Wali owuliddeko ku mbeera eyitibwa SIRS (Systemic Inflammatory Response Syndrome)? Erinnya lino liyinza okuba eppya gy’oli. Naye embeera ya bulabe nnyo eyinza okubaawo munda mu mibiri gyaffe. Kiba ng’omubiri okusukkiridde okukola ku kizibu ekitono ne gutandika omuliro omunene. Kino tunaayogera mu bujjuvu?

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SIRS (Systemic Inflammatory Response Syndrome) kye ki?

Mu ngeri ennyangu, SIRS bwe buba omubiri gwaffe bwe gusukkiridde okukola ku kintu ekituleetera okunyigirizibwa. Kilowoozeeko ng’enkola y’ebyokwerinda mu ggwanga. Omulabe omutono bw’ajja, alina okukirwanyisa mu ngeri entuufu. Naye mu SIRS, kiringa eggye lino bwe litandika olutalo olunene ku kintu ekitono. Kino kireeta okuzimba okw’amaanyi mu mubiri gwonna. Okuzimba kuno kuyinza okwonoona ebitundu byaffe ebikulu, okubireetera okulekera awo okukola, n’oluusi n’okuteeka obulamu bwaffe mu matigga. Eno y’ensonga lwaki kya bulabe. Bwe twogera ku bintu ebituleetera situleesi, bye biruwa?

Yinfekisoni : Yinfekisoni ezireetebwa obuwuka , akawuka , ffene, n’ebirala Oluusi, ne yinfekisoni y’ekiwundu ekitono esobola okuvaako omusujja, naye bwe yeeyongera okusajjuka, kiyinza okuvaako SIRS.
Okulongoosebwa: Ne bwe bamala okulongoosebwa ennyo, oluusi omubiri gusobola okukola bwe guti.
Okuzimba okw’amaanyi : Bwe wabaawo okuzimba okw’amangu, okw’amaanyi awalala mu mubiri, okugeza, obulwadde bw’olubuto .
Ischemia: Kino omusaayi bwe gukendeera okutuuka mu kitundu ky’omubiri oba ekitundu ky’omubiri. Olwo obutoffaali obuli mu bitundu ebyo ne butandika okufa, era n’omubiri gusobola okuddamu kino.
Kookolo: SIRS era esobola okubaawo mu mbeera za kookolo ezimu.

Ebintu nga bino bye bisinga okuvaako SIRS.

SIRS ne Sepsis kintu kimu?

Yee, wadde nga waliwo akakwate akatono wakati w’ebintu bino byombi, sepsis mbeera ya njawulo katono okusinga SIRS. Wuliriza bulungi. Singa ekivaako SIRS kiba yinfekisoni , ekyo kye tuyita sepsis . Otegedde? Kwe kugamba, kumpi buli muntu alina obulwadde bwa sepsis alina SIRS. Kubanga obubonero bwa SIRS bubaawo ng’omubiri guzzeemu okukwatibwa yinfekisoni. Wabula si buli muntu alina SIRS nti alina obulwadde bwa sepsis. Kubanga SIRS tesobola kuva ku yinfekisoni zokka, wabula n’ensonga endala ng’okulongoosebwa, kookolo, n’okukendeera kw’omusaayi, nga bwe kyayogeddwako emabegako. Obulwadde bwa Sepsis era bulwadde bwa bulabe nnyo eri obulamu era nga kyetaagisa obujjanjabi obw’amangu.Eno y’ensonga lwaki kikulu nnyo okubeera nga omanyi byombi.

SIRS ya bulijjo etya?

Kizibu abanoonyereza okwogera ddala engeri kino gye kitera okubaawo, kubanga si buli muntu alina SIRS nti atuuka mu ddwaaliro mu budde. Naye SIRS mbeera ya bulijjo nnyo mu bitongole by’abalwadde ab’amangu n’ebifo eby’abalwadde abayi (ICUs) . Mu kunoonyereza okumu, baatunuulira abalwadde kumpi 27,000 abaali mu malwaliro. Ku abo, 15% baalina obubonero obutakka wansi wa bubiri obwanditwaliddwa nga SIRS nga baweereddwa ekitanda mu ddwaaliro. Era 47% baatuukiriza ebisaanyizo bya SIRS waakiri omulundi gumu mu kiseera we babeera mu ddwaaliro. N’olwekyo oyinza okulowooza ku ngeri kino gye kiyinza okuba eky’amaanyi.

Bubonero ki obulaga obulwadde bwa SIRS? Obategeera otya?

Olw’okuba SIRS erina ebintu bingi ebigiviirako era ekosa ebitundu by’omubiri bingi eby’enjawulo, obubonero buyinza okwawukana ennyo. Naye bw’oba olina obubonero buno obumu oba obusingawo, tobubuusa maaso. Kiba kya magezi okunoonya amagezi mu bwangu eri abasawo. Bino bye bimu ku bubonero obulaga nti obulwadde buno:

Okumyuuka n’okuzimba (edema) mu bitundu by’omubiri ebikoseddwa: okufaananako n’okuzimba okwetooloola ekiwundu, oba kiyinza okusingawo.
Obulumi obw’amaanyi: Obulumi obutagumiikiriza mu kitundu ekikoseddwa.
Okufiirwa emirimu mu bitundu by’omubiri: Okugeza obutasobola kutambuza mukono oba kigere.
Obukoowu obw’amaanyi: Oyinza okuwulira ng’okooye nnyo era ng’olina otulo ne kiba nti tolina ky’osobola kukola.
Omutima gweyongera okukuba (Tachycardia): Omutima gukuba mangu okusinga ku gwa bulijjo. Kiyinza okusukka emipiira 90 buli ddakiika.
Obutabeera bulungi mu kussa: Okukaluubirirwa okussa, okweyongera kw’okussa (emirundi egisukka mu 20 buli ddakiika).
Omusujja oba Hypothermia : Omubiri guyinza okubuguma ennyo ne gufuna omusujja, oba, okwawukana ku ekyo, ebbugumu ly’omubiri liyinza okukka wansi wa diguli 36 (96.8 Fahrenheit).
Okukankana oba okuwunya: Otandika okukankana ng’olina omusujja.
Olususu luwulira nga lwokya oba nga lunyirira olw’entuuyo: Oluusi olususu luyinza okuwulira nga lwokya oba nga lunyirira olw’entuuyo.
Okusiiyibwa ku lususu: Ebika by’okusiiyibwa eby’enjawulo, gamba nga eczema, bisobola okulabika ku lususu.
Okutabulwa, okutabulwa oba enkyukakyuka endala mu birowoozo: Obubonero ng’okutabulwa, okutabulwa, n’okwogera obubi.
Okubulwa amagezi: Kano kabonero ka bulabe nnyo.

Ekisinga obukulu:Bw’oba olina obubonero buno, nsaba tosigala waka. Genda mu ddwaaliro erikuli okumpi amangu ddala nga bwe kisoboka, oba kuba 1990 okufuna ambyulensi. SIRS mbeera ya bujjanjabi ya mangu.

Biki ebivaako SIRS?

SIRS ebaawo, nga bwe kyayogeddwako emabegako, ng’abaserikale baffe abaserikale bakola ekisusse ku kintu ekituleetera okunyigirizibwa. Mu budde obwabulijjo, omubiri gwaffe gukozesa okuzimba okutuyamba. Lowooza ku kino, bwe tufuna ekiwundu, kizimba ne kimyufu kubanga obutoffaali bujja okukirwanyisa ne butandika okuwona ekiwundu. Naye mu SIRS, okuddamu kuno kufuuka kwa maanyi mu ngeri eteetaagisa , era okuzimba kuno kwennyini kutuleetera obulabe bungi. Zino ze zimu ku nsonga enkulu eziyinza okukosa embeera ya SIRS:

Acute aspiration of food or liquids: Singa emmere oba amazzi gamira nga olya oba okunywa, ebintu bino ne biyingira mu mawuggwe, kino nakyo kiyinza okuleeta SIRS.
Acute end-organ ischemia: Omusaayi ogugenda mu kitundu ekikulu, gamba ng’obwongo, omutima oba ensigo, bwe guyimirira mangu oba ne gukendeera nnyo.
Acute pancreatitis: Eno nayo mbeera ya maanyi.
Ebizibu ebiva mu ddagala: Omubiri gusobola okukola obubi ku ddagala erimu.
Yinfekisoni za bakitiriya: Yinfekisoni za bakitiriya ez’amaanyi nga pneumonia ne meningitis.
Kookolo w’omusaayi (hematologic malignancy): Embeera nga leukemia, lymphoma, ne multiple myeloma.
Okwokya: SIRS nayo esobola okubaawo olw’okwokya okunene.
Erythema multiforme: Kino kikwata nnyo ku lususu.
Obutatambula musaayi mu byenda byo n’okukutuka mu lubuto.
Okukozesa ebiragalalagala ebitali bya bujjanjabi n’okukozesa ebisusse.
Obulwadde bw’emisuwa: Eno mbeera ya kuzimba era ebeera mu misuwa.
Toxic shock syndrome: Eno era mbeera ya bulabe eri obulamu bw’omuntu ereetebwa obuwuka obuleeta obulwadde.
Obuvune n‟obuvune obuva ku kulongoosebwa.
Embeera eziringa ssennyiga w’akawuka: Oluusi ne ssennyiga owa bulijjo asobola okufuuka SIRS singa afuuka ow’amaanyi.
Obulwadde bwa ffene obubunye mu bantu abalina abaserikale b’omubiri abanafu.

Kati osanga okitegedde nti SIRS esobola okubaawo olw’ensonga nnyingi.

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

Abantu abamu batera okulwala SIRS okusinga abalala. Ka tuzuule ani gwe bali.

Emyaka: Abaana abato n’abantu abasukka mu myaka 65 bali mu bulabe bwa maanyi kubanga abaserikale b’omubiri b’abantu bano bombi bayinza okuba nga banafu katono.
Okubeera n’abaserikale b’omubiri abanafuye: Abantu abajjanjabwa kookolo, abalina akawuka ka siriimu, n’abo abakyusiddwa ebitundu by’omubiri banafuye, ekibaleetera okulwala SIRS.
Embeera ezitawona: Abantu abalina embeera eziwangaala nga sukaali, cirrhosis (okukaluba kw’ekibumba), ne COPD (obulwadde bw’amawuggwe obutawona) nabo bali mu bulabe obw’amaanyi.
Obulwadde obuliwo: Bw’oba olina dda yinfekisoni, gamba ng’ekifuba, obulwadde bw’okuzimba omutwe oba cellulitis (obulwadde bw’olususu), butera okufuuka obw’amaanyi ne bugenda mu maaso n’okutuuka ku SIRS.

Kale bw’oba ggwe oba omuntu gw’omanyi alina ensonga zino ez’akabi, kikulu nnyo naddala okumanya obubonero bwa SIRS.

Abasawo bazuula batya obulwadde bwa SIRS?

Olw’okuba SIRS mbeera eyinza okutta omuntu, abasawo bagezaako okugizuula nga bukyali. Bakozesa bino wammanga okukikola:

Okukebera omubiri: Omubiri gwo gukeberebwa naddala obubonero obukulu ng’omusujja, okukuba kw’omutima, okussa, ne puleesa.
Obubonero bwo: Tukubuuza n’obwegendereza ku buzibu bw’owulira.
Ebyafaayo byo eby’obujjanjabi: Ojja kubuuzibwa ebintu ng’endwadde z’omaze n’eddagala ly’omira.
Ekiyinza okuvaako SIRS: Singa ekivaako SIRS kisobola okuzuulibwa, era kijja kuyamba mu kuzuula.

Ebiseera ebisinga, omusawo alina obubonero buno ajja kwekengera SIRS n’atandika obujjanjabi mu bwangu. Wabula okugatta ku ekyo, bayinza n’okukola ebigezo ebirala ebiwerako okwongera okwekenneenya obulamu bwo n’okuzuula ekituufu ekivaako SIRS. Okugeza nga:

Okukebera omusaayi: Bino bisobola okukebera ebintu bingi. Okugeza, basic metabolic panel, complete blood count (CBC) (kino kikebera omuwendo gw’obutoffaali obweru), okukebera lactic acid, okukebera enkola y’ekibumba, okukebera enkola y’ekibumba, n’ebirala.
Omuwendo gwa oxygen mu musaayi.
Okukebera omusulo.
Okukebera okukuza obuwuka: Okuzuula oba waliwo yinfekisoni era bwe kiba bwe kityo, obuwuka ki bwe buva.
Ebigezo by’okukuba ebifaananyi:Ebintu nga X-ray oba CT scans bisobola okulaga ebigenda mu maaso munda mu mubiri.

emisingi gya SIRS

Okuzuulibwa nti olina SIRS, olina okuba n’obubonero bubiri ku buno wammanga:

Ebbugumu ly’omubiri: Okweyongera diguli ezisukka mu 38 (100.4 Fahrenheit) oba okukendeera okusukka diguli 36 (96.8 Fahrenheit).
Omutima okukuba: Kyongera okutuuka ku kukuba okusukka mu 90 buli ddakiika.
Omuwendo gw’okussa: Okweyongera kw’omuwendo gw’omukka buli ddakiika okusukka 20, oba okukendeera kwa puleesa y’ekitundu eya CO2 mu musaayi etasukka mmHg 32.
Omuwendo gw’obutoffaali obukola omusaayi (white blood cell): Okweyongera okusukka mu 12,000.

Naye ku baana, emisingi gino gya njawulo katono. Okuzuulibwa nti balina SIRS, balina okuba n’obutoffaali obweru obutali bwa bulijjo n’ebbugumu ly’omubiri eritali lya bulijjo. Kino kiri bwe kityo kubanga omutima gw’abaana n’okussa bitera kuba waggulu katono okusinga ogw’abantu abakulu.

SIRS ejjanjabibwa etya?

Waliwo ebintu bibiri ebikulu by’olina okulowoozaako ng’ojjanjaba SIRS. Ekimu kwe kujjanjaba ekizibu ekikulu ekivaako SIRS. Ekirala kwe kuziyiza obulwadde bw’obutakola bulungi mu bitundu by’omubiri ebingi (MODS). Enkola z’obujjanjabi ziyinza okwawukana okusinziira ku kivaako SIRS. Wabula bino bye bimu ku bujjanjabi obusinga okukozesebwa:

Okuwa amazzi okuyita mu musuwa (IV fluids): Kino kiyamba okulaba ng’omusaayi gutambula bulungi mu bitundu by’omubiri n’okuziyiza puleesa okukka ennyo.
Eddagala eritta obuwuka: Singa SIRS eva ku bulwadde bwa bakitiriya, eddagala lino liweebwa.
Eddagala eriweweeza ku misuwa: Puleesa bw’eba ntono nnyo, zino ziweebwa okugizza mu mbeera eya bulijjo.
Corticosteroids: Zino zikozesebwa okutangira omubiri okugenda mu shock oba okuguyamba okudda engulu.
Insulin okuyita mu musuwa (IV insulin): Fuga ssukaali mu musaayi (bwe kiba kyetaagisa).
Okulongoosa: Okugeza, okulongoosa okunoonyereza okuggya amasira ku kiwundu ekizimba, okuggyamu ebitundu ebyonooneddwa oba okuzuula ekikyamu munda.

Teebereza, bw’oba olina ekibumba ekikulemeredde, oyinza okwetaaga okulongoosebwa omusaayi (okulongoosa omusaayi). Mu ngeri y’emu, bw’oba olina obuzibu mu kussa, kiyinza okwetaagisa okuyungibwa ku kyuma ekissa.

Kisoboka okudda engulu okuva mu SIRS? Entunula eri etya?

Enteebereza ya SIRS esinziira ku nsonga eziwerako.

Engeri gye wazuulibwa mangu era n’ojjanjabibwa.
Kiki ekivaako SIRS?
Oba olina ensonga ez’akabi eziyinza okuvaako okulwala SIRS (e.g., abaserikale b’omubiri abanafu).

Amawulire amalungi gali nti singa bajjanjabwa mangu, abantu abasinga obungi abalina SIRS bawona ddala era basobola okudda mu bulamu obwa bulijjo. Kyokka eno mbeera ya maanyi era oluusi eyinza okutta omuntu. Omuwendo gw’abafa okuva mu SIRS guli nga 7%. Omuwendo gw’abafa naddala olw’obulwadde bwa sepsis guli bwe guti:

Ku bulwadde bwa sepsis: 1.3%
Ku bulwadde bwa sepsis obw’amaanyi: 9.2% .
Ku septic shock (embeera eva ku sepsis): 28% .

N’olwekyo, kikulu nnyo okunoonya amagezi g’abasawo amangu ddala ng’obubonero bwa SIRS bulabika, kubanga waliwo akabi ak’okufa.

Bizibu ki ebiyinza okuva mu SIRS?

SIRS (naddala nga evudde ku yinfekisoni) esobola okugenda mu maaso n’efuuka sepsis ey’amaanyi oba septic shock. Era kiyinza okuvaako okulemererwa kw’ebitundu by’omubiri ebingi oba ekitundu kimu. Okugatta ku ekyo, ebizibu ebivaamu nga:

Acute adrenal insufficiency: Kino kye kiseera endwadde zo ez’ekibumba bwe zitakola busimu bukulu bumala nga cortisol.
Acute encephalopathy: Obulwadde bwonna obw’obwongo obukosa enkola oba ensengekera y’obwongo.
Acute Respiratory Distress Syndrome (ARDS): Amawuggwe gaayonoonese nnyo.
Acute transaminitis: Okweyongera kw’emiwendo gy’enziyiza ezimu ezikosa enkola y’ekibumba.
Acute tubular necrosis: Okwonooneka kw’ensigo.
Okuzimba omusaayi mu misuwa emiwanvu (Deep Vein Thrombosis - DVT).
Disseminated Intravascular Coagulation (DIC): Kino kireetera obutundutundu obutono obw’omusaayi okutondebwa mu mubiri gwonna, ekyongera okuvaamu omusaayi.
Hemolysis: Okumenya obutoffaali obumyufu.
Metabolic acidosis: Okwongera asidi mu mubiri.
Thrombocytosis (okweyongera kw’omuwendo gw’obutoffaali obukola omusaayi) oba thrombocytopenia (okukendeera kw’omuwendo gw’obutoffaali obukola omusaayi).

Ebimu ku bizibu bino bisobola okujjanjabibwa n’okuwona, era bisobola okukyusibwa. Naye ebimu, gamba ng’okwonooneka kw’obwongo, bisobola okuba eby’olubeerera. Y'ensonga lwaki SIRS ya bulabe nnyo.

Kiki kye tuyinza okukola okuziyiza SIRS?

Wadde nga SIRS tesobola kuziyizibwa ddala, waliwo ebintu ebitonotono bye tuyinza okukola okukendeeza ku mikisa gy’okugwawo. Ka tulabe kye bali.

Bulijjo goberera enkola ennungi ez’obuyonjo: Fuba okuziyiza obulwadde bw’akawuka naddala ng’oyita mu bintu ng’okunaaba mu ngalo.
Okukuuma ebiwundu ebitemeddwa n’ebirala nga biyonjo okutuusa lwe biwona: Weegendereze obutaleka wadde ekiwundu ekitono kuzimba.
Okufuna eddagala erigema mu budde: Kino kiyinza okukuuma yinfekisoni nnyingi.
Funa obujjanjabi obutuufu ku mbeera ezitawona: Kikulu okukuuma endwadde nga sukaali ne puleesa nga zifugibwa.
Laba omusawo singa obubonero bw’embeera oba obulwadde obuliwo bweyongera: Tobuusa maaso kintu kitono.
Funa omusawo mu bwangu bw’oba olina obuvune obw’amaanyi oba ng’oteebereza nti olina yinfekisoni: Obujjanjabi obw’amangu busobola okuziyiza okwonooneka okw’amaanyi.

Obubaka Obusembayo Okutwala Awaka

Ekintu ky’olina okusooka okujjukira kiri nti SIRS (Systemic Inflammatory Response Syndrome) mbeera ya mangu ey’obujjanjabi eyinza okutta omuntu . Okuziyiza SIRS, kyetaagisa okunoonya obujjanjabi obw’amangu ku yinfekisoni yonna, obuzibu bw’embeera y’obujjanjabi, oba obuvune obw’amaanyi. Singa tezijjanjabwa, SIRS esobola okuleeta ebizibu eby’amaanyi n’okufa. Bw’oba olina ebintu eby’obulabe eri SIRS (e.g., abaserikale b’omubiri okunafuwa, obulwadde obutawona), yogerako n’omusawo wo ku ngeri y’okuddukanyaamu obulabe obwo, obubonero bwa SIRS bwe buli, n’eky’okukola singa bubaawo. Faayo ku bulamu bwo era otegeezebwe. Ekyo kye kintu ekisinga obukulu! SIRS, Systemic Inflammatory Response Syndrome, Sepsis, Sepsis, Okuzimba, Obulwadde, Okuddamu kw’omubiri, Obujjanjabi obw’amangu