Okussa kwo kuli kwa maanyi nnyo? (Respiratory Depression/Hypoventilation) - Ka twogere ku nsonga eno!

Wali owuliddeko ng’olina obuzibu mu kussa, oba ng’ossa ddala obubi? Mpozzi nga wawulira ng’oziyira oba ng’okooye. Ensonga emu eyinza okuba emabega w’ebintu bino kwe kukendeera kw’okussa, nga kino mu by’obujjanjabi kye tuyita (Respiratory Depression) oba (Hypoventilation) .

Okwennyamira mu kussa kye ki?

Mu ngeri ennyangu, okwennyamira mu kussa ( oba hypoventilation) kwe kussa kwo okukendeera ennyo, oba okussa okutono ennyo. Kino bwe kibaawo, okuwanyisiganya empewo tekubaawo bulungi mu mawuggwe go. Lowooza ku kino, bwe tussa, okisigyeni mu mpewo ennungi agenda mu musaayi ng’ayita mu nsawo z’empewo entonotono (alveoli) mu mawuggwe gaffe. Ate era, kaboni dayokisayidi (CO2) , ekintu ekifuuse kasasiro eri omubiri gwaffe, adda mu mawuggwe okuva mu musaayi n’afulumizibwa. Kino kye tuyita okuwanyisiganya ggaasi .

Kati, mu mbeera ya (Hypoventilation) , ekibaawo nti olw’okuba tossa bulungi, omukka ogwo ogwa kaboni dayokisayidi (CO2) teguva mu mubiri ne gukuŋŋaanyizibwa mu musaayi. Kino tukiyita (Hypercapnia) . Tekikoma awo, oluusi amawuggwe gayinza obutafuna mukka gwa oxygen gumala. Olwo omukka gwa oxygen mu musaayi gukendeera, ekintu ekiyitibwa (Hypoxemia) . Otegedde?

Obubonero bwe buliwa?

Bw’oba ​​okendedde mu kussa (hypoventilation) , oyinza okufuna obubonero nga:

• Okuziyira n’okusiiyibwa.
• Okulumizibwa omutwe.
• Okuwulira ng’okooye, otulo , oba ng’okooye buli kiseera.
• Okutabulwa, okutabulwa , oba enkyukakyuka mu mbeera y’obwongo.
• Omutima gweyongera.
• Okuziyira.
• Okussa kuwulira nga kugenda mpola, nga tekuwanvu oba nga kuzibuwaliddwa.
• Okukyusa langi y’olususu, emimwa oba enjala za bbululu (cyanosis) . Kano kabonero ka maanyi nnyo.

Kiki ekivaako kino?

Ebikulu ebivaako okussa obubi biyinza okuba okukozesa obubi eddagala erimu, okunywa ennyo , oba okukola ku mwenge oba ebiragalalagala ebimu nga tosuubira. Lowooza ku bintu bino:

• Opioids: Zino era ziyitibwa ebiragalalagala . Eby’okulabirako mulimu eddagala lya morphine , tramadol, oxycodone (OxyContin®) , ne fentanyl . Abantu abamu bakozesa bubi ebiragalalagala bino.
• Eddagala lya Benzodiazepines:Zino zitera kuba za kukkakkanya bantu n’empeke ez’okwebaka. Eby’okulabirako mulimu eddagala lya lorazepam (Ativan®) , alprazolam (Xanax®) , ne diazepam (Valium®) .
• Barbiturates: Eddagala lino oluusi liweebwa ku kukonziba oba omutwe omuzito .
• Ebiragalalagala ebimenya amateeka: Ebintu nga heroin ne gamma hydroxybutyrate (GHB) .
• Empeke z’okwebaka: Eddagala eriwandiikibwa omusawo nga zolpidem (Ambien®) .
• Okubudamya: Era kiyinza okuva ku ddagala eriweebwa okukuleetera otulo nga tonnalongoosebwa.

Ng’oggyeeko eddagala n’eddagala lino, endwadde n’embeera endala nazo zisobola okuvaako empewo okukendeera :

• Omugejjo: Kino kiyitibwa Obesity Hypoventilation Syndrome (OHS) . Kitegeeza nti okussa kufuuka kuzibu olw’omugejjo.
• Embeera ezireeta obuzibu mu kussa: Ng’ekyokulabirako, obulwadde bw’amawuggwe obutawona (COPD) n’okuziyiza okussa mu tulo .
• Embeera ezikendeeza ku kussa: Okugeza , stroke ne hypothyroidism .
• Embeera ezikosa omugongo, obusimu, oba okufuga ebinywa: Eby’okulabirako mulimu okulemererwa kw’ebinywa , obuzibu mu busimu oba omugongo, multiple sclerosis (MS) , ne amyotrophic lateral sclerosis (ALS) .
• Enkyukakyuka mu nkula y’ekifuba oba omugongo: Embeera nga scoliosis ( curvature of the spine), ankylosing spondylitis, ne flail chest .
• Obutwa oba obutwa: Ebintu nga tetanus , obutwa bwa ciguatera, ne botulism .

Bintu ki ebyongera ku bulabe?

Obulabe bw’okussa obubi buyinza okweyongera olw’ensonga zino wammanga:

• Okukozesa obubi eddagala nga opioids oba benzodiazepines .
• Bw’oba ​​waakalongoosebwa (olw’okubudamya).
• Singa wabaawo endwadde ezimu ez’amawuggwe, ebinywa, n’obusimu (obwongo n’omugongo), nga bwe twayogeddeko waggulu.

Kino kiyinza okuleeta bizibu ki?

Kaboni dayokisayidi mu musaayi gwoSinga CO2 efuuka waggulu nnyo, kiyinza okuleeta ebizibu eby’akabi, n’okutta omuntu. Weetegereze:

• Respiratory Acidosis: Kino kitegeeza nti omusaayi gwo gulimu asidi mungi okusinga bwe gulina okuba.
• Okulemererwa okussa: Kino kye kiseera ebitundu by’omubiri gwo bwe bitafuna mukka gwa oxygen gumala.
• Cardiac Arrest: Omutima okuyimirira mu bwangu.
• Coma.
• Puleesa y’amawuggwe: Puleesa yeeyongera mu misuwa egyegatta ku mawuggwe.

Kino okizuula otya?

Okuzuula ekizibu ky’okussa , omusawo ajja kusooka kukubuuza ku bubonero bwo, ebyafaayo byo eby’obujjanjabi, n’eddagala lyonna ly’omira. Oluvannyuma, bayinza okulagira okukeberebwa omusaayi mu ngeri ey’enjawulo okupima obungi bwa kaboni dayokisayidi (CO2) mu musaayi gwo. Bayinza n'okulagira okukeberebwa okulala okuzuula kiki ddala ekivaako empewo okukendeera .

Ebigezo bya ngeri ki ebikolebwa?

Okukebera nga kuno kuyinza okukolebwa okuzuula ekivaako okussa obubi:

• Okukebera omukka mu musaayi mu misuwa: Kino kikebera obungi bwa oxygen, carbon dioxide ne asidi mu musaayi.
• Ebigezo by’emirimu gy’amawuggwe: Bino bye bigezo ebikebera amawuggwe go bwe gakola obulungi.
• Pulse Oximetry: Ekyuma ekipima obungi bwa oxygen mu musaayi gwo nga kikwata akatundu akatono ku ngalo yo. Kino oyinza okuba nga wali okirabye.
• Okukebera omusaayi: Waliwo okukebera omusaayi okulala kungi okuyinza okuyamba okuzuula embeera eno oba ebigireeta. Eby’okulabirako mulimu Complete Blood Count (CBC) , Basic Metabolic Panel (BMP) , Toxicology Screen (okukebera ebintu ng’eddagala), okukebera omusaayi gwa Carbon Dioxide (CO2) , n’okukebera enkola ya Thyroid .
• Okukuba ebifaananyi: Omusawo ayinza okulagira okukeberebwa X-ray mu kifuba kyo, CT scans (Computed Tomography scans) mu kifuba oba omutwe gwo okunoonya embeera endala ezikusibukako.
• Okunoonyereza ku tulo / Polysomnography: Okukebera kuno kuyamba okuzuula embeera nga sleep apnea ne obesity hypoventilation syndrome .

Kijjanjabwa kitya?

Obujjanjabi bw’okussa obubi businziira ku kivaako n’engeri embeera gy’eri ey’amaanyi. Abajjanjabi bayinza okukuwa obujjanjabi nga:

• Noninvasive Ventilation: Kino kizingiramu okukozesa ekyuma ekikuyamba okussa ng’oyita mu masiki ekwata ku maaso. Okugeza, ekyuma kya Continuous Positive Airway Pressure (CPAP) oba ekyuma kya Bilevel Positive Airway Pressure (BiPAP®) . Bino oyinza okuba nga wali owuliddeko.
• Eddagala eriweweeza ku kussa: Oluusi, singa embeera eno eva ku ddoozi esukkiridde oba ng’ekizibu ekiva mu ddagala, eddagala erikyusa eddagala liyinza okuweebwa. Okugeza, singa embeera eno eva ku opioids , ebivaamu bisobola okukendeezebwa nga bawa eddagala eriyitibwa Naloxone/Narcan® .
• Obujjanjabi bwa Oxygen: Oxygen asobola okuweebwa bwe kiba kyetaagisa.
• Okuyingiza empewo mu byuma: Singa embeera eba ya maanyi nnyo, omuntu ayinza okwetaaga okukkakkanya, okuteekebwa mu ttanka, n’okussa ekyuma.

Embeera ya ngeri ki eyinza okusuubirwa okugenda mu maaso? (Endowooza)

Enteebereza y’okussa obubi esinziira ku kivaako. Embeera ey’amangu, gamba ng’okukozesa eddagala lya opioid erisukkiridde, eyinza okutta omuntu singa tebujjanjabwa mangu. Kyokka, singa embeera eno eva ku buzibu bw’okusannyalala mu tulo, obulwadde bw’okusannyalala mu tulo obuva ku mugejjo ( OHS ) , oba embeera endala eziwangaala, kijja kwetaagisa okujjanjabibwa buli kiseera era kijja kutereera mpolampola.

Kiyinza okuziyizibwa?

Engeri esinga obulungi ey’okuziyiza okussa obubi kwe kumira eddagala lyo nga bwe likulagiddwa ddala n’okuddukanya embeera yonna ey’obujjanjabi. Kakasa nti obuuza omusawo wo oba omukugu mu by’eddagala nga tonnamira ddagala bbiri oba okusingawo naddala eddagala lya opioids ne benzodiazepines erikukendeeza ku ndowooza yo oba okukuleetera otulo. Also , be aware of the possible adverse reactions eziyinza okubaawo nga eddagala lino limira n’omwenge.

"Eddagala mukwano singa likozesebwa mu ngeri entuufu, naye mulabe singa likozesebwa mu bukyamu."

Ddi lwe nnina okulaba omusawo?

Yogerako n’omusawo wo mu mbeera zino:

• Bw’oba ​​olina ekibuuzo kyonna oba ky’obuusabuusa ku mbeera y’obujjanjabi gy’olina.
• Bw’oba ​​olina ebibuuzo oba okubuusabuusa ku ddagala eriwandiikiddwa omusawo.
• Bw’oba ​​olina obubonero bw’okussa obubi naddala ng’olina embeera endala ez’obujjanjabi ezongera ku bulabe.

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

Bw’oba ​​olina obubonero buno obw’amaanyi , genda mu kisenge ky’abalwadde ab’amangu ekikuli okumpi:

• Bwoba olina okukonziba .
• Singa embeera y'obwongo ekyuse era nga waliwo okutabulwa .
• Bw’owulira otulo nga tosobola kusigala ng’otunula.
• Bw’oba ​​olina disorientation ku kifo w’oli ne ddi lw’oli.
• Singa ofuna okutya oba okwekengera okutali kwa bulijjo (paranoia) .
• Singa olususu, emisumaali oba emimwa gifuuka bbululu.

Bibuuzo ki by’osaanidde okubuuza omusawo?

Kiyinza okuba eky’omugaso okubuuza omusawo wo ebibuuzo nga bino:

• "Lwaki kino kyantuukako?"
• "Nkole ki okutangira ekintu nga kino okubaawo mu biseera eby'omu maaso?"
• "Bujjanjabi ki bwe nnina?"

N’ekisembayo, ebintu by’olina okujjukira (Obubaka bw’okutwala awaka) .

Obulwadde bw’okussa mbeera ya maanyi nnyo nga kaboni dayokisayidi (CO2) azimba mu musaayi gwo. Naye emirundi mingi kiyinza okuziyizibwa. Bw’oba ​​omira eddagala eriyinza okukuleetera okwennyamira mu kussa, yogerako n’omusawo okukakasa nti olimira bulungi era nga tolina bulabe. Bw’oba ​​olina embeera endala ey’obujjanjabi eyinza okuleeta embeera eno, buuza omusawo wo ku mitendera gy’oyinza okukola okukendeeza ku bulabe bwo. Asobola okwogera naawe ku bikweraliikiriza n’okukola enteekateeka y’okuddukanya embeera yo n’eddagala lyo mu ngeri ey’obukuumi. Okufaayo ku bulamu bwo kye kintu ekisinga obukulu.

` Okwennyamira mu kussa, obutassa empewo, okukendeeza ku kussa, kaboni dayokisayidi, omukka gwa oxygen, obulwadde bw’amawuggwe, okukozesa ebiragalalagala