Waliwo embeera ey’amangu olw’omusaayi/amazzi amatono mu mubiri? Ka tuyige ku hypovolemic shock eno!

Wali ozirika mu bwangu, n’oziyira, n’okukaluubirirwa okussa? Oba wali olabye omuntu ng’afunye obuvune obw’amaanyi n’avaamu omusaayi mungi? Emu ku mbeera ez’obulabe ennyo eziyinza okubaawo mu mbeera ng’ezo ye hypovolemic shock, gye tugenda okwogerako leero. Eno mbeera eyeetaaga obujjanjabi obw’amangu, n’olwekyo kikulu nnyo okugimanya.

Hypovolemic shock kye ki? Ka tukitegeere mu ngeri ennyangu!

Mu ngeri ennyangu, hypovolemic shock bwe bungi bw’omusaayi oba amazzi mu mubiri gwo bwe bukendeera mu bwangu ne kiba nti omutima gwo tegusobola kutambuza musaayi mu mubiri gwo gwonna obulungi. Kilowoozeeko ng’emmotoka eggwaamu amafuta. Omusaayi gulinga amafuta eri emibiri gyaffe.

Embeera eno etera okubaawo ng’ebitundu ebisukka mu 20% oba kimu kya kutaano ku bungi bw’omusaayi gwonna mu mubiri gwaffe gufiiriddwa. Kino tekiyinza kubaawo kuvaamu musaayi mungi gwokka olw’obuvune obw’amaanyi. Oluusi, ekiddukano eky’amaanyi, okusesema okutambula obutasalako, oba okutuuyana ennyo nabyo bisobola okuvaako embeera eno, ekivaako amazzi amangi okubula okuva mu mubiri.

Eno mbeera ya mangu mu by’obujjanjabi, n’olwekyo bw’olaba obubonero, kyetaagisa okukuba ku ssimu 1190 oba 1990 mu bwangu n’ogenda mu basawo.

Kiki ekigenda mu maaso ku puleesa mu kiseera kino?

Hypovolemic shock bwebaawo, omuwendo gwa puleesa yo ogwa wansi oguyitibwa diastolic pressure, mu kusooka guyinza okweyongera katono. Naye omusaayi oba amazzi bwe geeyongera okuva mu mubiri gwo, omuwendo ogw’oku ntikko oguyitibwa puleesa y’omubiri (systolic pressure) gujja kutandika okukendeera mpolampola.

Ani asinga okukulaakulanya kino?

Embeera eno esobola okutuuka ku muntu yenna naddala omuntu abadde mu kabenje akanene era ng’afiirwa omusaayi mungi. Ekirala, nga bwe twagambye emabegako, omuntu asesema ennyo, alina ekiddukano oba atuuyana ennyo naye asobola okuggwaamu amazzi mu mubiri.

Embeera eno ya bulijjo etya?

Okutwalira awamu, ekika kyonna eky’okusannyalala kibaawo mu bantu abatakka wansi wa 1 ku buli 1,000. Wabula, hypovolemic shock kye kika kya shock ekyokubiri ekisinga okubeerawo. Mu nsi ezimu ezikyakula, businga kubeera mu baana abato olw’ekiddukano.

Kiki ekituuka ku mubiri mu kiseera ky’okusannyalala kw’omusaayi (hypovolemic shock)?

Hypovolemic Shock ebaawo ng’ebitundu ebikulu mu mubiri gwaffe (okugeza, obwongo, omutima, ensigo) tebifuna musaayi na oxygen byetaagibwa. Kino kiringa omuti ogufa nga teguliimu mazzi. Ebitundu byaffe nabyo tebisobola kukola nga tetulina musaayi.

Mu kiseera kino, omubiri gwaffe gukola mu ngeri ey’amagezi ennyo. Olw’okuba omusaayi guli mutono mu mubiri, gukulembeza okugabira ebitundu ebibiri ebisinga obukulu okusobola okuwangaala, obwongo n’omutima . Eno y’ensonga lwaki omusaayi ogugenda mu bitundu by’omubiri gukendeera, n’ebitundu by’omubiri binnyogoga.

Ku kigero, omuntu azitowa kkiro nga 70 alina omusaayi gwa liita nga 5 mu mubiri gwe. Ekyo kitegeeza ebitundu nga 7% ku buzito bw’omubiri gwabwe. Mu hypovolemic shock, ekitundu ekinene eky’omuwendo guno kibula.

Mitendera ki ena egy’okukankana?

Waliwo embeera nnya enkulu mu mbeera eno, okusinziira ku buzibu.

• Omutendera 1: Kino w’ofiirwa ebitundu nga 15% ku bungi bw’omusaayi gwo (nga mililita 750 (750 mL) – ekyo kiringa obunene bw’eccupa ennene ey’amazzi). Puleesa yo n’okukuba kw’omutima biyinza okuba nga bya bulijjo mu kiseera kino.
• Omutendera 2: Kino kye kiseera omusaayi bwe gukendeera ebitundu 15% okutuuka ku 30% (750 mL okutuuka ku 1,500 mL – eccupa z’amazzi nga bbiri ennene). Omutima gutandika okweyongera, ate n’okussa kweyongera.
• Omutendera 3: Wakati wa 30% ne 40% ku musaayi gw’omubiri (1,500 mL okutuuka ku 2,000 mL – eccupa z’amazzi nga ssatu ennene!) zibula. Puleesa ekka nnyo, omutima n’okussa byeyongera. Omusulo ogufuluma nagwo gukendeera nnyo.
• Omutendera 4: Guno gwe mutendera ogusinga okuba ogw’amaanyi. Ebitundu ebisoba mu 40% ku musaayi gw’omubiri (>2,000 mL) gufiiriddwa. Puleesa eri wansi nnyo, omutima gukuba nnyo, era omusulo gufuluma kumpi teguliiwo.

Bubonero ki bwe tusaanidde okumanya?

Omusaayi oba amazzi gye gakoma okubula okuva mu mubiri, obubonero gye bukoma okubeera obw’amaanyi. Wano waliwo obubonero obutera okulabika obw’okusannyalala kw’omusaayi (hypovolemic shock):

• Okwongera ku sipiidi y’okussa: Okuwulira ng’ossa mangu okusinga ku bulijjo.
• Okuwulira ng’osobeddwa oba nga towummudde: Kizibu okussaayo omwoyo, era oyinza okuwulira ng’otabuse.
• Okutuuyana ekisusse: Amangu ago, omubiri gunnyogoga ne gutandika okutuuyana.
• Okubulwa amagezi (okuzirika): Oyinza okubulwa ekizibu mu bwangu nga tolina ky’okola.
• Olususu olunnyogovu: Ebitundu by’omubiri biwulira nga binnyogoga bw’obikwatako.
• Okuwulira nga munafu: Omubiri gunafuwa nnyo ne guba nga tegusobola kukola kintu kyonna.
• Okukendeera kw’ebbugumu ly’omubiri ne puleesa.
• Okweyongera kw’okukuba kw’omutima (okweyongera kw’okukuba kw’omukka).

Singa obubonero buno obumu oba obusingawo bulabibwa nga buvaamu omusaayi omungi, kiyinza okuba nga kya hypovolemic shock.

Ensonga ki enkulu eziviirako kino?

Ekisinga okuvaako kwe kufiirwa omusaayi oba amazzi amangi okuva mu mubiri. Okuvaamu omusaayi kuno kuyinza okuva munda (mu ngeri gye tutasobola kulaba) oba okuva ku kiwundu ekirabika. Okwongerezaako,

• Okwokya
• Obulwadde bw’olubuto
• Ebivaako ng’okutuuyana ennyo, okusesema oba ekiddukano nabyo biyinza okuba nga bye bivaako.

Engeri ki ezisoboka okuvaamu omusaayi?

Ebikulu ebivaamu omusaayi ebiyinza okuvaako okusannyalala kw’omusaayi (hypovolemic shock) bye bino:

• Obuvune obuva ku kabenje ak’amaanyi: Ebintu ng’akabenje ku luguudo, okugwa okuva ku buwanvu n’ebirala.
• Mu kiseera ky’okulongoosebwa oba oluvannyuma lw’okulongoosebwa (okulongoosebwa): Okulongoosebwa okumu kuyinza okuvaamu omusaayi omutono.
• Olubuto olutali mu lubuto: Eno mbeera ya bulabe nnyo, kuba eyinza okuvaako omusaayi okuva munda mu mubiri.
• Okukutuka kw’emisuwa: Kino kitegeeza nti omusuwa gunafuwa, ne guzimba ng’akapiira, ne gukutuka mu bwangu.
• Obuzibu mu nkola y’okugaaya emmere: Okugeza okuvaamu omusaayi olw’amabwa mu lubuto.

Kino omusawo akizuula atya?

Bwe bakuleetebwa mu ddwaaliro, omusawo oba nnansi ky’agenda okusooka okukola kwe kukukebera. Olwo, bayinza okukola ebigezo ebitonotono okukakasa embeera eyo.

• Okukebera omusaayi: Kebera olabe omusaayi gwo bwe guli omutono era oba ebitundu by’omubiri ng’ensigo byo bikoseddwa.
• Electrocardiogram (ECG): Laba enkola y’omutima.
• Echocardiogram: Sikaani y’omutima.
• Right heart (Swan-Ganz) catheterization: Okukebera okw’enjawulo okupima puleesa eziri mu mutima.
• CT scan (Computed tomography - CT) oba okukebera okulala okw’amasannyalaze: Okuzuula omusaayi we gukulukuta munda mu mubiri.
• Endoscopy: Okukebera enkola y’okugaaya emmere ng’okozesa ttanka eriko kkamera.

Okijjanjaba otya? Ebintu by’olina okukola mu bwangu!

Oluvannyuma lw’okuleetebwa mu ddwaaliro mu ambyulensi oba mu ngeri endala, abasawo kye basooka okukola kwe kukuteeka mu layini ya IV ne bakuwa amazzi (nga saline) . Olwo ne bakuwa omusaayi bwe kiba kyetaagisa. Era bakuwa eddagala okuzza puleesa mu nteeko.

Ekisinga obukulu kwe kujjanjaba ekizibu ekyaleetawo ensisi. Okugeza okuyimiriza okuvaamu omusaayi, oba okulongoosebwa singa oba ofunye obuvune mu kabenje. Oluvannyuma lw’ekyo, ojja kukuumibwa mu kitongole ekirabirira abalwadde abayi (ICU) okwetegereza.

Bika ki eby’eddagala eriweebwa?

Ezimu ku ddagala erikulu eriweebwa ku hypovolemic shock lye:

• Epinephrine (Eddagala eriyitibwa Epinephrine - Adrenalin®) .
• Eddagala lya Norepinephrine (Eddagala lya Norepinephrine - Levophed®) .
• Ekirungo kya Dopamine
• Dobutamine (Eddagala lya Dobutamine - Inotrex®) .

Eddagala lino liyamba okuzzaawo omutima ne puleesa.

Waliwo ebizibu byonna ebiva mu bujjanjabi buno?

Eddagala lino oluusi liyinza okuvaako ebizibu ebitonotono.

• Puleesa n’okukuba kw’omutima okweyongera
• Okukaluubirirwa okussa
• Okulumwa omutwe (okulumwa omutwe) .
• Omutima obutakuba bulungi

Kiki kye tuyinza okukola okukendeeza ku kabi kano?

Kizibu okulagula n'okuziyiza obubenje obw'amaanyi. Wabula waliwo ebintu bye tuyinza okukola okukendeeza ku bulabe bw’okusannyalala kw’omusaayi (hypovolemic shock) okuva ku nsonga endala:

• Bw’oba ​​omira eddagala erifulumya amazzi , limira ddala nga omusawo bw’akulagidde. Ekirala nywa amazzi amangi okwewala okuggwaamu amazzi mu mubiri.
• Bw’oba ​​olina ekiddukano oba ng’osesema, nywa amazzi amangi oba amazzi nga Jeevani okuzzaamu amazzi agabula mu mubiri.
• Bw’oba ​​otuuyana nnyo, nywa amazzi amangi okudda mu kifo ky’amazzi g’ofiirwa.

Ekisinga obukulu: Bw’olaba ng’omusaayi gukulukuta, oba ng’olina ekisala ekitasobola kuyimirizibwa, kuba 1190 oba 1990 mu bwangu, oba genda mu kitongole ky’abalwadde ab’amangu mu ddwaaliro erikuli okumpi. Okufuna obuyambi amangu kiyinza okuyamba okufuga embeera ng’omusaayi mungi tegunnabula.

Kiki ekibaawo singa ofuna obulwadde bwa hypovolemic shock? Kitwala bbanga ki okuwona?

Oba owona embeera eno n’owona kisinziira ku bintu ebiwerako. Omusaayi oba amazzi mmeka agaabula, amangu ago, embeera endala ez’obujjanjabi z’olina, n’ekyavaako ensisi nabyo bisobola okukola kinene.

Singa otandika obujjanjabi bw’okusannyalala nga bukyali, ebivaamu bisobola okukyusibwa. Bw’oba ​​okyali muto ate ng’okusannyalala si kwa maanyi nnyo, olina emikisa mingi egy’okuwona. Kyokka oluusi ebitundu by’omubiri okwonooneka kuyinza okuvaako omutima okulwala. Singa ebitundu by’omubiri ebisukka mu kimu biremererwa, embeera eyo etera okutta abantu. Ne bwe wabaawo obujjanjabi, hypovolemic shock oluusi eyinza okutta omuntu.

Nnyinza ntya okwerabirira okutuusa lwe ndiwona?

Bw’omala okutuuka awaka okuva mu ddwaaliro, olina okugoberera ddala ebiragiro by’omusawo. Omubiri gwo guyise mu buvune bungi, n’olwekyo olina okuwummulako n’okudda engulu awaka nga tonnagenda ku mulimu. Ddira eddagala omusawo lye yakulagidde ddala, era olabirire bulungi ebiwundu byonna.

Ddi lwe nneetaaga okuddamu okulaba omusawo?

Omusawo ajja kukusaba oddeyo ku ssaawa z’okugoberera alabe bw’okola. Tosubwa appointment zino, kubanga awo omusawo w’asobola okuzuula amangu ebizibu byonna ebipya ebiyinza okuvaamu.

Ddi lw’osaanidde okugenda mu kitongole ekijjanjaba abalwadde ab’amangu (ETU) ?

Bw’olaba omuntu ng’alaga obubonero bw’okusannyalala kw’omusaayi (hypovolemic shock), kuba 1190 oba 1990 mu bwangu. Omuntu gy’akoma okufuna obuyambi amangu, gy’akoma okubeera omulungi. Okutuusa ng’obuyambi butuuse, galamiza omuntu oyo ng’amagulu ge gasituddwa ekigere nga kimu waggulu w’omubiri gwonna. Totambuza mubiri, okuggyako okusitula amagulu. Bwe wabaawo okuvaamu omusaayi, fuba okugukomya, era omubiri gubugume.

Bw’oba ​​wali olina obulwadde bwa hypovolemic shock, singa ebiwundu byo bitandika okuddamu okuvaamu omusaayi, oba bwe birabika nga bikulukuta, ddamu genda mu kisenge ky’abalwadde ab’amangu.

Bibuuzo ki ebikulu by’olina okubuuza omusawo?

Bw’olaba omusawo, tewerabira okubuuza ebibuuzo bino:

• Ensisi eno eya hypovolemic enandeeta ebikosa eby’ekiseera ekiwanvu?
• Kintwalira bbanga ki okuwona mu bujjuvu?
• Nneetaaga okumala bbanga ki okumira eddagala lye wawandiikira?

N’ekisembayo, obubaka obutwala awaka

Hypovolemic shock mbeera ya mangu ey’obujjanjabi. Kyokka, okufuna obujjanjabi amangu kiyinza okutaasa obulamu bwo. Abasawo basobola okuzzaawo embeera eno naye kijja kukutwalira ekiseera okudda engulu. Naddala singa ensisi eva ku kabenje ak’amaanyi, kiyinza okutwala ekiseera ekiwanvu okudda engulu. Kale, goberera ddala ebiragiro by’omusawo wo era weefaako bulungi n’obuvune bwo. Bulijjo weegendereze!

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