Tulina ne kuyiga ku ‘Perfusion Pressure’, so si puleesa yokka gye tuwulira mu mibiri gyaffe?

Oboolyawo owuliddeko ku ‘puleesa’, nedda? Naye leero tugenda kwogera ku kintu ekikulu kyenkanyi, naye mpozzi towulidde nnyo ku nsonga eyo. Oyo ye 'Perfusion Pressure'. Mu ngeri ennyangu, eno ye puleesa eyeetaagisa okusobola okusiba omusaayi mu bitundu by’omubiri gwaffe eby’enjawulo. Puleesa eno bw’eba entuufu, ebitundu byaffe bye bisobola okufuna omukka gwa oxygen n’ebiriisa bye byetaaga.

‘Perfusion Pressure’ kye ki? Ka tukitegeere mu ngeri ennyangu.

Teebereza, okusobola okufukirira ebimera mu lusuku lwo, weetaaga okubaawo puleesa ennungi mu payipu eva mu ppampu y’amazzi, nedda? Mu ngeri y’emu, ebitundu ebisinga obukulu mu mubiri gwaffe, kwe kugamba omutima, obwongo, ensigo, bino byonna, okusobola okufuna omukka gwa oxygen n’ebiriisa nga biyita mu musaayi, kino kye bayita ‘perfusion pressure’ kiteekwa okuba nga kiri mu kifo. Mu ngeri ennyangu, ‘perfusion pressure’ ye puleesa entuufu eyeetaagisa okugabira omusaayi mu kitundu oba ekitundu ky’omubiri. Kasita puleesa eno eba ku ddaala erimala, ekitundu ekyo kijja kufuna omusaayi ogwetaagisa. Eno y’ensonga lwaki kino kitundu kikulu nnyo mu nkola yaffe ey’okutambula kw’omusaayi. Teebereza, kiki ekibaawo singa puleesa eno ekendeera mu bifo ebimu? Awo we wava ebizibu ebinene. Okukendeera kuno mu puleesa kuyinza okuba okw’akabi naddala mu mutima ne ku bwongo bwaffe. Kubanga ebitundu bino bwe bitafuna musaayi bulungi, kiyinza okuvaako embeera ez’amaanyi, oluusi eziyinza okutta omuntu.

‘Pleesa eno ey’okufuuwa omusaayi’ ekola etya?

Omutima gwaffe gulinga ppampu. Kikola obutasalako, si bwe kiri? Buli omutima gwaffe lwe gukuba, gusika omusaayi omutono okuva mu mutima ne gugusindika mu misuwa (emisuwa) mu mubiri gwaffe gwonna. Olwo omusaayi guno ne guva mu misuwa okutuuka mu misuwa. Awo omukka oguyitibwa oxygen mu musaayi w’awanyisiganyizibwa n’obutoffaali bw’omubiri gwaffe. Omulimu ogwo bwe gukolebwa, omusaayi oguli mu misuwa gudda mu mutima nga guyita mu misuwa. Enzirukanya eno ebaawo buli sikonda omutima lwe gukuba. Kale enkola eno okukola obulungi, ekiyitibwa ‘perfusion pressure’ kyetaagisa nnyo.

Omanya otya oba ‘perfusion’ eno etambula bulungi?

Okukebera okufuuwa omusaayi (perfusion tests) okutazingiramu bitundu bya mubiri munda mu mubiri ebiseera ebisinga kutandikira ku kyuma ekiyitibwa pulse oximeter. Oboolyawo okirabye, oluusi oteeka ekyuma ekiringa clip ku ngalo yo okukebera oxygen mu musaayi gwo. Ekyo kye kiri. Kisindika ekitangaala ekimyufu ne infrared okuyita mu lususu lwo. Molekyulu eri mu musaayi gwaffe eyitibwa hemoglobin etambuza omukka gwa oxygen. Hemoglobin eno enywa ekitangaala mu ngeri ya njawulo nga etambuza omukka gwa oxygen ate nga tegutambuza. Ng’okozesa enjawulo eyo, ekipima omukka gw’omukka (pulse oximeter) kisobola okubala omukka gwa oxygen gwe guli mu musaayi gwo n’okumanya oba omusaayi gutuuka bulungi mu kitundu ekimu. Ebimu ku bipima pulse oximeters zino biringa clip gy’oteeka ku ngalo. Ebimu bijja ne sensa gy’onyiga ku lunwe oba awalala, ng’akasiiga. Oluusi kino osobola okukiyunga ku kikuta ky’amatu oba mu kyenyi.

Kale kino ‘Perfusion Index’ kye ki?

Perfusion Index (PI) kye kipimo ky’omusaayi bwe gutambula obulungi mu kitundu ky’omubiri gwo ekigere. Kipima obungi bw’omusaayi ogutaliimu mukka gwa oxygen mu kitundu ekyo bw’ogeraageranya n’omuwendo gw’omusaayi ogutaliimu mukka gwa oxygen. Obusobozi bwe bumu obwa pulse oximeter okupima obungi bwa oxygen mu musaayi era buyamba ku Perfusion Index. Nga tupima obungi bwa oxygen obutwalibwa hemoglobin, kisoboka okupima obungi bw’omusaayi omupya (i.e. omusaayi ogukyalina oxygen) ogukulukuta mu kitundu ekyo. Enkola ya Peripheral Perfusion Index nkola ekozesa omusingi guno okuyamba abasawo okwekenneenya n’okujjanjaba omuntu omulwadde. Omuwendo omutono kitegeeza nti oba omutima gwo tegukuba musaayi gumala, oba waliwo ekiremesa omusaayi okutambula obulungi mu bitundu by’omubiri gwo ebisinga okuba ewala n’omutima gwo (nga emikono n’amagulu).

Njawulo ki eriwo wakati wa ‘Perfusion Index’ ne ‘Blood Pressure’?

Bino byombi bipimo ku ngeri enkola yaffe ey’okutambula kw’omusaayi gy’ekola obulungi. Naye enkola za njawulo, era tezipima kintu kimu.

• Perfusion Index: Kino kipimo omusaayi bwe gukulukuta mu kitundu ekimu. Omuwendo ogusingako gulaga nti omusaayi gutambula bulungi . Omuwendo omutono guyinza okulaga nti olina obuzibu ku mutima gwo oba emisuwa gyo .
• Puleesa : Eno epima puleesa eri munda mu misuwa gyo, epimibwa mu milimita za mercury (mm/Hg). Waliwo omuwendo ogw’okungulu n’ogw’okunsi. Omuwendo ogwa waggulu (`Systolic` pressure) gwe puleesa eri ku misuwa buli omutima lwe gukuba. Omuwendo ogwa wansi (` Diastolic` pressure) gwe puleesa ku misuwa wakati w’okukuba kw’omutima emirundi ebiri.

Ekikulu: Okuva bwe kiri nti bino ebibiri bipima ebintu eby’enjawulo, toyinza kulowooza nti ekimu kirungi ate ekirala nakyo kirungi. Byonna bikulu.

‘Prefusion pressure’ ekola etya mu mutima gwo?

Omutima gwaffe kinywa ekyetaaga okukola obutasalako mu bulamu bwaffe bwonna. Omutima okusobola okukola obulungi omulimu gwagwo, gwetaaga omukka gwa oxygen buli kiseera. Kino kifuna okuva mu misuwa egy'enjawulo egyayitibwa coronary arteries . Teebereza, omutima gukozesa wakati wa 70% ne 80% ku oxygen ayita mu misuwa gino! Tewali kitundu kirala kikozesa omukka gwa oxygen mungi nga guno.Coronary Perfusion Pressure (CPP) y’ekuuma omusaayi nga gukulukuta mu misuwa gino. Singa puleesa eno ekka, omutima tegufuna musaayi na mukka gwa oxygen bimala. Kino kiyinza okuvaako ebizibu ebiyinza okutta omuntu.

Kino okisanga otya?

Pulse oximetry tekozesebwa kupima puleesa ya coronary perfusion (CPP). Kino okupima, abasawo bakwata ebipimo ebirala bibiri ne babikozesa okubala puleesa y’okufuuwa omusaayi mu mutima. Ebipimo bino bisobola okukolebwa nga bakozesa echocardiography (okusika omutima) oba nga bakozesa heart catheterization ( okukebera nga mu mutima bayingizibwa ttanka ennyimpi). Ebipimo bino ebibiri bye bino: 1. Aortic Diastolic Pressure: Eno ye puleesa eri mu aorta yo (omusuwa ogusinga obunene ogutwala omusaayi okuva ku mutima okutuuka mu mubiri gwonna) wakati w’okukuba kw’omutima. Kino kizuulibwa nga opima ‘puleesa’ yo eya bulijjo. Eno ye nnamba eya wansi (`Diastolic` pressure) eya puleesa yo . 2. ‘Left Ventricular End-Diastolic Pressure` (LVEDP): Eno ye puleesa eri munda mu kisenge kya kkono, ekimu ku bisenge bibiri ebya wansi eby’omutima, wakati w’okukuba kw’omutima emirundi ebiri. Kati ‘puleesa eno ey’okufuuwa omusaayi’ (CPP) esangibwa bweti: ‘Pleesa y’omusuwa gw’omusuwa’ - ‘Pleesa y’omusuwa gwa kkono End-Diastolic’ = ‘Pleesa y’okufuyira omusuwa’.

Kale ‘perfusion pressure’ eno ekosa etya obwongo?

Oluvannyuma lw’omutima, ekitundu ekirala ekikulu ekyetaaga omukka gwa oxygen bwe bwongo bwaffe. Cerebral Perfusion Pressure (CPP) y’ekakasa nti omusaayi gutambula bulungi mu bitundu by’obwongo byonna. Singa obwongo tebufuna musaayi gumala, osobola okuzirika mu sikonda ntono. Bwe kityo bwe kiri ekikulu.

Kino okisanga otya?

Okukebera kubiri nakyo kyetaagisa okubala ‘cerebral perfusion pressure’ (CPP) y’obwongo. 1. Puleesa: Okusooka, ‘puleesa’ epimibwa. Olwo, abasawo babala ‘Mean Arterial Pressure’ (MAP) . MAP eno ye puleesa eya wakati mu misuwa gyo mu kiseera ky’omutima gumu (ekiseera wakati w’omutima gwo lwe gukonziba n’okuwummulamu). MAP eno ebalirirwa bweti:

• Kubisaamu ennamba eya wansi eya ‘puleesa’ yo (`Diastolic` pressure) ku bibiri.
• Gatta omuwendo waggulu (`Systolic` pressure) ku ky'okuddamu ky'ofuna.
• Byonna bigatte waggulu ogabane omuwendo oguvaamu ku 3. (MAP = [Systolic BP + (2 x Diastolic BP)] / 3)

2. Puleesa y'omutwe (ICP): Puleesa y'omutwe kitegeeza "munda mu kiwanga." Wakati w’obwongo bwaffe n’eggumba ly’ekiwanga waliwo amazzi g’omu bwongo (CSF).Waliwo amazzi agayitibwa puleesa y’omutwe (intracranial pressure). ICP eno ye puleesa yonna munda mu kiwanga olw’obwongo bwo, omusaayi oguli mu kyo, n’amazzi ga CSF. Waliwo enkola ez’enjawulo ez’okupima kino, era oluusi olina okuyingiza ekivuga ekiweweevu mu kiwanga. Kati, ‘puleesa y’okufuyira mu bwongo’ (CPP) esangibwa bweti: ‘Pleesa y’emisuwa ey’amakulu’ (MAP) - ‘Pleesa y’omu mutwe’ (ICP) = ‘Pleesa y’okufuyira mu bwongo’ (CPP) .

Embeera ki ez’obujjanjabi eza bulijjo ezireetebwa ebizibu ebikwatagana ne ‘perfusion pressure’?

Ekizibu ekikulu ekibaawo nga tewali ‘perfusion pressure’ emala wonna mu mubiri gwo kiyitibwa ‘ischemia’ . Kino kitegeeza nti ekitundu ekyo tekifuna musaayi gumala, n’olwekyo tekifuna mukka gwa oxygen n’ebiriisa bimala. Singa ‘ischemia’ eno ebaawo mu mukono oba ekigere, ebitundu ebiri mu kitundu ekyo bisobola okutandika okufa. Kino kiyinza okuvaako ebintu nga ‘gangrene’ (okuvunda kw’ebitundu by’omubiri) n’okukwatibwa yinfekisoni. Singa kino kikosa ekitundu ekinene, ekitundu ekyo kiyinza okutandika okulemererwa mpolampola, ekiviirako ebizibu eby’amaanyi ennyo, n’okufa. Wano waliwo ezimu ku mbeera eziyinza okuva oba ezikwatagana n’ebizibu bya ‘perfusion pressure’:

• Omutima okulwala
• Omutima okulemererwa
• Obulwadde bw’emisuwa gy’omusaayi
• Storoko
• Okusannyalala kw’omutima
• Cerebral hypoxia (okwonooneka kw’obwongo obuva ku butabeera na oxygen mu bwongo) .
• Obulwadde bw’emisuwa
• Amabwa mu magulu n’ebigere
• Obulwadde bwa Raynaud (okukendeeza ku musaayi mu bitundu by’omubiri) .

Kiki kye nnyinza okukola okukuuma ‘puleesa yange ey’okufuuwa omusaayi’ ku mutindo ogutaliiko bulabe?

‘Prefusion pressure’ yo naddala mu mutima n’obwongo, ebiseera ebisinga si kizibu okuggyako ng’olina obulwadde obw’enjawulo obukwata ku mutima gwo n’enkola y’okutambula kw’omusaayi. Wabula osobola okukola ebintu bino okutangira oba okulwawo okukula kw’endwadde zino:

• Kuuma omugejjo omulungi. Si kirungi kuba munene nnyo oba mugonvu nnyo.
• Lya emmere ennungi. Lya emmere erimu amafuta amatono, omunnyo, ne ssukaali, ate ng’erimu ebibala n’enva endiirwa.
• Lekera awo okukozesa ebintu ebikolebwa mu taaba (omuli taaba ataliimu mukka ne vaping). Bino bireeta okwonooneka okw’amaanyi mu misuwa.

"Lowooza ku kino, obulamu obulungi bulinga okulabirira emibiri gyaffe. Nga bwe tukola saaviisi y'emmotoka okugikuuma mu mbeera ennungi, naffe twetaaga okulabirira obulungi emibiri gyaffe."

Engeri esinga okuzuula obuzibu bwonna obuyinza okuba nga bukosa ‘puleesa y’okufuuwa’ kwe kwekebejja omubiri buli mwaka.Kino era kiyitibwa ‘okukebera obulamu obulungi’. Bw’oba ​​okeberebwa mu ngeri ennyangu ng’olaba omusawo, emirundi mingi osobola okuzuula ebizibu eby’amaanyi nga tonnaba na kulaga bubonero. Bw’ozikwata nga bukyali, osobola okufuna obujjanjabi n’okomya okwonooneka okw’olubeerera oba okukendeeza ku buzibu bwazo. Bw’oba ​​olina edda embeera ekosa ‘perfusion pressure’, kakasa nti olaba omusawo buli kiseera okulondoola embeera yo n’okufuna obujjanjabi bwe kiba kyetaagisa. Ekirala, goberera ebiragiro by’omusawo n’okumira eddagala nga bwe likulagidde. Bw’oba ​​olina ebibuuzo oba nga weetaaga obuyambi, omusawo wo y’asinga okwogera naye.

Obubaka Obusembayo Okutwala Awaka

Puleesa y’okufuuwa omusaayi yeetaagibwa nnyo buli kitundu ky’omubiri gwaffe, buli kitundu ky’omubiri, okukola obulungi. Awatali ‘perfusion’ eno, omusaayi tegukulukuta mu bifo byonna we gwetaaga. Obutatambula buno obw’omusaayi buyinza okuvaamu ebizibu eby’amaanyi oluvannyuma lw’ekiseera, oba n’okuleetawo ebizibu eby’amaanyi ebiyinza okutta omuntu. Bw’oba ​​oyagala okumanya ebisingawo ku ‘perfusion pressure’ eno n’engeri gy’ekukwatamu, kakasa nti oyogera n’omusawo. Bano be bantu abasinga okukubuulira ddala by’olina okwetaaga ne by’olina okukola okwerabirira. Olwo osobola okulabirira obulamu bwo n’okumala ebiseera ku bintu ebisinga okukukwatako. Tewali kintu kya muwendo okusinga okubeera omulamu obulungi, nedda?

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Puleesa y’okufuuwa, puleesa, obulamu bw’omutima, obulamu bw’obwongo, okutambula kw’omusaayi, oxygen, obulamu