He aha nā nīnau āu e nīnau ai i ke kauka?

He mea kōkua paha ka nīnau ʻana i kāu kauka i nā nīnau e like me kēia:

• "No ke aha lā i hiki mai ai kēia iaʻu?"
• "He aha kaʻu e hana ai i mea e pale aku ai i kēia mea i ka wā e hiki mai ana?"
• "He aha nā koho lapaʻau e loaʻa iaʻu?"

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻO ke kaumaha hanu kahi maʻi koʻikoʻi kahi e hōʻiliʻili ai ke kalapona ʻokikene (CO2) i loko o kou koko. Akā hiki ke pale pinepine ʻia. Inā ʻoe e lawe ana i nā lāʻau lapaʻau e hiki ai ke hoʻoulu i ke kaumaha hanu, e kamaʻilio me kāu kauka e hōʻoia i kou lawe ʻana iā lākou me ka pololei a me ka palekana. Inā loaʻa iā ʻoe kekahi maʻi olakino ʻē aʻe e hiki ai ke hoʻoulu i kēia maʻi, e nīnau i kāu kauka e pili ana i nā hana hiki iā ʻoe ke hana e hōʻemi i kou pilikia. Hiki iā ia ke kamaʻilio me ʻoe e pili ana i kou mau hopohopo a hana i kahi hoʻolālā e mālama palekana i kou kūlana a me nā lāʻau lapaʻau. ʻO ka mālama ʻana i kou olakino ka mea nui loa.

ʻO ke kaumaha o ka hanu, ka nele o ka ea, ka emi ʻana o ka hanu ʻana, ke kalapona ʻokikene, ka oxygen, ka maʻi māmā, ka hoʻohana ʻana i nā lāʻau lapaʻau