Me ako tātou mō te 'mīhini ngākau-pūkahukahu' (Cardiopulmonary Bypass) e whakamahia ana i te wā o te pokanga ngākau.

Kei te whakaritea koe, tetahi rānei o tō whānau kia pokanga nui mō te ngākau tuwhera? Kua rongo pea koe i ngā tākuta e kī ana ka honoa koe ki tētahi "mīhini ngākau-pūkahukahu." He mea noa te mataku me te hiahia ki te mōhio ina rongo koe i tēnei ingoa. He aha rawa tēnei mīhini? He aha tāna mahi? He mea hei wehi? Me kōrero ngāwari, me mārama hoki.

He aha te Cardiopulmonary Bypass?

He māmā noa iho, he mīhini tēnei e mahi ana mō te wā poto hei whakakapi i tō ngākau me ō pukahukahu. I te wā o te pokanga, ka hurihia te toto o tō tinana mā tēnei mīhini, kaua ki tō ngākau me ō pukahukahu. Koia i huaina ai ko te "takahi".

Whakaarohia, ka riro i tēnei mīhini ngā mahi matua e rua a tō ngākau me ō pukahukahu i te wā o te pokanga:

1. Te tāpiri i te hāora ki te toto (ko ngā pukahukahu te tikanga o tēnei).

2. Te pupuhi i te toto whai hāora puta noa i te tinana (ko te ngākau te kaiwhakahaere o tēnei mahi).

Ina honoa ki tēnei mīhini, ka taea e ngā tākuta te whakamutu i tō ngākau mā te hoatu ki a koe he rongoā motuhake e kiia nei ko te "Cardioplegia". Kātahi ka taea e te taote pokanga te mahi haumaru me te ngāwari i tētahi ngākau kāore e patupatu ana, kāore hoki e toto. I taua wā, ka whiwhi ngā okana katoa o tō tinana i te toto whai hāora e hiahiatia ana e ia mā tēnei mīhini. Ka karangahia hoki tēnei āhua e ngā tākuta ko "kei runga i te papu."

He rite tonu tēnei me te pokanga CABG?

Ae, he rerekē ēnei e rua. Engari he maha ngā wā ka puta tahi ēnei e rua. Ka whakapoauau ētahi i ēnei kupu e rua nā te mea kei roto i ēnei kupu e rua te kupu "bypass".

• CABG (Coronary Artery Bypass Grafting): Koinei te pokanga tuturu. Ina āraia ngā uaua coronary e tuku toto ana ki te ngākau e ngā putunga ngako, ka hangaia he ara hou (bypass) hei karo i te aukati me te tuku i te toto kia rere.

• Te Tātaritanga o te Manawa me te Pūkahukahu: He tikanga tēnei e whakamahia ana hei āwhina i te taote pokanga i te wā o te pokanga CABG (i tētahi atu pokanga manawa rānei). Ko te tikanga he huri i te rere o te toto huri noa i te manawa me ngā pūkahukahu.

Me pēhea te mahi a tēnei mīhini?

Hei mārama ki tēnei, me mahara tātou ki te huarahi noa e rere ai te toto i roto i tō tātou tinana. Ka uru te toto kore-hāora i roto i te tinana ki te taha matau o te ngākau mā roto i ngā uaua nui e rua (vena cava). Mai i reira, ka pamuhia taua toto ki ngā pukahukahu. I roto i ngā pukahukahu, ka whakakiia te toto ki te hāora, ā, ka hoki taua toto whai-hāora ki te taha maui o te ngākau. Hei whakamutunga, ko te taha maui o te ngākau te mea e pamu ana i taua toto ma ki te tinana katoa.

Ka tangohia tēnei chakra mai i te tinana mō tētahi wā poto e te mīhini karo manawa me te manawa.

1. I mua i te urunga ki te ngākau, ka kumea ētahi o te toto rawakore-hāora ki roto i te mīhini mā roto i ngā ngongo (cannulas).

2. Ko te wāhanga o roto i te mīhini e kiia nei ko te "Oxygenator" ka tāpiri i te hāora ki te toto.

3. Ka hono anō te papu i roto i te mīhini i te toto whai hāora ki te uaua matua (Aorta) e tohatoha ana i te toto ki te tinana i muri i te ngākau.

Koinei te huarahi e whiwhi ai te tinana i te hāora kia oti rā anō te pokanga.

He aha ngā mahi e whai wāhi ana i te wā o te pokanga?

He tino whakamahere te whakahaere a te tīma hauora i tēnei tikanga. He tīma kei roto ko te taote pokanga, he tohunga whakamoe, me te tohunga whakaheke toto, he tohunga kua whakangungua motuhake ki te whakahaere i tēnei mīhini, e whai wāhi ana ki tēnei.

• Te whakarite i te mīhini: Tuatahi, ka tangohia katoatia te hau i roto i ngā ngongo o te mīhini, ā, ka whakakīia ki tētahi wai motuhake (te otinga whakapūkara). Nā te mea he tino morearea te mirumiru hau (`(Air Embolism)`) e tomo ana ki te tinana.
• Te hoatu rongoā ki a koe hei ārai i te toto totoka: I mua i te hono atu ki te mīhini, ka hoatu he rongoā kaha hei whakangawari i te toto e kiia nei ko te Heparin hei ārai i te toto totoka.
• Te hono atu ki te mīhini: Mā ngā tākuta koe e hono atu ki te mīhini. Kei te mahi tonu tō ngākau me tō pukahukahu i tēnei wā.
• Te aukati o te ngākau me te pūkahukahu: Kia mōhio kei te mahi tika ngā mea katoa, ka whakamutua te ngākau mā te hoatu i tētahi rongoā e kiia nei ko te "Cardioplegia". Inaianei ka riro i te mīhini ngākau-pūkahukahu te mahi katoa.
• Te pokanga me te aroturuki: I a te taote pokanga e mahi ana i te pokanga, ka aroturuki tonu te tīma, tae atu ki te kaiwhakaora toto, i te mīhini me te āhua o tō tinana (pēnei i te pāmahana me te toto toto tiketike).
• Te whakamutu i te whāngai ū: Kia oti pai te pokanga, ka tīmata anō tō ngākau, ka tukuna ō pukahukahu kia manawa, ā, ka tangohia koe i te mīhini.

He aha ngā mōrearea o tēnei tikanga?

Pērā i ngā pokanga nui katoa, he tūponotanga kei roto i tēnei tikanga. Tērā pea ka rerekē ēnei tūponotanga i runga i te roa o te wā e hono ana koe ki te mīhini me tō āhua hauora i mua i te pokanga.

Engari kia maumahara, he tino whakangungua, he mātau hoki tō tīma hauora ki te whakahaere i ēnei mōrearea katoa. Ko ētahi o ngā raruraru ka puta ko:

• Ngā toto totoka
• Te toto nui
• Te whiu, te pakaru roro rānei
• Te pakaru o te whatukuhu, o te pukahukahu rānei
• Te mumura me te mate pāwera i roto i te tinana

Kōrerohia marietia ki tō tākuta mō ēnei tūponotanga me ngā mahi ka taea e koe te mahi hei karo i aua tūponotanga i mua i tō pokanga.

Me aha i roto i tētahi āhuatanga ohorere?

Ina puta koe i te hōhipera i muri i te pokanga, ka whakamāramahia e tō tākuta ki a koe ngā rā me hoki mai koe me ngā tohutohu me whai e koe. He mea tino nui kia tino whai i ēnei tohutohu.

Ko ngā tohu ohorere o te whiu ka uru atu ki:

• Te ngoikore, te ngoikore rānei i tetahi taha o te tinana
• Te uaua ki te kōrero, te koretake o te kupu
• Te pōhēhē ohorere
• Te uaua ki te hikoi, te ngaro o te taurite
• Te uaua ki te kite