Ebitundu by’omubiri ebiwerako mu mubiri gwo birema omulundi gumu? Ka twogere ku mbeera eno eyitibwa Multiple Organ Dysfunction Syndrome (MODS)!

Oboolyawo owulidde nti omuntu bw'alwala ennyo mu bwangu n'abeera mu kisenge ky'abalwadde abayi (ICU) mu ddwaaliro, agamba nti, "Abasawo baagambye nti ebitundu by'omubiri gwe ebimu tebikola bulungi." Oba, "Bakuumibwa nga balamu ebyuma." Mu butuufu, mu kiseera ekyo, omuntu oyo ayinza okuba ng’alina embeera ey’amaanyi ennyo. Mu busawo, kino tukiyita Multiple Organ Dysfunction Syndrome, oba mu Lungereza, ``Multiple Organ Dysfunction Syndrome - MODS.'' Erinnya liwulikika nga litiisa katono, naye ka twogere ku kiki kye liri, lwaki libaawo, n'engeri y'okuwangaala mu ngeri ennyangu gy'osobola okutegeera.

Ddala MODS kye ki?

Mu ngeri ennyangu, MODS mbeera ya bujjanjabi ya mangu nnyo (acute) . Ekibaawo mu kino kiri nti enkola z’ebitundu by’omubiri bibiri oba okusingawo ezikwatagana zikoma mangu okukola obulungi. Lowooza ku kino, omubiri gwaffe gulina enkola nnyingi ng’enkola y’okussa, enkola y’okugaaya emmere, n’enkola y’okufulumya omusulo. Bino bikolera wamu okutukuuma nga tuli balamu bulungi. MODS bw’ebaawo, enkola z’ebitundu bino teziyinza kukola ku bwazo. Olwo ebyuma ebiyamba obulamu (`life support`) byetaagibwa okukola emirimu gy'ebitundu ebyo.

MODS esobola okukosa ekitundu kyonna mu mubiri, naye ebisinga okumanyika bye bino:

• Amawuggwe
• Omutima
• Obwongo
• Ensigo
• Ekibumba
• Omusaayi (omusaayi) .

MODS ziyinza okuba n’ensonga nnyingi eziviirako. Ekisinga okuvaako obulwadde buno bwe yinfekisoni ey’amaanyi (sepsis) . Abasawo bwe baba bajjanjaba MODS, basooka kugezaako kufuga mbeera eyaliwo eyavaako embeera eno. Era bakola emitendera okutangira enkola z’ebitundu by’omubiri ebirala okwonooneka.

MODS mbeera ya bujjanjabi ya bulabe nnyo . Kiyinza okutta omuntu singa tekijjanjabwa mangu. Abantu bangi abalina MODS baweebwa ekitanda mu ddwaaliro ly‟abalwadde abayi (ICU) era beetaaga okulondoola buli kiseera n‟okuyambibwako obulamu.

Embeera eno eyitibwa amannya amalala agawerako, omuli:

• Okulemererwa kw’ebitundu by’omubiri ebingi
• Enkola y’ebitundu by’omubiri ebingi okulemererwa

Enkola ki ez’ebitundu by’omubiri eziyinza okukosebwa MODS?

MODS esobola okukosa enkola z’ebitundu by’omubiri bbiri oba okusingawo ku zino wammanga:

1. Enkola y’okussa (amawuggwe) .

Amawuggwe gaffe bwe gatasobola kuwa mubiri mukka gwa oxygen gwe gwetaaga, ekitegeeza nti ebitundu by’omubiri tebifuna mukka gwa oxygen gumala (hypoxia) oba omubiri tegufuna kaboni dayokisayidi (CO2) (hypercapnia) amala, tukiyita okulemererwa okussa. Mu MODS, olina obuzibu mu kussa era oyinza n’okwetaaga empewo ey’ebyuma okukuyamba okussa. Ekisinga okwonooneka kw’amawuggwe mu MODS ye Acute Respiratory Distress Syndrome (ARDS).Mu mbeera eno eya ARDS, amawuggwe gakaluba, ekizibuwalira ennyo okukuuma omukka gwa oxygen ogwa bulijjo mu musaayi.

2. Enkola y’emisuwa gy’omutima (omutima) .

Enkola yaffe ey’emisuwa gy’omutima y’ekuba omusaayi mu mubiri gwonna. Omutima okulemererwa n’okusannyalala kw’omusaayi (circulatory shock) mbeera ng’ekinywa ky’omutima kinafu oba okukaluba, ekigiremesa okukuba omusaayi ogumala mu mubiri gwonna. Okuzimba okuyitiridde okubaawo ne MODS kuyinza okuvaako emisuwa okugaziwa, ne kikendeeza ku muwendo gw’omusaayi ogutuuka mu bitundu by’omubiri n’ebitundu by’omubiri. Kino kiyinza okuvaako puleesa okukka (puleesa okukka oba okusannyalala) mu MODS. Amazzi nago gasobola okukulukuta okuva mu misuwa gino ne kivaako okuzimba (edema).

3. Enkola y’omusaayi (omusaayi) .

MODS zisobola okuleeta obutakwatagana mu puloteyina ezimu mu musaayi. Kino kiyinza okuvaako obuzibu bw’okuvaamu omusaayi n’okuzimba . Oyinza okulaba ng’olususu lunyiga oba okuvaamu omusaayi munda mu lubuto. Ekizibu ekisinga okukosa enkola y’omusaayi yo ye Disseminated Intravascular Coagulation (DIC) . Mu mbeera eno, omusaayi guyinza okutandika okukulukuta okuva mu bifo ebiyitibwa catheters oba tubes mu lususu lwo.

4. Enkola y’obusimu (obwongo) .

Obwongo bwaffe kitundu kikulu nnyo ekifuga buli nkola mu mubiri. Ekitundu oba byonna eby’obwongo bwe bikoma okukola olw’okwonooneka kw’obwongo oba ebitundu ebirala eby’obusimu obw’omu makkati (nga mw’otwalidde n’omugongo n’obusimu obukwatagana nabwo), tukiyita `okulemererwa kw’obusimu`. Mu MODS, okuzimba, okuzimba omusaayi olw’obuzibu mu nkola y’omusaayi, ne puleesa entono bisobola okukendeeza ku muwendo gw’omusaayi ogukulukuta mu bwongo. Kino kiyinza okwonoona obwongo ne kireeta okutabulwa (`delirium`) .

5. Enkola y’ekibumba (ensigo) .

Okulemererwa kw’ekibumba kwe kuba ng’ensigo tezisobola kukola mirimu gyazo egimu oba gyonna omuli n’okusengejja ebisasiro okuva mu musaayi. Enkola y’ekibumba esengejja omusaayi gwaffe, n’ekola omusulo, n’okuggya amazzi agateetaagisa mu mubiri. Mu MODS, enkola eno esobola okukosebwa.

6. Enkola y’ekibumba (ekibumba) .

Okulemererwa kw’ekibumba kwe kuba nti ekibumba tekisobola kukola bimu oba byonna ku mirimu gyakyo emingi, gamba ng’okuggya obutwa mu musaayi, okusengejja obutoffaali obumyufu obukadde, n’okufulumya eggi (asidi wa kyenvu/kijanjalo ayamba okugaaya emmere). Okuzimba n’okukendeera kw’omusaayi mu kibumba kiyinza okuvaako ekibumba okulemererwa. Kino kiyinza okuvaako olususu ne/oba amaaso okufuuka ebya kyenvu (jaundice). Ekibumba okulemererwa nakyo kiyinza okuvaako ebitundu ebirala okulemererwa.

MODS ya bulijjo etya?

MODS mbeera etera okulabibwa mu bulwadde obw’amaanyi, obw’amaanyi. Okunoonyereza kulaga nti wakati wa 28% ne 88% ku balwadde abali mu bifo eby’abalwadde abayi bayinza okulwala MODS. Era kye kisinga okutta abantu mu bifo ebijjanjabirwamu abalwadde abayi (ICUs).

Bubonero ki obusooka obwa MODS?

Olw’okuba MODS esobola okukosa ekitundu kyonna mu mubiri, obubonero businziira ku kitundu ekikoseddwa. Obubonero buno buyinza okuba obutono mu ntandikwa y’obulwadde obuleeta MODS, oba buyinza okuba obw’amaanyi . MODS bw’egenda ekulaakulana okuva ku bulwadde obw’amaanyi, oyinza okufuna:

• Okuziyira n’okusiiyibwa
• Endya
• Okuwulira ng’olina obunafu obuyitiridde oba ng’okooye
• Omusujja
• Okunyogoza wansi
• Okutabulwa oba okukaluubirirwa okussa ebirowoozo ku kintu
• Okussa okw’amangu, okutali kwa maanyi
• Omutima okukuba amangu oba mu ngeri etali ya bulijjo
• Obulumi mu kifuba ne/oba mu lubuto okumala ebbanga eddene
• Okuzimba mu lubuto
• Okuzimba kw’ebitundu by’omubiri
• Okufuuka okwa kyenvu kw’olususu oba amaaso (jaundice) .
• Okukyusa langi y’olususu, emimwa, olulimi, ennyindo, enjala oba amaaso mu langi ya bbululu oba enzirugavu/enjeru (cyanosis) .
• Okufiirwa okutegeera

Kiki ekivaako MODS?

MODS esobola okuva ku bulwadde bwonna obw’amaanyi, obuvune, oba yinfekisoni. Abasawo n’abanoonyereza n’okutuusa kati tebamanyi kituufu ekivaako MODS. Wabula okunoonyereza okuliwo kati kulaga nti okuzimba n’okukendeeza ku musaayi bitera okuvaako MODS. MODS teva ku mbeera emu ey’obujjanjabi. Kikula okuva mu bintu ebiddiriŋŋana ebikosa enkola z’ebitundu by’omubiri bingi oba byonna. Okukendeera kw’omusaayi n’omukka gwa oxygen kiyinza okuvaako okwonooneka.

Teebereza, mu bulwadde obw’amaanyi, wayinza okubaawo ebintu ebiwerako ebivaako MODS.

1. Ekintu ekikulu ekibaawo: Kino kye kivaako ekisooka. Okugeza, yinfekisoni ey’amaanyi (sepsis), akabenje ak’amaanyi (nga akabenje k’emmotoka), oba omutima ogw’amaanyi.

2. Ekyokubiri: Kino abaserikale b’omubiri bwe basukkiridde okukola, ne kivaako okuzimba okw’amaanyi mu mubiri gwonna.

3. Ekintu eky’okusatu: Singa ofuna yinfekisoni empya, oba ng’olina okulongoosebwa okujjanjaba embeera eyasooka, ekyo kiyinza okuba eky’okusatu.

Ebimu ku bitera okuvaako MODS bye bino:

• Sepsis oba septic shock: Kino kiyinza okuba okuzimba okw’amaanyi okuva ku yinfekisoni ey’amaanyi eya bakitiriya oba akawuka.
• Obuvune obuva ku buvune: Ebintu ng’akabenje k’emmotoka, okwokya ennyo, okufumita ebiso oba okukuba amasasi.
• Obulwadde bw’olubuto: Okuzimba kw’olubuto. Kino kiyinza okuva ku mayinja mu nnyindo, okunywa omwenge ekisusse, eddagala erimu, n’ensonga endala.
• Obulwadde bw’omutima obw’amaanyi: Buva ku kuzibikira mu musuwa ogugaba omusaayi mu mutima.
• Ekibumba okulemererwa: Kino kiyinza okuva ku Hepatitis B, Hepatitis C, obulwadde bw’ekibumba obw’amasavu, okunywa omwenge ennyo, n’obulwadde bwa cirrhosis.
• Obuvune obw’obutwa n’obutwa:Kiva ku kukwatibwa obutwa. Okugeza, okukozesa ebiragalalagala oba omwenge mu bwangu oba obutawona, eddagala ery’obutwa ng’eddagala ly’ebiwuka n’ebintu eby’edda ebiziyiza okuzimba (asbestos), n’obulwadde bwa bakitiriya.

Embeera zino zireeta enkyukakyuka ez’amaanyi mu baserikale b’omubiri gwo n’omusaayi, era nga kino kikosa n’ebitundu by’omubiri ebirala.

Ekitundu ki ekisooka okulemererwa mu MODS?

Kumpi buli muntu alina MODS asooka kufuna buzibu bw’amawuggwe , naye abasawo n’abanoonyereza nakati tebannaba kutegeera bulungi lwaki okulemererwa kw’amawuggwe kutera okubaawo nga MODS tennabaawo.

Ani asinga okukosebwa MODS?

Omuntu yenna asobola okulwala MODS, naye otera okulwala MODS singa oba olina embeera enkulu, gamba ng’obulwadde obutawona oba obutaba na busimu obuziyiza endwadde.

Oyinza otya okuzuula MODS?

Abasawo bakozesa okukebera okw’enjawulo okuzuula ebitundu by’omubiri ebiremye mu mubiri gwo gwonna. Mu bino biyinza okuli:

• Okukebera omusaayi
• Okukebera omukka mu musaayi mu misuwa
• Okukebera enkola y’ekibumba
• Okukebera enkola y’ekibumba
• Obuwangwa bw’omusaayi n’ebitundu by’omubiri
• Echocardiogram (okukebera omutima) .
• Okukebera ebifaananyi nga ultrasound oba CT scan

MODS ejjanjabwa etya?

Obujjanjabi bwa MODS businziira ku kivaako n’enkola z’ebitundu by’omubiri ezikoseddwa. Ebimu ku bikozesebwa mu bujjanjabi mulimu:

• Jjanjaba omusaayi omutono ng’owa amazzi mu misuwa (IV) .
• Okugaba eddagala lya vasopressor okwongera okutambula kw’omusaayi mu misuwa n’ebitundu by’omubiri (tissue perfusion).
• Muwe eddagala eritta obuwuka okujjanjaba yinfekisoni ne/oba sepsis.
• Okuteekebwamu omusaayi okudda mu kifo ky’omusaayi ogwabula olw’obuvune oba okulongoosebwa.
• Obujjanjabi bwa oxygen okusobola okuwa omubiri omukka omungi.
• Bw’oba ​​tosobola kussa ku bubwo, oyinza okwetaaga ekyuma ekikuyingiza empewo okukuyamba okussa.
• Okulongoosa omusaayi okuyamba okuggya kasasiro n’amazzi agasukkiridde mu mubiri gwo.
• Extracorporeal membrane oxygenation (ECMO) okugatta oxygen mu musaayi n’okuggyamu kaboni dayokisayidi.
• Enkola ya molekyu ezinyiga ekibumba (MARS) okuwanirira ekibumba.
• Okulongoosa abalwadde abalina obuvune obw’amaanyi.
• Okulongoosa okukyusa ebitundu by’omubiri kwe kukyusa ekitundu ky’omubiri ekirwadde oba ekitali kikola bulungi n’ossaamu ekitundu ekiramu okuva eri omuntu akigaba.
• Bw’oba ​​olina omusaayi mu lubuto (GI) oba embeera y’omu lubuto ekulemesa okulya, oba bw’oba ​​tosobola kulya mu mubiri, oyinza okwetaaga okufuna ebiriisa ng’oyita mu IV (intravenous) oba enteral nutrition (parenteral nutrition).

Nja kuwulira mangu ntya oluvannyuma lw’okujjanjabibwa?

Okuwona kwo kujja kusinziira ku kivaako n’obujjanjabi. Omusawo asobola okukuwa endowooza ennungi ku ddi lw’oyinza okusuubira okulaba ng’oteredde oluvannyuma lw’okujjanjabibwa.

Ebiseera bya MODS eby’omu maaso bye biruwa?

Ebiseera by’omu maaso ebya MODS bisinziira ku nsonga enkulu. Oluusi obusimu bwo obumu oba bwonna buyinza okudda mu mbeera eya bulijjo, naye oyinza okwetaaga okuyambibwako obulamu obw’ekiseera okutuusa lw’odda engulu.

Okuzuula amangu n‟okujjanjaba MODS n‟ekigiviirako kikulu nnyo mu kuddukanya obulungi embeera eno.

Enteebereza ya MODS ya njawulo mu bitundu by’abalwadde abayi (ICUs). Abasawo embeera eno bagitwala ng’etera okutta abalwadde abaweebwa ebitanda mu bifo eby’okulongoosebwamu abalwadde abayi.

Singa obulwadde buno bugenda ku mutendera ogw’amaanyi, ebitundu by’omubiri eby’olubeerera biyinza okwonooneka. Oyinza okwetaaga okuyambibwako obulamu obw’ekiseera ekiwanvu oba okukyusibwa ebitundu by’omubiri. Era kiyinza okutta omuntu.

Okunoonyereza okusingawo kwetaagibwa okuzuula ensonga eziyinza okukosa MODS, ekiyinza okuvaamu ebiseera eby’omu maaso ebirungi eri abalwadde.

Omuwendo gw’abawona okuva mu MODS guli gutya?

Abasawo n’abanoonyereza bateebereza nti omuwendo gw’abantu abawangaala mu MODS guli wakati wa 50% ne 60% .

MODS esobola okuziyizibwa?

Ebimu ku bintu ebivaako MODS tebisobola kuziyizibwa. Era mu kiseera kino tewali ddagala lya njawulo eriyinza kuyamba okuziyiza MODS. Abanoonyereza babadde banoonya engeri y’okujjanjaba obulwadde bwa MODS nga bukyali okutangira obulwadde buno okweyongera. Mu kiseera kino okunoonyereza okuwerako kugenda mu maaso mu mulimu guno.

Osobola okuyamba okukuuma ebitundu byo ng’okola ebintu nga:

• Kuuma ebitundu byo obutakubwa nsisi ng’oyambala emisipi ng’otambulira mu mmotoka n’ebintu ebikuuma ng’ozannya emizannyo egy’amaanyi.
• Gemebwa okutangira yinfekisoni ez’amaanyi ng’abasawo bakugambye.
• Okukendeeza oba okulekera awo okumira eddagala eritali lya musawo, gamba ng’eddagala eriziyiza okuzimba eritali lya steroid (NSAIDs), eriyinza okwonoona ekibumba.
• Kendeeza oba okulekera awo okumira eddagala oba ebintu ebirala ebiyinza okuvaako amabwa mu lubuto, gamba nga NSAIDs, okunywa sigala, n’omwenge .
• Funa obujjanjabi bwa puleesa (puleesa) .

Bw’oba ​​oli mu ddwaaliro ng’olina obulwadde obw’amaanyi, abasawo bo basobola okukola ebintu nga bino okutangira MODS okweyongera:

• Okukendeeza ku kwonooneka kw’amawuggwe go olw’empewo ey’ebyuma.
• Kkomya okuteekebwamu omusaayi okutuusa nga kyetaagisa nnyo.
• Okukozesa eddagala eriweweeza ku musaayi bwe kiba kyetaagisa okuziyiza omusaayi okuziyira.

Ddi lwe nnina okulaba omusawo?

Bw’oba ​​olina obulwadde obutawona era ng’ofuna obubonero bwa MODS, ekiyinza okuvaako obulwadde obw’amaanyi n’okulemererwa kw’ebitundu by’omubiri, bulijjo kirungi okugenda ew’omusawo. Basobola okukubuulira obubonero oba obubonero ebitongole by’olina okutunuulira n’engeri y’okuddukanyaamu embeera yonna.

Ddi lwe nnina okugenda mu kitongole ky’abalwadde ab’amangu (ETU) ?

Bw’oba ​​olina obubonero bwa MODS, genda mu kisenge ky’abalwadde ab’amangu ekikuli okumpi oba kuba 911. Kino kiyinza okukutta singa tojjanjabwa mangu.

Bibuuzo ki bye nnina okubuuza omusawo?

Bino bye bimu ku bibuuzo by’oyinza okwagala okubuuza omusawo wo:

• Kiki ekivaako MODS?
• Bujjanjabi ki bwe nnina?
• Eddagala ki ly’ogamba?
• Biruubirirwa ki eby’okulabirira kwange?
• Mirundi emeka gye nneetaaga obujjanjabi?

Mu bufunze n’obubaka obusembayo

Okay, kale kati okimanyi nti multiple organ dysfunction syndrome (MODS) mbeera ya maanyi ekosa enkola z’ebitundu by’omubiri bibiri oba okusingawo mu mubiri gwo. Wadde nga MODS esobola okukosa enkola y’ebitundu by’omubiri byonna, esinga kukosa mawuggwe, omutima, ensigo, ekibumba, obwongo n’omusaayi. Waliwo ebintu bingi ebiyinza okuvaako kino. Ebisinga okubeerawo bye bino: okulumwa ennyo, okulwala ennyo, n’okukwatibwa yinfekisoni ezisaasaana. Obujjanjabi bussa essira ku kujjanjaba embeera eri wansi ate nga buziyiza okwongera okwonooneka kw’enkola z’ebitundu ebirala.

Kya bulijjo okuwulira ng’otya ng’owulira nti ebitundu by’omubiri gwo oba omuntu wo tebikola. Naye abasawo n’abakozi mu kitongole ekijjanjaba abalwadde ab’amangu (ETU) ne Intensive Care Unit (ICU) batendekeddwa okuwagira enkola z’ebitundu byo byonna, okuziyiza okwongera okwonooneka, n’okuyamba omubiri gwo okuwona. Kale toggwaamu ssuubi. Bw’ofuna obujjanjabi obw’amangu n’okubuulirirwa kw’abasawo okutuufu, osobola okugezaako okuva mu mbeera eno.

` Okulemererwa kw’ebitundu by’omubiri ebingi, MODS, okulemererwa kw’ebitundu by’omubiri, sepsis, obujjanjabi obw’amaanyi, okulemererwa kw’ebitundu by’omubiri, okuwagira obulamu