Amawuggwe go galina obuzibu mu kussa? Ka tuyige ku bulwadde buno obw’akabi obwa ARDS (Acute Respiratory Distress Syndrome)!

Wali osanga nga kizibu nnyo okussa mu bwangu, ng’owulira ng’ekifuba kikutte? Oba ojjukira ekiseera omuntu gw’omanyi lwe yalwala ennyo mu bwangu, n’atasobola kussa bulungi n’aweebwa ekitanda mu ddwaaliro erijjanjaba abalwadde abayi (ICU)? Oboolyawo ekyavaako yali mbeera eyitibwa ARDS (Acute Respiratory Distress Syndrome) . Kino kya maanyi katono naye bw’oba ​​otegeezeddwa bulungi, kyangu okutegeera ebintu bingi. Ka twogere ku nsonga eno mu bujjuvu, nedda?

ARDS kye ki? Ka tukitegeere mu ngeri ennyangu.

Mu ngeri ennyangu, ARDS mbeera ya maanyi nnyo era ekosa amawuggwe gaffe. Lowooza ku kino: Amawuggwe gaffe galina obusawo obutonotono obw’empewo (obuyitibwa alveoli). Ziringa obuzabbibu obutono ku muzabbibu. Bwe tussa, ensawo zino ez’empewo ziyingiza omukka gwa oxygen okuva mu mpewo ne gugufulumya mu musaayi. Naye ARDS bw’ebaawo, ensawo zino ez’empewo zijjula amazzi. Kiringa bbaatule erimu amazzi. Olwo amawuggwe ne gatasobola kujjula bulungi mpewo, era omukka gwa oxygen ogugenda mu musaayi gukendeera nnyo. Kino tukiyita hypoxia. Abasawo batera okussa ARDS mu kibinja kya ARDS nga ekitono, eky’ekigero oba eky’amaanyi . Kizuulibwa nga tugeraageranya omutindo gwa oxygen mu musaayi n’omuwendo gwa oxygen ogwetaaga okutuusibwa ku mutindo ogwo. ARDS era esobola okuleetera ebitundu ebirala ebikulu ng’obwongo bwaffe, omutima, ensigo, n’ebyenda obutafuna mukka gwa oxygen gwe byetaaga. N’olwekyo, ARDS mbeera ya bulabe era eyinza n’okuteeka obulamu mu matigga. ARDS etera okubaawo ng’omuntu ajjanjabirwa mu ddwaaliro olw’obulwadde obulala, obulwadde oba akabenje. Kyokka obubonero buno bw’ofuna awaka, kikulu okugenda mu ddwaaliro mu bwangu.

Waliwo emitendera esatu egy’obulwadde bwa ARDS?

Abasawo oluusi bagabanyaamu ARDS mu mitendera esatu: Exudative, Proliferative, ne Fibrotic. Kino okusinga kitegeeza eddaala ly’okuzimba n’okuzimba amazzi mu mawuggwe, n’oluvannyuma engeri amawuggwe gye gatandika okuwona. Si buli muntu nti agenda mu maaso okutuuka ku mutendera 3. Omutendera guno guzingiramu enkovu mu mawuggwe (`(Lung fibrosis)`) n’obwetaavu bw’okuyingiza empewo mu byuma okugenda mu maaso.

ARDS ya bulijjo etya?

Eno mbeera ya maanyi. Bukwata abantu nga 200,000 omwaka mu Amerika yokka. Mu nsi yonna, bukosa abantu nga obukadde 3 omwaka. ARDS evunaanyizibwa ku bitundu nga 10% ku bantu bonna abayingizibwa mu kisenge ky’abalwadde abayi (ICU). Era evunaanyizibwa ku bitundu nga 25% ku bantu bonna abayingizibwa mu ddwaaliro okuweebwa empewo mu byuma.

Bubonero ki obulaga obulwadde bwa ARDS? Okitegeera otya?

Obubonero bwa ARDS buyinza okwawukana okusinziira ku kivaako, obuzibu bw’embeera eno, n’embeera yonna ey’amawuggwe oba omutima gy’olina edda. Obubonero obukulu bwe buno:

• Obuzibu obw'amaanyi mu kussa :Kiwulira nga tosobola kussa, ng’oziyira.
• Okussa amangu n’okukola ennyo : Okussa n’amaanyi mangi, ng’olinga assa omukka.
• Omutima gweyongera.
• Okukyusa langi y’emisumaali n’emimwa eya bbululu: Kino kiva ku mukka gwa oxygen omutono mu musaayi.

Teebereza, omwami Nalin yalina omusujja omungi n’okusesema okumala ennaku bbiri. Amangu ago, yafuna obuzibu okussa, ekifuba ne kiwulira nga kinywezeddwa. Mukyala we yakiraba ng’emisumaali gye gifuuse bbululu. Bwe baaddukidde mu ddwaaliro, abasawo baagamba nti yandiba nga ya ARDS .

ARDS esobola okukula mu ssaawa okutuuka ku nnaku okuva ku kintu ekivaako, era nayo esobola okweyongera amangu ennyo.

Biki ebivaako ARDS?

Waliwo ebintu bingi ebiyinza okuvaako ARDS. Ka tulabe ebikulu:

• Sepsis : Ekisinga okuvaako ARDS y’embeera eyitibwa sepsis. Embeera eno eyinza okubaawo nga yinfekisoni ey’amaanyi mu mawuggwe go (nga pneumonia ) oba yinfekisoni mu kitundu ekirala esaasaana mu mubiri gwo gwonna, ekivaako okuzimba okw’amaanyi.
• Aspiration pneumonia: Singa ebiri mu lubuto (emmere, amazzi) bigenda mu mawuggwe, kiyinza okuleeta okwonooneka okw’amaanyi mu mawuggwe ne ARDS. Kino kibaawo nga ekintu kye tulya oba kye tunywa kigenda mu mifulejje gy’empewo. Kino kisinga kutuuka ku muntu azirika oba akaddiye.
• Okuteekebwamu omusaayi: Waliwo akabi k’okukwatibwa ARDS singa oweebwa omusaayi ogusukka mu yuniti 15 mu bbanga ttono.
• Covid-19 `( COVID-19 )`: Akawuka ka Covid-19 kayinza okuleeta obulwadde bwa ARDS obw'amaanyi.
• Pancreatitis : Obulwadde bw’olubuto obuzimba ennyo.
• Obubenje obw’amaanyi oba okwokya: Obubenje n’okugwa bisobola okwonoona obutereevu amawuggwe, oba biyinza okwonoona ebitundu by’omubiri ebirala mu mubiri ne bivaako okuzimba okw’amaanyi mu mawuggwe.
• Obuvune bw’okussa: Okussa omukka oba omukka ogw’eddagala ogulimu ennyo.
• Drug overdose : Okumira ennyo eddagala, nga cocaine oba opioids.
• Okubbira mu mazzi oba okumpi okubbira mu mazzi: Bw’obbira amazzi gayingira mu mawuggwe ne gagoonoona.

Ani ali mu bulabe obw’amaanyi obw’okulwala ARDS?

ARDS etera okuva mu bantu abajjanjabwa edda mu ddwaaliro olw’akabenje oba obulwadde. Kyokka tekitegeeza nti ojja kubufuna olw’okuba oli mu ddwaaliro. Waliwo ebintu ebiwerako ebikyongera ku bulabe bwo:

• Okubeera ng’alina emyaka egisukka mu 65 egy’obukulu.
• Okukozesa taaba (okunywa sigala).
• Okukozesa ebiragalalagala.
• Okubeera n’obulwadde bw’amawuggwe obwaliwo edda.

Bizibu ki ebiyinza okuva mu ARDS?

ARDS esobola okuleeta ebizibu eby’enjawulo, ng’oli mu ddwaaliro n’oluvannyuma lw’okudda eka. Ebimu ku byo bye bino:

• Okuzimba omusaayi oba okuzimba emisuwa emiwanvu (DVT).
• Pneumothorax: Kino kiyinza okubaawo olw’okunyigirizibwa kw’ekyuma ekissa ku mawuggwe ayonoonese era agakalubye.
• Delirium: Okutaataaganyizibwa mu kutegeera.
• Okulemererwa kw'ebitundu by'omubiri ebingi .
• Obunafu bw’ebinywa.
• Enkovu mu mawuggwe oba fibrosis.
• Obuzibu bw‟okunyigirizibwa oluvannyuma lw‟okukosebwa (PTSD) .
• Ebizibu by'obulamu bw'obwongo nga okweraliikirira n'okwennyamira .

Ozuula otya obulwadde bwa ARDS? (Okuzuula obulwadde)

Abasawo bazuula obulwadde bwa ARDS nga basinziira ku kukeberebwa kw’omubiri n’ebyava mu kukeberebwa okuwerako. Olw’okuba obubonero bwa ARDS bufaananako n’obw’obulwadde bw’amawuggwe oba omutima obutawona, omusawo alina n’okugaana ebirala ebivaako obulwadde buno. Omusawo ayinza okulagira okukeberebwa okugatta awamu, gamba nga:

• X-ray y’ekifuba: Okulaba amazzi agali mu mawuggwe.
• Okukebera omusaayi: Kupima omukka gwa oxygen mu musaayi n’okuzuula obuzibu bwa ARDS.
• Echocardiogram (okukebera omutima mu ngeri ey’amaloboozi amangi): Laba engeri omutima gye gukola.
• Electrocardiogram (EKG): Epima amasannyalaze g’omutima.
• Sensulo y’engalo `(Pulse oximetry)`: Londoola obutasalako emiwendo gya oxygen.
• CT scan (Computed Tomography - CT scan): Funa ebisingawo ebikwata ku mawuggwe.
• Okutwala sampuli y’ebifulumizibwa okuva mu nkola y’okussa: Funa ekivaako obulwadde buno.

Bujjanjabi ki obw’obulwadde bwa ARDS?

Ekigendererwa ekikulu eky’okujjanjaba ARDS kwe kwongera ku mukka gwa oxygen mu musaayi n’okuziyiza ebitundu by’omubiri okulemererwa. Abantu abalina ARDS bayinza okwetaaga ekyuma ekissa empewo n’/oba obujjanjabi bwa oxygen okwongera ku muwendo gwa oxygen mu musaayi. Era bayinza okwetaaga obuyambi okuggulawo emikutu gy’empewo egyazibiddwa olw’okwonooneka. Omusawo wo ayinza okukola emitendera okukendeeza ku bizibu ebiva mu ARDS, gamba nga:

• Okuwa empeke z’okwebaka (sedation) okuyamba okufuga obulumi n’okusigala nga mukkakkamu.
• Mu kifo ky’okukukyusakyusa, weeteeke mu mbeera ey’okusitama. Kino kitereeza entambula ya oxygen.
• Kola okukebera okussa era ozuule ekiseera ekituufu okuggyamu ttanka n’ekyuma ekissa.
• Okuwa eddagala eriweweeza ku musaayi okuziyiza omusaayi okuziyira.
• Okuwa eddagala erifulumya amazzi okuggya amazzi agasukkiridde mu mubiri.
• Okuwa eddagala okukendeeza ku mazzi agakuŋŋaanyizibwa mu mawuggwe.
• Eddagala eritta obuwuka liweebwa okuziyiza yinfekisoni oba okujjanjaba yinfekisoni eziriwo.
• Okuwa entambula ey’amaanyi n’obujjanjabi bw’omubiri okuziyiza obunafu bw’ebinywa.
• Okusindikibwa mu nteekateeka z’okuddaabiriza amawuggwe okunyweza amawuggwe n’okwongera ku busobozi bw’amawuggwe.

Kitwala bbanga ki okuwona obulwadde bwa ARDS? Omuwendo gw’abawona guli gutya?

Kisinziira ku buzibu bw’embeera n’ebbanga lye kitwala amawuggwe g’omuntu okudda engulu. Okunoonyereza okusinga kulaga nti ebiseera ebisinga kitwala emyezi mukaaga okutuuka ku mwaka amawuggwe okuddamu okukola obulungi oluvannyuma lwa ARDS. Kyokka, abantu abamu tebatereera mu bujjuvu. Omuwendo gw’abawangaala ku ARDS guli nga 55% okutuuka ku 70% , singa bajjanjabwa mangu. Omuwendo gw’abawona gukendeera singa obujjanjabi bulwawo oba singa ebitundu ebirala bitandika okulemererwa. Okuteebereza kwo kusalibwawo ensonga ng’embeera z’obujjanjabi zo ezikusibukako, ebyafaayo by’obujjanjabi, n’obuzibu bw’okussa. Omusawo wo ajja kuteesa naawe ku nsonga eno.

ARDS esobola okuziyizibwa?

Tewali ngeri ntongole ey’okuziyiza ARDS. Wabula bw’oba ​​olina obubonero bw’okussa obubi, oba ng’amawuggwe gaayonoonese oba embeera endala, okugenda mu ddwaaliro amangu ddala kiyinza okuyamba okutangira embeera eyo okweyongera. Okwewala okunywa sigala n’okukendeeza ku kunywa omwenge kiyinza okukendeeza ku bulabe bw’okulwala ARDS ey’amaanyi.

Obulamu buli butya oluvannyuma lwa ARDS? Kiki kye tusaanidde okumanya?

ARDS eyinza okutta obulamu n’okutiisa. Naye olw’obujjanjabi obulongooseddwa n’obuyambi bw’okussa (naddala okukyusa abalwadde ku lubuto lwabwe okulongoosa enkola y’okutuusa omukka gwa oxygen), kati abantu bangi bawona, era ebizibu bya ARDS bikendedde. Abantu abali wansi w’emyaka 65 n’abo abafuna ARDS oluvannyuma lw’akabenje oba okuteekebwamu omusaayi okutwalira awamu baba n’okuteebereza okulungi. Okuwona obulwadde bwa ARDS kiyinza okutwala ekiseera ekiwanvu. Abantu bangi abaggyibwa ku kyuma ekissa basobola okussa mu ddembe. Abamu bawona ddala, naye abalala bayinza okufuna obuzibu bw’amawuggwe obutawona. Beetaaga okulabirira omukugu mu by’amawuggwe (omusawo w’amawuggwe).

"Maama yafuna obulwadde bwa ARDS era yamala emyezi mu ddwaaliro. Ne bwe yakomawo awaka, yali akooye nnyo. Yali tasobola kukola mirimu mitono nnyo. Naye oluvannyuma lw'okugoberera ebiragiro by'abasawo n'okukola obujjanjabi bw'omubiri, agenda atereera mpola. Mu kiseera kino, obuwagizi n'okwagala kw'amaka ge bya muwendo nnyo."

Obulamu oluvannyuma lwa ARDS buyinza okuba obw’okusoomoozebwa. Mugumiikiriza era onoonye obuyambi okuva mu maka n’emikwano nga bw’odda engulu. Oyinza n’okwetaaga obuyambi mu mirimu gya buli lunaku okutuusa ng’amawuggwe go gatereera. Yogerako n‟omusawo wo ku bibiina ebiyamba oba ebirala ebiyinza okukuyamba okuddamu amaanyi.

Kakwate ki akali wakati wa COVID-19 ne ARDS?

Bino si kintu kimu. Omuntu alina COVID-19 asobola okufuna obulwadde bwa ARDS nga akawuka katuuse mu mawuggwe. Abanoonyereza bagamba nti omuwendo gw’okuwona omuntu alina COVID-19 ne ARDS guli nga 50% okutuuka ku 60%. Naye kino nakyo kisinziira ku bintu bingi, gamba ng’ebyafaayo by’obulamu n’embeera endala ez’obujjanjabi. Okumala ebiseera mu kifo awajjanjabirwa abalwadde abayi (ICU) kiyinza okuba ekizibu era ekizibu. Abantu abawona ARDS bayinza obutasobola kudda mangu mu bulamu bwabwe obwa bulijjo, kale mazima ddala weetaaga obuyambi. Kikulu okufuna obuyambi n’okubuulirirwa kw’abakugu mu kiseera ky’okuwona ARDS. Buuza ttiimu yo ey‟abasawo ku nteekateeka z‟okudda engulu oluvannyuma lw‟okulabirira abalwadde abayi n‟ebibiina ebiyamba ku yintaneeti mu kitundu kyo.

Ekisinga Obukulu: Ebintu By'olina Okujjukira (Obubaka Obutwala Awaka)

Okay, kale bino bye bintu ebitonotono by’olina okujjukira okuva mu bye twogeddeko:

• ARDS mbeera ya maanyi era ereeta okwonooneka kw’amawuggwe. Ensawo z’empewo mu mawuggwe zijjula amazzi, ekikendeeza ku mukka gwa oxygen oguyinza okutuuka mu musaayi.
• Bw’ofuna obubonero ng’okukaluubirirwa ennyo mu kussa, okussa amangu, oba emisumaali/emimwa egya bbululu, genda mangu omusawo amagezi.
• ARDS eyinza okuba n’ensonga nnyingi eziviirako. Sepsis, pneumonia, COVID-19, n’obubenje obw’amaanyi bitono.
• Obujjanjabi okusinga buzingiramu omukka gwa oxygen, okuwagira ekyuma ekissa, n’okuddukanya ebizibu .
• Kitwala ekiseera okudda engulu, era abantu abamu bayinza okufuna obuzibu mu mawuggwe okumala ebbanga eddene.
• Obujjanjabi obw’amangu n’obujjanjabi obulungi kikulu nnyo okutaasa obulamu n’okukendeeza ku bizibu.
• Obuwagizi okuva mu maka n‟abantu kyetaagisa nnyo eri omuntu awona obulwadde bwa ARDS.

Jjukira nti kikulu okumanya embeera eno. Ggwe oba omuntu gw’omanyi bw’afuna obubonero buno bwonna, tosattira wadde okutya, wabula genda ew’omusawo amangu ago. Mu ngeri eyo, osobola okutandika obujjanjabi obwetaagisa amangu ddala nga bwe kisoboka.