Omukka gwa oxygen mu musaayi gwo gutuufu? Ka tuyige ku kukebera ABG (Arterial Blood Gas) mu ngeri ennyangu!

Ffenna tumanyi engeri omukka gwa oxygen gy’ali omukulu eri emibiri gyaffe. Okussa obulungi n’okubeera n’omukka omutuufu mu musaayi kyetaagisa nnyo okusobola okubeera omulamu obulungi. N’olwekyo, oluusi abasawo beetaaga okumanya obulungi omukka gwa oxygen ne carbon dioxide ebiri mu musaayi gwo. Wano we wakolebwa okukebera kuno okuyitibwa ABG (Arterial Blood Gas).

Okukebera kuno okwa ABG (Arterial Blood Gas) kye ki?

Mu ngeri ennyangu, okukebera ABG (Arterial Blood Gas) kwe kukebera okukozesa omusaayi oguggyiddwa mu musuwa gwo okupima obungi bwa oxygen ne carbon dioxide mu musaayi gwo. Lowooza ku kino, emisuwa gy’omusaayi mu mubiri gwaffe mulimu ebika bibiri, ekimu gwe misuwa, ate omulala gwe misuwa. Emisuwa gitwala omusaayi omuyonjo ogulimu omukka gwa oxygen okuva ku mutima okutuuka mu mubiri gwonna. Kale, ku kukebera kuno okwa ABG, omusaayi guggyibwa mu misuwa egyo.

Okukebera kuno tekukoma ku kupima oxygen ne carbon dioxide, naye era kupima acid-base balance , oba pH, y’omusaayi gwo. Mu budde obutuufu emibiri gyaffe gitereeza nnyo emiwendo gya oxygen ne carbon dioxide mu musaayi gwaffe. Singa omukka gwa oxygen mu musaayi gwaffe gukendeera (mu by’obujjanjabi gwe tuyita `hypoxemia`), kiyinza okuleeta obuzibu obw’amaanyi ennyo . Kiyinza okwonoona obwongo n’omutima naddala.

Okukebera kwa ABG kuyamba abasawo okutegeera endwadde ezikwata ku nkola yo ey’okussa , enkola y’okutambula kw’omusaayi , n’enkola y’okukyusakyusa emmere (engeri gy’okyusaamu emmere gy’olya okugifuula amaanyi). Kino kikulu nnyo naddala mu mbeera ez'amangu .

Waliwo okukebera okulala okuyitibwa "okukebera omukka mu musaayi." Mu kukebera kuno, omusaayi gusobola okuggyibwa wonna mu mubiri (omusuwa, omusuwa oba emisuwa). Kyokka mu kukebera ABG, omusaayi gulina okuggyibwa mu musuwa .

Ekigezo kino ekya ABG kirina amannya amalala agawerako:

• Okukebera omukka mu musaayi
• Gaasi z’omusaayi mu misuwa
• ABG
• Okwekenenya omukka mu musaayi

Kiki ddala ekigezo kya ABG kipima?

Ekigezo kya ABG kitera okupima:

• Oxygen content (O2CT) : Kino kipima oxygen ali mu musaayi gwo.
• Hemoglobin : Hemoglobin ye puloteyina esangibwa mu butoffaali bwaffe obumyufu obutambuza omukka gwa oxygen mu mubiri gwonna. Kino kipima obungi bwa hemoglobin.
• Oxygen saturation (O2Sat) : Kino kipima oxygen mmeka etambuzibwa hemoglobin mu musaayi gwo.
• Partial pressure of oxygen (PaO2) : Kino kipima puleesa ya oxygen esaanuuse mu musaayi gwo. Kiraga engeri omukka gwa oxygen gy’ayingira obulungi mu musaayi gwo okuva mu mawuggwe go.
• Puleesa y’ekitundu kya kaboni dayokisayidi (PaCO2): Kino kipima obungi bwa kaboni dayokisayidi mu musaayi gwo n’engeri kaboni dayokisayidi gy’aggyibwamu obulungi mu mubiri gwo.
• pH (`pH`) : Kino kipima bbalansi wakati wa asidi ne base mu musaayi gwo. Mu budde obwabulijjo, pH y’omusaayi erina okuba wakati wa 7.35 ne 7.45. Ekintu kyonna ekitono okusinga ekyo kitwalibwa nga kya asidi nnyo, ate ekintu kyonna ekisinga ku ekyo kitwalibwa nga kya basic oba alkaline ennyo .
• Bicarbonate (`Bicarbonate - HCO3`) : Kino kibalirirwa nga tukozesa pH ne PaCO2. Kisalawo obungi bw’ekirungo kya base ekikolebwa okuva mu kaboni dayokisayidi.

Okukebera ABG kukolebwa ddi?

Abasawo batera okulagira okukeberebwa ABG mu mbeera nga zino:

• Eddagala ery’amangu : Kino kitegeeza endwadde oba obubenje obwetaagisa okujjanjabibwa mu bwangu.
• Anesthesiology : Ekitundu ky’obusawo ekikwata ku kulabirira abalwadde nga tebannalongoosebwa, nga balongooseddwa, n’oluvannyuma lw’okulongoosebwa.
• Pulmonology : Ekitundu ekikola ku ndwadde ezikwatagana n’enkola yo ey’okussa.

Abasawo bakozesa okukebera ABG okuzuula embeera eziwerako omuli:

• Acute respiratory distress syndrome (ARDS) : Eno embeera y’amawuggwe eyinza okutta omuntu era ereeta omukka gwa oxygen okutono mu musaayi mu ngeri ey’akabi. Kiyinza okuva ku mbeera nga sepsis ne COVID-19.
• Obulwadde bwa sepsis obw’amaanyi : Obulwadde bwa sepsis mbeera ya mangu ey’obujjanjabi eyinza okutta omuntu ng’eva ku ngeri omubiri gwo gye gukwatamu yinfekisoni.
• Septic shock : Eno era mbeera ya bulabe eri obulamu nga puleesa yo ekka mu ngeri ey’akabi oluvannyuma lw’okukwatibwa yinfekisoni.
• Hypovolemic shock : Embeera ey’amangu ng’omutima tegusobola kussa musaayi gumala mu mubiri olw’okufiirwa omusaayi omungi oba okufiirwa amazzi amalala.
• Diabetes-related ketoacidosis (DKA) : Kino kizibu kya maanyi, ekitta obulamu era nga kikwata abantu abalina ssukaali (naddala ssukaali ow’ekika kya 1) ne sukaali ow’ekika kya 1 atazuuliddwa. Kivaako omusaayi okufuuka asidi.
• Renal tubular acidosis (RTA) : Mu mbeera eno, ensigo zo teziggya bulungi asidi mu musaayi gwo mu musulo gwo, ekivaako omusaayi gwo okweyongera okubeera asidi.
• Acute respiratory failure : Kino amazzi bwe gakuŋŋaana mu nsawo z’empewo mu mawuggwe go, ne kizibuwalira amawuggwe okufulumya omukka gwa oxygen mu musaayi.
• Omutima okulemererwa ennyo: Eno mbeera omutima mwe gunafuwa mu bwangu ate n’emirimu gyagwo ne gikoma.
• Omutima okusiba : Kino omutima lwe gukoma okukuba mu bwangu.
• Obulwadde bwa asima : Obubonero bwa asima obweyongera mu bwangu obuva ku kunywezebwa kw’ebinywa ebyetoolodde emikutu gy’empewo.
• Ensobi ezizaalibwa mu nkyukakyuka y’emmere : Zino embeera ezitatera kubaawo, ez’obuzaale (ezisikira) omubiri gwo mwe gutasobola kukyusa bulungi mmere mu maanyi.

Bw’oba ​​olina emu ku mbeera zino ez’amawuggwe, omusawo ayinza n’okukeberebwa ABG okulaba oba obujjanjabi bwo bukola bulungi:

• Obulwadde bwa asima
• Obulwadde bw’amawuggwe obutawona (COPD) .
• Obulwadde bwa Cystic fibrosis
• Obulwadde bw’omutima

Ani akola okukebera kwa ABG?

Omusawo w’okussa atera okutwala omusaayi okukeberebwa ABG. Ziggya omusaayi mu musuwa oguli mu mukono gwo, mu mukono gwo oba mu kisambi kyo. Oluvannyuma beekebera omusaayi bo bennyini, oba ne bagusindika mangu nnyo mu laboratory, bannassaayansi mu laboratory y’ebyobujjanjabi gye bakebera sample.

Kiki ekibaawo nga tebannaba kukeberebwa ABG?

Omusawo w’okussa nga tannaggya musaayi ku mukono gwo, bayinza okukola okukebera okutambula kw’omusaayi okuyitibwa Allen test . Kino kizingiramu okukwata omukono gwo waggulu ng’omukono gwo gukutte ekikonde. Omusawo ajja kunyiga ku musuwa mu ngalo yo okumala sekondi ntono. Okukebera kuno okwangu kukebera oba emisuwa gyombi mu mukono gwo gikola bulungi era nga giggule.

Bw’oba ​​oli ku bujjanjabi bwa oxygen obw’okugatta, omusawo ayinza okuggyako omukka gwa oxygen ng’ebula eddakiika nga 20 okuggyibwako omusaayi. Kino kiyitibwa okugezesa empewo mu kisenge . Wabula bw’oba ​​tosobola kussa nga tolina mukka gwa oxygen ogw’okugatta, tebajja kukola kukebera kuno.

Obumanyirivu bwa ngeri ki bw’ofuna ng’okola ekigezo kya ABG?

Okukebera omusaayi okusinga kuggya omusaayi mu musuwa gwo. Naye okukeberebwa ABG, omusawo w’okussa aggya omusaayi mu musuwa gwo . Kino kiri bwe kityo kubanga omusaayi mu misuwa gulimu omukka gwa oxygen mungi okusinga omusaayi gw’emisuwa.

Omusawo w’okussa atera okuggya omusaayi mu musuwa oguyitibwa radial artery munda mu ngalo yo. Oluusi bayinza n’okuggya omusaayi mu musuwa oguli mu mukono gwo (brachial artery) oba mu kifuba (femoral artery).

Singa omwana eyaakazaalibwa yeetaaga okukeberebwa ABG, omusawo ayinza okuggya omusaayi mu kisinziiro oba mu nnabaana w’omwana.

Ekikulu: Okuggya omusaayi mu musuwa ebiseera ebisinga kiyinza okukuluma katono okusinga okuggya omusaayi mu musuwa. Kino kiri bwe kityo kubanga emisuwa giba mu buziba mu mubiri okusinga emisuwa, era giba n’obusimu obugyetoolodde. Oyinza okuwulira ng’olina ekiziyiro ekitono, ng’omutwe guziyira oba ng’oziyira ng’oggyiddwamu omusaayi.

Bino bye bikolwa by’olina okugoberera ng’okwata omusaayi okwekebejjebwa ABG:

1. Ojja kutuula mu ntebe oba ng’ogalamidde ku kitanda. Omusawo w’okussa ajja kusanga omusuwa, ebiseera ebisinga munda mu ngalo yo. Bayinza n’okukozesa ultrasound scan (`ultrasound imaging`) okuzuula omusuwa.

2. Omusuwa bwe guzuulibwa, ekifo ekyo kiyonjebwa ne kitta obuwuka.

3. Olwo bajja kuyingiza empiso entono mu musuwa gwo ne bakuggyamu omusaayi. Oyinza okuwulira obulumi obw’amaanyi ng’empiso egenda mu musuwa.

4. Oluvannyuma lw’okuyingiza empiso, omusaayi omutono gukuŋŋaanyizibwa mu mpiso.

5. Bwe bamala okutwala omusaayi ogumala okukeberebwa, bajja kuggyamu empiso ne bassa puleesa mu kifo ekyo nga bakozesa akatundu ka ppamba oba gaasi okukomya okuvaamu omusaayi. Bw’oba ​​omira eddagala eriweweeza ku musaayi, kiyinza okukwetaagisa okukwata puleesa okumala eddakiika ttaano oba kkumi oba okusingawo.

6. Bassaako bbandi ku kitundu. Olwo omulimu ne guggwa.

Kiki ky’oyinza okusuubira oluvannyuma lw’okukeberebwa ABG?

Oyinza okuwulira ebiwundu ebimu ne/oba okulumwa empiso we yayingizibwa. Omusawo ayinza okukugamba nti tositula kintu kyonna kizito okumala essaawa 24 ng’omaze okuggyibwako omusaayi.

Waliwo akabi konna akali mu kukeberebwa kwa ABG?

Singa omusawo w’okussa akola okukebera kuno mu butuufu, okukebera kwa ABG kuba kwa bulabe butono nnyo . Emisuwa gya buli muntu gya sayizi ya njawulo, era gyawukana okuva ku ludda olumu olw’omubiri okudda ku lulala. Kale kiyinza okuba ekizibu katono okuggya omusaayi mu bantu abamu okusinga abalala.

Obulabe obuva mu kuggyibwako omusaayi okukeberebwa ABG butono nnyo, naye ebintu nga bino bisobola okubaawo:

• Okuwulira ng’oziyira oba ng’omutwe guzibye.
• Okubeera n’okukuba empiso emirundi egiwerako okuzuula omusuwa.
• Okuzimba omusaayi (a hematoma - okukuŋŋaanyizibwa kw’omusaayi wansi w’olususu).
• Okuvaamu omusaayi ekisusse.
• Obulwadde (waliwo akabi akatono essaawa yonna olususu lwe lumenyese).

Kitwala bbanga ki okufuna ebyava mu kukeberebwa kwa ABG?

Ebigezo bya ABG bitera okuwa ebivuddemu mu bwangu nnyo . Abasawo abajjanjaba okussa ne bannassaayansi mu laboratory batera okukozesa ebyuma ebikebera omukka mu musaayi mu ngeri ey’otoma, ebiyinza okuvaamu ebivaamu mu ddakiika 10-15.

Ebyava mu kukeberebwa kwa ABG byogera ki?

Lipoota z’okukebera omusaayi, omuli ne lipoota z’okukebera ABG, zitera okubaamu ebikwata ku musaayi bino wammanga:

• Erinnya ly’omusaayi ogukeberebwa oba ebyo ebyapimibwa mu musaayi gwo.
• Ennamba oba ekipimo ky’ebyava mu kukeberebwa omusaayi gwo.
• Ekyo kye kipiimo ekya bulijjo eky’okugezesebwa.
• Amawulire agalaga oba ebyavaamu byo bya bulijjo, si bya bulijjo, oba waggulu oba wansi.

Singa ebyava mu kukeberebwa kwo okwa ABG tebiba bya bulijjo, kiyinza okutegeeza ebintu nga:

• Tofuna oxygen emala.
• Tofulumya mukka gwa kaboni dayokisayidi ogumala.
• Omusaayi gwo gulina pH obutakwatagana (oba asidi nnyo oba alkaline ennyo).

Okukebera ABG kuyinza okuyamba okuzuula endwadde ezimu. Singa ebyavaamu tebiba bya bulijjo, omusawo ayinza okulagira okukeberebwa okulala (nga okukeberebwa omusaayi okulala ne/oba sikaani) okukakasa oba okugaana nti omuntu azuuliddwa.

Miwendo ki egya bulijjo egy’okukebera ABG?

Ensimbi eza bulijjo zisobola okwawukana katono okuva ku laabu okudda ku ndala. Bw’onoofuna ebyava mu kukebera omusaayi gwo, bijja kubaamu amawulire agalaga ebipimo ebya bulijjo bye biri ku buli kipimo okuva mu laabu eyo. Bw’oba ​​olina ekibuuzo kyonna ku bivudde mu kunoonyereza kwo, kakasa nti obuuza omusawo wo .

Okutwalira awamu, emiwendo gya wakati ku mutindo gw’ennyanja giri bwe giti:

• pH : 7.35-7.45
• Puleesa y’ekitundu kya okisigyeni (`PaO2`) : milimita 75 ku 100 eza mercury (mmHg) .
• Puleesa y’ekitundu kya kaboni dayokisayidi (`PaCO2`) : 35 ku 45 mmHg
• Bicarbonate (`HCO3`) : 22 okutuuka ku 26 milienkanankana buli liita (mEq/L) .
• Okujjula kwa oxygen (`O2Sat` oba `SaO2`) : 95% okutuuka ku 100% .

Ku buwanvu bwa ffuuti 3,000 (mita 900) n’okudda waggulu, omukka gwa oxygen ogwa wakati guba wansi nnyo.

Ddi lwe nnina okulaba omusawo wange?

Bw’oba ​​olina obulwadde bw’amawuggwe obutawona nga COPD oba asima, kirabika ojja kwetaaga okulaba omusawo wo buli kiseera n’okukeberebwa ABG okukakasa nti obujjanjabi bwo bukola bulungi. Bw’ofuna obubonero bwonna obweraliikiriza obukwata ku bulwadde bw’amawuggwe, yogerako n’omusawo wo amangu ddala nga bwe kisoboka.

N’ekisembayo, ebintu by’olina okujjukira

An ABG test is a useful diagnostic tool , naddala mu mbeera ezimu ez’amangu. Abasawo era bakozesa okukebera kuno okulondoola embeera z’obulamu ezimu. Bw’oba ​​okeberebwa ABG, kimanye nti nkola ya njawulo katono ku ya bulijjo, era eyinza okukuluma katono. Bw’oba ​​olina ekibuuzo kyonna ku nkola eno oba ky’osuubira, tolwawo kubuuza musawo wo . Bali wano okukuyamba.

` Okukebera omukka mu musaayi, ggaasi y’omusaayi mu misuwa, oxygen, carbon dioxide, pH value, enkola y’okussa, okukebera eby’obujjanjabi