Yu tink se di we aw yu de blo tu shalo? (Respiratory Depression/Hypoventilation) - Lɛ wi tɔk bɔt dis!

Yu dɔn ɛva fil lɛk se i nɔ izi fɔ yu fɔ blo, ɔ lɛk se yu rili nɔ gɛt bɛtɛ briz? Sɔntɛm yu bin de fil lɛk se yu de tɔn ɔ yu taya. Wan rizin we kin mek dɛn tin ya apin na we pɔsin nɔ de blo bɛtɛ, we na wetin wi kin kɔl (Respiratory Depression) ɔ (Hypoventilation) .

Wetin na diprɛshɔn we de mek pɔsin nɔ ebul fɔ blo fayn?

Fɔ tɔk am simpul wan, diprɛshɔn we yu de blo ( ɔ hypoventilation) na we yu de blo tumɔs, ɔ yu de blo tu shalo. we dis kin apin, di εkshεnj we di briz de chenj nכ de apin fayn fayn wan na yu lכng. Tink bɔt am, we wi de blo, ɔksijɛn we de na di fresh briz de go insay di blɔd tru di smɔl smɔl ay sak dɛn (alveoli) we de na wi lɔng. Dɔn bak, di kabon dayɔgzayd (CO2) , we na dɔti tin fɔ wi bɔdi, kin go bak na di lɔng dɛn frɔm di blɔd ɛn pul am. Dis na wetin wi kɔl gas ɛkshɛnj .

Naw, insay di kes fɔ (Hypoventilation) , wetin kin apin na dat bikɔs yu nɔ de blo fayn, da kabon dayɔgzayd (CO2) gas de nɔ de kɔmɔt na di bɔdi ɛn gɛda na di blɔd. Wi kɔl dis (Hypercapnia) . Nɔto dat nɔmɔ, sɔntɛnde di lɔng dɛn nɔ kin gɛt bɛtɛ ɔksijɛn. Dɔn di ɔksijɛn we de na di blɔd kin go dɔŋ, we dɛn kɔl (Hypoxemia) . Yu ɔndastand?

Wetin na di sayn dɛm we de sho se yu gɛt dis sik?

We yu nɔ de blo bɛtɛ (hypoventilation) , yu kin gɛt sɔm sayn dɛn lɛk:

• Nɔs ɛn vɔmit.
• Ed de at.
• Fɔ fil taya, slip , ɔ taya ɔltɛm.
• Disorientation, confusion , ɔr chenj na yu maynd.
• Di at rit de go ɔp.
• Diziz we pɔsin kin gɛt.
• Di brith kin fil slo, shalo, ɔr de wok tranga wan.
• Blu di kɔlɔ we de chenj na di skin, di lip, ɔ di finga nel (cyanosis) . Dis na sayn we rili siriɔs.

Wetin kin mek dis apin?

Di men tin dɛn we kin mek pɔsin nɔ ebul fɔ blo fayn na we i nɔ de yuz sɔm mɛrɛsin dɛn di rɔŋ we, we i tek am pasmak , ɔ we i gɛt sɔm kayn rɔm ɔ drɔgs we i nɔ bin de ɛkspɛkt. Tink bɔt dɛn tin ya:

• Opioid: Dɛn kin kɔl dɛn tin ya bak nakotik . Sɔm ɛgzampul dɛn na mɔfin , tramadɔl, ɔksikɔdɔn (OxyContin®) , ɛn fɛntanil . Sɔm pipul dɛn kin yuz dɛn drɔgs ya bad bad wan.
• Bɛnzodiazepin dɛn: .Bɔku tɛm, dɛn tin ya na tin dɛn we de mek pɔsin fil fayn ɛn tin dɛn we pɔsin kin yuz fɔ slip. Sɔm ɛgzampul dɛn na lorazepam (Ativan®) , alprazolam (Xanax®) , ɛn dayazepam (Valium®) .
• Barbiturates: Sɔntɛnde, dɛn kin gi dɛn mɛrɛsin ya fɔ mek pɔsin gɛt sik we de mek i sik ɔ fɔ mek i gɛt maygren .
• Ilɛgal drɔgs: Tin dɛn lɛk heroin ɛn gama hydroxybutyrate (GHB) .
• Pils fɔ slip: Na mɛrɛsin dɛn we dɛn kin gi yu lɛk zolpidem (Ambien®) .
• Anestesia: I kin kam bak wit di mɛrɛsin we dɛn gi yu fɔ mek yu slip bifo dɛn du yu ɔpreshɔn.

Apat frɔm dɛn mɛrɛsin ɛn mɛrɛsin ya, ɔda sik ɛn kɔndishɔn dɛn kin mek bak pɔsin nɔ gɛt bɛtɛ ventilashɔn :

• Fɔ fat: Dɛn kɔl dis Obesity Hypoventilation Syndrome (OHS) . I min se i kin at fɔ blo bikɔs i fat.
• Di tin dɛn we kin mek i nɔ izi fɔ blo: Fɔ ɛgzampul, di sik we dɛn kɔl chronic obstructive pulmonary disease (COPD) ɛn we kin mek i nɔ ebul fɔ blo fayn .
• Di tin dɛn we kin mek pɔsin nɔ ebul fɔ blo fayn: Fɔ ɛgzampul , strok ɛn haypotayroydism .
• di tin dεm we de afekt di spayna, nεv, כ mכsul kכntrכl: εgzampl dεm na mכskul dεstrofi, nεv כ spεnal kכd dizכrd, mכltipl sklεrosis (MS) , εn amyotrophic lateral sclerosis (ALS) .
• di chenj dεm na di shep fכ di chεst כ spayna: kכndyushכ n dεm lεk sכliכsis ( kכva fכ di spayna), ankylosing spondylitis, εn flail chεst .
• Pɔyzin ɔ pɔyzin: Tin dɛn lɛk tetanus , ciguatera toxicity, ɛn botulism .

Us tin dɛn kin mek di prɔblɛm bɔku?

Di risk fɔ mek yu nɔ blo fayn kin bɔku bikɔs ɔf dɛn rizin ya:

• Misyuz ɔf mɛrɛsin dɛn lɛk opioid ɔ benzodiazepines .
• If dɛn jɔs dɔn du ɔpreshɔn pan yu (bikɔs ɔf anestezi).
• If sɔm sik dɛn de na di lɔng, mɔsul, ɛn nervɔs sistɛm (bren ɛn spɛshal kɔd), lɛk aw wi bin dɔn tɔk bɔt ɔp.

Us prɔblɛm dɛn dis kin mek?

Kabon dayɔgzayd we de na yu blɔdIf di CO2 lɛvɛl tumɔs, i kin mek prɔblɛm dɛn we kin mek pɔsin denja, ivin we kin mek pɔsin in layf de pan denja. Tek wan luk:

• Respiratory Acidosis: Dis min se yu blɔd gɛt mɔ asid pas aw i fɔ bi.
• Respiratory Failure: Dis na we yu bɔdi in tisu dɛn nɔ de gɛt inof ɔksijɛn.
• Cardiac Arrest: Na di at we de stɔp wantɛm wantɛm.
• Kɔma.
• Pulmonary Hypertension: Na di prɛshɔn we de go ɔp na di blɔd vesel dɛn we gɛt kɔnekshɔn to di lɔng dɛn.

Aw yu kin no bɔt dis?

Fɔ no if yu gɛt pwɛl hat sik , dɔktɔ go aks yu fɔs bɔt yu sik, yu mɛrɛsin histri, ɛn ɛni mɛrɛsin we yu de tek. Dɔn, dɛn kin ɔda spɛshal blɔd tɛst fɔ no ɔmɔs kabon dayɔgzayd (CO2) de na yu blɔd. Dɛn kin ɔda ɔda tɛst dɛn bak fɔ no wetin de mek di bɔdi nɔ gɛt bɛtɛ ventilashɔn .

Us kayn tɛst dɛn kin du?

Dɛn kin du dɛn tɛst ya fɔ no di men tin we kin mek pɔsin nɔ ebul fɔ blo fayn:

• Atrial Blɔd Gas Tɛst: Dis kin chɛk di ɔksijɛn, kabon dayɔgzayd, ɛn asid we de na di blɔd.
• Pulmonary Function Tests: Dis na test dεm we de chɛk aw yu lכng dεm de wok fayn fayn wan.
• Pulse Oximetry: Na tin we de mɛzhɔ di ɔksijɛn we de na yu blɔd bay we i de tay smɔl klip na yu finga. Sɔntɛm yu dɔn si dis.
• Blɔd Tɛst: Bɔrku ɔda blɔd tɛst de wae kin ɛp fɔ no dis sik ɔr de kɔz am. Sɔm ɛgzampul dɛn na Kɔmplit Blɔd Kɔnt (CBC) , Besik Mɛtabolik Panɛl (BMP) , Tɔksikɔlɔji Skrin (fɔ chɛk fɔ tin dɛn lɛk drɔgs), Kabon Dayɔksayd (CO2) blɔd tɛst, ɛn Tayrɔyd Fɔnkshɔn Tɛst.
• Imajin: Dɔktɔ kin ɔda fɔ mek dɛn tek ɛkstrem rayt na yu chɛst, CT skan (Computed Tomography scans) fɔ yu chɛst ɔ ed fɔ luk fɔ ɔda tin dɛn we de ɔnda yu.
• Slip Stɔdi / Polisomnografi: Dis tɛst de ɛp fɔ no di tin dɛm lɛk slip apnea ɛn obesity hypoventilation syndrome .

Aw dɛn kin trit am?

Tritmɛnt fɔ shɔt briz de dipen pan di kɔz ɛn aw di sik tranga. Di wan dɛn we de kia fɔ yu wɛlbɔdi biznɛs kin gi yu tritmɛnt dɛn lɛk:

• Noninvasive Ventilation: Dis na fɔ yuz mashin we de ɛp yu fɔ blo tru wan mask we fit oba yu fes. Fɔ ɛgzampul, wan Kɔntinyu Pozitiv Aywe Prɛshɔn (CPAP) mashin ɔ wan Baylevɛl Pozitiv Aywe Prɛshɔn (BiPAP®) mashin. Sɔntɛm yu dɔn yɛri bɔt dɛn tin ya.
• Respiratory Stimulant Medications: Sɔntɛnde, if dis sik na bikɔs dɛn tek am pasmak ɔ na di sayd ɛfɛkt we wan mɛrɛsin gɛt, dɛn kin gi am mɛrɛsin dɛn we de mek pɔsin nɔ ebul fɔ blo fayn . Fɔ ɛgzampul, if dis sik na bikɔs ɔf opioid , dɛn kin ridyus di ifɛkt bay we dɛn gi wan mɛrɛsin we dɛn kɔl Naloxone/Narcan® .
• Ɔksijɛn Tɛrapi: Dɛn kin gi am ɔksijɛn if nid de.
• Mɛkanikal Ventileshɔn: If di sik rili siriɔs, i kin nid fɔ mek pɔsin fil fayn, put am na tiub, ɛn mek mashin blo.

Us kayn tin go apin we wi de go bifo? (Autluk) .

Di prɔgnosis fɔ shɔt briz de dipen pan di kɔz. Wan imejensi, lɛk fɔ tek opioid ɔvados, kin kil pɔsin if dɛn nɔ trit am kwik. Bɔt if dis sik na bikɔs ɔf slip apnɛa, obesity-related obstructive sleep apnea syndrome ( OHS ) , ɔ ɔda tin dɛn we kin apin fɔ lɔng tɛm, i go nid fɔ kɔntinyu fɔ trit am ɛn i go bɛtɛ smɔl smɔl.

Yu tink se dɛn go ebul fɔ stɔp am?

Di bɛst we fɔ mek yu nɔ blo shɔt na fɔ tek yu mɛrɛsin dɛn jɔs lɛk aw dɛn tɛl yu fɔ tek am ɛn fɔ kɔntrol ɛni sik we de ɔnda yu. Mek shɔ se yu aks yu dɔktɔ ɔ fama bifo yu tek tu ɔ mɔ mɛrɛsin, mɔ di opioid ɛn benzodiazepines, we de mek yu nɔ gɛt bɛtɛ maynd ɔ we de mek yu slip. Dɔn bak , no bɔt di bad tin dɛn we kin apin we pɔsin tek dɛn mɛrɛsin ya wit rɔm.

"Mɛdisin na padi if yu yuz am kɔrɛkt wan, bɔt na ɛnimi if yu yuz am kɔrɛkt wan."

Ustɛm a fɔ go to dɔktɔ?

Tɔk to yu dɔktɔ pan dɛn kayn tin ya:

• If yu gɛt ɛni kwɛstyɔn ɔr dawt bɔt wan mɛrɛsin wae yu gɛt.
• If yu gɛt kwɛstyɔn ɔ dawt bɔt wan mɛrɛsin we dɔktɔ gi yu.
• If yu gɛt sayn dɛm wae de sho se yu nɔr de blo fayn, mɔr lɛk if yu gɛt ɔda mɛrɛsin wae de mek yu gɛt mɔr sik.

Ustɛm yu fɔ go na Imejɛnsi Tritmɛnt Yunit (ETU) ?

If yu gɛt ɛni wan pan dɛn siriɔs sayn ya , go na di imejensi rum we de nia yu wantɛm wantɛm:

• If yu gɛt sik we de mek yu sik .
• If di mental stet dɔn chenj ɛn kɔnfyushɔn de .
• If yu fil so slip dat yu nɔ ebul fɔ wek.
• If yu gɛt disorientation bɔt usay yu de ɛn ustɛm yu de.
• If yu gɛt frayd ɔ saspek we nɔ kɔmɔn (paranoia) .
• If di skin, di nel, ɔ di lip tɔn blu.

Us kwɛstyɔn dɛn yu fɔ aks di dɔktɔ?

I go fayn fɔ aks yu dɔktɔ kwɛstyɔn dɛn lɛk dɛn wan ya:

• "Wetin mek dis apin to mi?"
• "Wetin a fɔ du fɔ mek sɔntin lɛk dis nɔ apin tumara bambay?"
• "Us tritmɛnt opshɔn dɛn a gɛt?"

Fɔ dɔn, tin dɛn fɔ mɛmba (Take-Home Message) .

Diprɛshɔn wae de mek yu nɔr de blo fayn na siriɔs sik wae de kam wit kabon dayɔgzayd (CO2) na yu blɔd. Bɔt bɔku tɛm, dɛn kin ebul fɔ stɔp am. If yu de tek mɛrɛsin wae kin mek yu nɔr de blo fayn, tɔk to yu dɔktɔ fɔ mek shɔ se yu de tek dɛn kɔrɛkt wan ɛn sef wan. If yu gɛt ɔda sik we go mek yu gɛt dis sik, aks yu dɔktɔ bɔt di tin dɛn we yu go du fɔ ridyus di prɔblɛm we yu gɛt. I kin tɔk to yu bɔt di tin dɛn we de mɔna yu ɛn mek wan plan fɔ mɛn yu sik ɛn di mɛrɛsin dɛn we yu de tek sef wan. Fɔ kia fɔ yu wɛlbɔdi na di tin we impɔtant pas ɔl.

` Diprɛshɔn we de mek pɔsin nɔ ebul fɔ blo fayn, we de mek pɔsin nɔ ebul fɔ blo fayn, we i nɔ de blo fayn, we gɛt kabon dayɔgzayd, ɔksijɛn, sik we de mek pɔsin in lɔng, we i de yuz drɔgs