I thawk a thuk lutuk em? (Respiratory Depression/Hypoventilation) - Hemi chungchang hi han sawi ila!

Thâwk harsa tak angin i inhria ngai em, a nih loh leh thawk harsa tak tak angin i inhria ngai em? I luak chhuak emaw, i chau emaw pawh a ni mai thei. Heng thilte chhan awm thei pakhat chu thawk a tlahniam a, chu chu damdawi lam chuan (Respiratory Depression) emaw (Hypoventilation) emaw kan tih hi a ni.

Respiratory depression tih hi eng nge ni?

A awlsam zawngin, thawkna lama harsatna ( or hypoventilation) chu i thawk chhuah a hniam lutuk a, a nih loh leh i thawk a hniam lutuk a ni. Chutiang a nih chuan i lungah boruak inthlak danglamna a thleng dik lo. Ngaihtuah teh, kan thawh hian boruak thianghlima oxygen chu kan lung chhunga boruak bawm (alveoli) te tak te hmangin thisenah a lut thin. Tin, kan taksa tana bawlhhlawh, carbon dioxide (CO2) , chu thisen atang hian lung chhungah a lut leh a, a thawk chhuak thin. Hei hi gas exchange kan tih chu a ni .

Tunah chuan (Hypoventilation) -ah chuan thil thleng chu i thawk tha lo a nih avangin chu carbon dioxide (CO2) gas chu taksa atangin a chhuak lo va, thisenah a pung khawm ta a ni. Hei hi (Hypercapnia) kan ti a ni. Chu mai ni lovin, a chang chuan lung hian oxygen a dawng tlem thei bawk. Tichuan thisenah oxygen level a tlahniam a, chu chu (Hypoxemia) an ti a. I hrethiam em?

Eng nge a lan chhuah dan?

Thâwk lak a tlahniam (hypoventilation) , i neih chuan hetiang chi hi i nei thei a ni:

• Nausea leh luak chhuak.
• Lu na.
• Chau, mutthilh , emaw, rilru hah reng reng.
• Disorientation, confusion , emaw, rilru dinhmun inthlak danglamna emaw.
• Heart rate a sang chho zel.
• Luak chhuak thei.
• Thâwk chu a slow, a thuk lo, a thawkrim hle niin a lang.
• Vun, hmui emaw, kut zungtang emaw rawng dum (cyanosis) . Hei hi chhinchhiahna pawi zawk a ni.

Eng thilin nge hei hi a thlen?

Thâwk hahna thlentu ber chu damdawi ṭhenkhat hman dik loh, overdose , emaw, zu emaw, ruihhlo emaw ṭhenkhata beisei loh taka thil tih a ni thei. Hêng thilte hi han ngaihtuah teh:

• Opioids: Hengte hi narcotics an ti bawk. Entirnan , morphine , tramadol, oxycodone (OxyContin®) , leh fentanyl te hi a ni. Mi thenkhat chuan heng ruihhlo te hi an hmang sual thin.
• Benzodiazepines te hi: 1.1.Hengte hi sedative leh mutna damdawi a ni tlangpui. Entirnan, lorazepam (Ativan®) , alprazolam (Xanax®) , leh diazepam (Valium®) te hi a ni.
• Barbiturates: Heng damdawi te hi a chang chuan seizure emaw migraine emaw tan pek thin a ni .
• Dan loa ruihhlo: Heroin leh gamma hydroxybutyrate (GHB) ang chi thil .
• Mut theihna damdawi: Damdawi damdawi, zolpidem (Ambien®) .
• Anesthesia: Operation hmaa mutthilh tir tura damdawi an pek vang pawh a ni thei.

Heng damdawi leh damdawi bakah hian natna leh dinhmun dangin hypoventilation a thlen thei bawk :

• Thau lutuk: Hei hi Obesity Hypoventilation Syndrome (OHS) an ti a. Thau lutuk vangin thawk a harsa tihna a ni.
• Thâwk lama harsatna thlentu dinhmun: Entîr nân, chronic obstructive pulmonary disease (COPD) leh obstructive sleep apnea .
• Thluak chakna tihtlemtu dinhmun: Entirnan , stroke leh hypothyroidism .
• Spine, nerve, emaw muscle control tichhe thei dinhmun: Entirna atan muscular dystrophy, nerve emaw spinal cord disorders, multiple sclerosis (MS) , leh amyotrophic lateral sclerosis (ALS) te hi a ni.
• Chest emaw spine emaw pianzia inthlak danglamna: Scoliosis ( ruhro curvature), ankylosing spondylitis, leh flail chest ang chi natna te.
• Toxins emaw poisoning emaw: Tetanus , ciguatera toxicity, leh botulism ang chi thilte.

Eng thil nge risk tipung?

Thâwk hah lutuk hi a hnuaia thil awmte avang hian a pung thei a ni:

• Damdawi opioid emaw benzodiazepines emaw hman dik loh .
• Tun hnaia operation i neih tawh chuan (anesthesia vangin).
• A chunga kan sawi tawh ang khan lung, ruh leh nervous system (thluak leh ruhro) natna thenkhat a awm chuan.

Hei hian eng harsatna nge a thlen theih?

I thisenah carbon dioxide a awmCO2 level a san lutuk chuan harsatna hlauhawm tak, nunna atana hlauhawm tak pawh a thlen thei a ni. En teh:

• Respiratory Acidosis: Hei hian i thisen chu a nih tur aia acidic a ni tihna a ni.
• Respiratory Failure: Hei hi i taksa tissue ten oxygen an hmuh tlem vang a ni.
• Cardiac Arrest: Thinlung tawp nghal mai.
• Coma ah a awm.
• Pulmonary Hypertension: Lung nena inzawm thisen kalna kawng hrang hranga pressure sang.

Engtin nge hei hi i diagnose?

Respiratory depression , hriat theih nan doctor chuan i natna lan chhuah dan te, i damdawi lam chanchin te, leh damdawi i ei lai te a zawt hmasa ang che. Tichuan, i thisena carbon dioxide (CO2) awm zat tehna atan thisen test bik an ti thei ang. Hypoventilation thlentu dik tak hriat tumin test dang pawh an ti thei bawk .

Eng ang test nge tih thin?

Thâwk harsa chhan bulpui ber hriat nân hetiang test hi tih theih a ni:

• Arterial Blood Gas Test: Hei hian thisen a oxygen, carbon dioxide leh acidity awm zat a enfiah thin.
• Pulmonary Function Tests: Hengte hi i lung hnathawh that dan enfiahna test a ni.
• Pulse Oximetry: I kut zungtang-ah clip te tak te dahin i thisena oxygen awm zat tehna hmanrua a ni. Hei hi i hmu tawh mai thei.
• Thisen Test: He natna emaw, a chhan emaw hriat theihna tur thisen test dang tam tak a awm. Entirnan , Complete Blood Count (CBC) , Basic Metabolic Panel (BMP) , Toxicology Screen (damdawi ang chi thil awm leh awm loh enfiahna), Carbon Dioxide (CO2) thisen test, leh Thyroid Function Test te hi a ni.
• Imaging: Doctor chuan i rilru X-ray, i rilru emaw lu emaw CT scan (Computed Tomography scans) a order thei a, a hnuaia natna dang zawng turin a ti thei bawk.
• Sleep Study / Polysomnography: He test hian sleep apnea leh obesity hypoventilation syndrome ang chi natna te a hriat theih nan a pui a ni.

Engtin nge enkawl a nih?

Thâwk harsa enkawlna chu a chhan leh a natna a nasat danah a innghat a ni. Healthcare provider-te chuan enkawlna an pe thei che a, chungte chu:

• Noninvasive Ventilation: Hei hian i hmai chunga mask in fit hmanga thawk chhuahna tur machine hman a ni. Entirnan, Continuous Positive Airway Pressure (CPAP) machine emaw Bilevel Positive Airway Pressure (BiPAP®) machine emaw hmanga siam a ni. Chûngte chu i hre tawh mai thei.
• Respiratory Stimulant Medications: A chang chuan, he natna hi overdose vang emaw, damdawi pakhat side effect angin emaw a nih chuan reversal agent damdawi pek theih a ni. Entirnan, he natna hi opioids avanga lo awm a nih chuan Naloxone/Narcan® tih damdawi pek hian a nghawng chu tihziaawm theih a ni.
• Oxygen Therapy: A tul chuan oxygen pek theih a ni.
• Mechanical Ventilation: A natna a nasat em em chuan mi chu sedated a ngai mai thei a, tube-ah dah a ngai thei a, machine hmanga thawk tir a ngai thei bawk.

Hmalam pan zelin eng ang dinhmun nge beisei theih ang? (Hmuh dan tur) .

Thâwk harsa lo awm theihna tur prognosis chu a chhan a innghat a ni. Emergency, opioid overdose ang chi hi enkawl vat loh chuan thihna thlen thei a ni. Mahse, chu natna chu sleep apnea, obesity-related obstructive sleep apnea syndrome ( OHS ) , emaw, hun rei tak chhunga natna dang emaw avanga lo awm a nih chuan enkawl chhunzawm zel a ngai dawn a, zawi zawiin a ṭha chho zel ang.

A veng thei ang em?

Thâwk hahna laka invenna ṭha ber chu i damdawi ei tur chu a tih ang chiaha ei a, a hnuaia damdawi lam dinhmun eng pawh enkawl hi a ni. Damdawi pahnih emaw a aia tam emaw i ei hmain i doctor emaw pharmacist emaw zawt hmasa phawt ang che, a bik takin opioid leh benzodiazepines, i concentration tichhe thei emaw, mutthilh tir emaw. Also , heng damdawi te hi zu nena ei a nih chuan a nghawng tha lo awm thei te pawh hre reng ang che.

"Damdawi hi hman dik a nih chuan ṭhian a ni a, hman dik loh chuan hmelma a ni thung."

Engtikah nge Doctor ka hmuh ang?

Heng thil thlengah hian i doctor nen inbia ang che:

• Damdawi lam dinhmun i neih chungchangah zawhna emaw rinhlelhna emaw i neih chuan.
• Doctor-in damdawi a pek chungchangah zawhna emaw rinhlelhna emaw i neih chuan.
• Thâwk hahna chhinchhiahna i neih chuan, a bik takin damdawi lam thil dang i neih chuan i hlauhawmna a tipung a ni.

Engtikah nge Emergency Treatment Unit (ETU) ah i kal ang ?

Heng symptoms na tak tak te hi i neih chuan , emergency room hnai ber ah kal nghal rawh:

• Seizures i neih chuan .
• Rilru dinhmun a danglam a , buaina a awm chuan .
• I mutthilh lutuk a, i muhil thei lo tih i hriat chuan.
• I awmna leh engtikah nge i awm tih chungchangah disorientation i neih chuan.
• Hlauhna emaw rinhlelhna danglam tak (paranoia) i tawn chuan .
• Vun, nail emaw hmui emaw a rawn sen chuan.

Doctor hnenah eng zawhna nge i zawh tur?

I doctor hnenah hetiang zawhna hi zawh hi a \angkai thei ang:

• "Engvangin nge hetiang hi ka chungah a lo thlen?"
• "Nakin lawkah hetiang thil hi a thlen loh nan eng nge ka tih ang?"
• "Eng enkawlna kawng nge ka neih?"

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Respiratory depression hi natna khirh tak a ni a, i thisenah carbon dioxide (CO2) a lo awm khawm a ni. Mahse, ven theih a ni fo. Respiratory depression thlen thei damdawi i ei a nih chuan i doctor nen inbia la, dik tak leh him takin i ei em tih enfiah rawh. Hetiang natna thlen thei damdawi dang i neih chuan i doctor hnenah i hlauhawmna tihziaawmna tura i tih theih dan tur zawt rawh. I ngaihtuahnate chu a sawipui thei che a, i dinhmun leh damdawi ei turte him taka enkawl dan tur ruahmanna a siam thei bawk. I hriselna enkawl hi a pawimawh ber a ni.

` Thluak lama harsatna, thawk tha lo, thawk a tlahniam, carbon dioxide, oxygen, lung natna, ruihhlo hmansual