Kua rongo katoa tātou i te toto toto tiketike. Engari i mōhio koe he rite tonu te morearea o te toto toto iti, ā, tera pea he morearea ake? Kua rongo pea koe i te tangata e pāngia ohorere ana e te mate kino, ā, ka whakaurua ki te Wāhanga Tiaki Kaha (ICU). I aua wā, tera pea kua tino heke te toto o taua tangata. Ina tupu tēnei, ka ngaro i ngā whekau tino nui o te tinana, pērā i te roro, te ngākau, me ngā whatukuhu, te toto whai hāora e hiahiatia ana e rātou. I tēnei rā, ka kōrero tātou mō tētahi momo rongoā motuhake, tino kaha e whakamahia ana e ngā tākuta hei whakaora i ngā oranga i roto i ēnei āhuatanga ohorere e morearea ana te ora. Koinei te mea e kiia nei ko ngā Vasopressors i roto i te rongoā.
He aha ngā vasopressors ngāwari?
He kupu ngāwari noa iho, he momo rongoā te vasopressor e whakamahia ana e ngā tākuta hei āwhina i te hunga he tino iti te toto toto kia hoki mai ki te āhua noa. Ko te mahi a ēnei rongoā mā te whakawhāiti, te whakawhāiti rānei, i ngā oko toto o roto i te tinana.
Whakaarohia pēnei. He rite te toto e rere ana puta noa i ō tātou tinana ki tētahi pūnaha paipa wai. Mēnā ka nui, ka wetekina rānei ēnei paipa (ngā uaua toto), ka heke te pēhanga o te wai (toto) e rere ana i roto i a rātou. Koinei te mea e kiia nei e tātou he āhua ohorere. I ngā wā pēnei, ka mutu te rere o te toto ki ngā whekau nui o te tinana. Ki te kore he hāora, ka mutu te mahi a aua whekau, ā, ka tūpono pea te ora o taua tangata.
I te nuinga o te wā, ina heke te pēhanga pēnei, ko te mea tuatahi me mahi ko te hoatu i te tote (wai IV). Engari ki te kore te pēhanga e hoki ki te āhua noa ahakoa he tote, ko te mea e whai ake nei ka mahia e ngā tākuta ko te whakamahi i tētahi momo rongoā e kiia nei ko te vasopressor. He rongoā ēnei ka werohia tika ki roto i te uaua. I te nuinga o te wā ka hoatu mā roto i tētahi ngongo motuhake ka whakanohoia ki roto i tētahi uaua nui i te kaki, i te uma rānei, e kiia nei ko te catheter venous pokapū. Kātahi ka tere te haere o te rongoā ki te ngākau ka horapa puta noa i te tinana.
He pēhea te mahi a tēnei rongoā i roto i te tinana?
E rua ngā mahi matua a ngā rongoā vasopressor ina uru ki te tinana.
1. Te whakawhāiti i ngā oko toto: Koinei te mea nui. Ka whakawhāiti i ngā oko toto puta noa i te tinana. Pērā i te pēhi i te paipa wai ka tere ake te rere o te wai, ina whakawhāitihia ngā oko toto, ka piki ake te pēhanga o te toto i roto i a rātou.
2. Whakanuia te whakawhāititanga o te ngākau: Ka pā ētahi vasopressors ki te ngākau, ka whakanuia te nui o te toto e pupuhihia ana e ia i ia pao. Ko te tikanga ka whakanuia e rātou te kaha pupuhi o te ngākau mō te wā poto.
Ka tere te whakahoki mai o ēnei tikanga e rua i te toto toto iti, me te whakahoki mai i te rere o te toto ki ngā whekau nui pēnei i te roro, te ngākau, me ngā whatukuhu .
He aha ngā momo vasopressors e whakamahia whānuitia ana?
Ka whakamahia ngā vasopressors i roto i ngā wāhanga tiaki nui (ICU) hei rongoā i te toto toto iti nā ngā take maha. Ka whiriwhiria e te tākuta te rongoā tino tika i runga i te āhua o te tūroro.
| Ingoa Rongoā | Ētahi Ingoa Waitohu |
|---|---|
| Norepinephrine | Levophed® |
| Epinephrine | Adrenalin®, EpiPen® |
| Vasopressin | Pitressin®, Vasostrict® |
| Dopamine | Intropin® |
| Phenylephrine | Biorphen®, Vazculep® |
| Angiotensin-II | Giapreza® |
Kei te whakamahia e tātou tēnei momo rongoā i ia rā, i ia rā?
Āe. Ka whakamahia e mātou ētahi rongoā i ia rā, ā, he rite tonu te mahi ki tēnei rongoā, ahakoa kāore i te rite te kaha ki tēnei.
- Rongoā Whakaiti Ihu: Ina pāngia koe e te makariri, ka pūngā tō ihu. Ko ētahi pata ihu, ngā lozenges rānei e whakamahia ana e tātou, kei roto ngā matū pēnei i te `(Ephedrine)` me te `(Pseudoephedrine).` Mā ēnei e whakawhāiti ngā oko toto i roto i te ihu, e whakaiti ana i te pupuhi, e ngāwari ai hoki te manawa.
- EpiPen®: Kei roto i te EpiPen® te rongoā kotahi e kiia nei ko te Epinephrine, e whakamahia ana mō ngā mate pāwera kino, pērā i te anaphylaxis i puta mai i te ngau a te pī, te wāpu rānei.
- Ētahi rongoā makariri: Tērā pea kei roto i ētahi kete rongoā makariri te '(Phenylephrine)'. Nō tēnei kāwai vasopressor anō hoki tēnā.
He rite tonu ngā Vasopressors me ngā Inotropes?
Ae, e rua ēnei momo rongoā. Engari he maha ngā wā ka whakamahia ngātahitia ēnei momo e ngā tākuta. Kia mārama noa tātou ki te rerekētanga.
Whakaarohia ko tō tātou ngākau he motuka wai, ā, ko ō tātou uaua toto ngā paipa e rere ai te wai.
- Ngā Vasopressors: Ka mahi ēnei rongoā mā te whakawhāiti i ngā oko toto me te whakanui ake i te toto toto.
- Ngā Inotropes: Ka whakanui ake ēnei rongoā i te kaha o te motuka wai (te ngākau) , ka meinga kia pupuhihia he wai nui atu i te wā kotahi.
Nō reira, ki te iti te toto toto o te tangata, ā, he ngoikore tōna ngākau, ka hoatu ngātahitia e ngā tākuta ēnei rongoā e rua, ka whakanuia te pēhanga mā te whakawhāiti i te ngongo i tetahi taha, ka whakanuia hoki te mana o te mōta i tetahi taha kia pai ai te pupuhi toto ki te tinana.
I roto i ngā āhuatanga hea e hiahiatia ai ngā vasopressors?
He momo rongoā whakaora ora ngā vasopressors e hoatu ana ki te tūroro kei waenganui i te ora me te mate. Ehara ēnei i te rongoā e hoatu ana mō tētahi mate noa. Anei ētahi o ngā āhuatanga matua e hiahiatia ai ēnei.
| Āhua | He whakamārama māmā |
|---|---|
| ohorere | Ka taea e te toto toto te heke tino iti nā ngā āhuatanga pēnei i te mate kino (sepsis), te toto nui, me te mate ngakau. |
| Te whakaekenga o te ngākau | Nā te aukati i te uaua toto e tuku toto ana ki te ngākau, ka ngoikore te mahi a te ngākau, ā, ka heke te toto toto. |
| Te ngoikore o te ngākau | Kāore e taea e te ngākau te pupuhi i te toto e ranea ana ki te tinana. |
| Te Whakamamae Tuaiwi | I ētahi pokanga, ka taea e ngā rongoā whakamoe e hoatu ana ki te tuaiwi te whakaheke ohorere i te toto toto. |
| Te tauhohenga kino o te rongoā | Ka taea e ngā mate pāwera kino ki ētahi rongoā te whakaheke i te toto toto. |
| Ngā aituā me ngā pokanga | Te toto toto iti nā te nui o te toto e puta. |
He pānga taha kei tēnei rongoā?
Ae. He tino kaha ngā rongoā vasopressors. Nō reira, ka pā mai pea ngā pānga taha. Nā konei, ka hoatuhia ēnei rongoā ki roto i te wāhanga tiaki nui (ICU), me te aroturuki tonu i te āhua o te tūroro . Ka aroturuki tonu ngā tākuta me ngā nēhi i te tere o te manawa o te tūroro, te toto toto, me ngā taumata hāora.
Ko ētahi pānga taha pea ko:
- Te manukanuka me te kore okiokinga
- Ānini
- Mamae o te uma
- Te uaua ki te manawa
- Te tere o te manawa puhoi rawa (Bradycardia)
- Te pikinga o te tere o te ngakau i te āhua rerekē (Tachycardia)
- Te pā o te manawa kāore i te tika (Arrhythmia)
- Te toto toto tiketike rawa atu i te mea e tika ana. (Ka taea e tēnei te arahi ki tētahi āhuatanga kino pērā i te toto i roto i te roro)
- Nā te nui rawa o te kuiti o ngā uaua toto ka heke te rere o te toto ki ngā pito o ngā maihao me ngā matimati, ka mangu ai aua wāhi.
Ahakoa he kino ēnei pānga taha, he mea nui kia mahara ka hoatu ēnei rongoā i roto i ngā āhuatanga tino kino, tino morearea hoki. Ka ngana tonu ngā tākuta ki te paunatia ngā painga me ngā huakore, me te mahi i te mea pai mō te tūroro.
Kia pēhea te roa o te wā e ora ai?
He uaua ki te hoatu i tētahi whakautu kotahi ki tēnei pātai, nā te mea ko te roa o tō ora ake ehara i te mea e whakatauhia ana e te rongoā vasopressor i hoatu ki a koe, engari e te mate hauora i ārahi ai ki te hoatutanga o te rongoā .
Hei tauira, ko te tangata kua pāngia e te mate urutā i te wāhi i roto i te puku i te wā o te mate kino, me noho pea ia ki te hōhipera mō ngā wiki, tae atu ki ngā marama, kia ora ai. Heoi, ko te tangata kua hoatu tēnei rongoā mō te wā poto i te wā o te pokanga hei whakaiti i te pēhanga i puta mai i te rongoā whakamoe ka tere ake te ora.
Ko te mea nui, nā te mea i hoatu he rongoā kaha ki a koe, ko te tikanga kua ora koe i tētahi mate tino kino. Nō reira, me hoatu e koe te wā e hiahiatia ana e tō tinana kia ora ai.
Kia hoki wawe koe ki te kāinga i te hōhipera, kaua e hoki wawe ki tō āhua noa. Tangohia te rongoā kua tohua e tō tākuta i te wā tika. Kia mau hoki ki ō wā tirotiro. Ki te kore koe e pai anō, hei tauira, ki te uaua ki te manawa, ki te mamae te uma, ki te kore rānei e pai, waea atu ki tō tākuta tonu , haere rānei ki te Tari Ohotata (ETU) o te hōhipera tata.
Karere Tangohia ki te Kāinga
- He momo rongoā tino kaha ngā vasopressors e whakamahia ana hei whakaora i ngā oranga i roto i ngā āhuatanga ohorere, pērā i te ohorere, ina tino heke te toto toto ki raro rawa.
- Ko tā rātou mahi matua he whakawhāiti i ngā oko toto, he whakanui i te toto toto, me te whakarite kia rere te toto ki ngā whekau nui.
- Nā te kaha o te rongoā me ngā pānga taha pea, ka hoatu noa ēnei rongoā ki ngā wāhanga tiaki nui (ICU), i raro i te tirotiro tonu a ngā tākuta me ngā nēhi.
- Mena kua tukuna tēnei maimoatanga ki a koe, ki tētahi rānei e tata ana ki a koe, ko te tikanga kei te ora ia i tētahi mate tino kino. He mea nui kia tino whai i ngā tohutohu a te rata i muri i te putanga mai i te hōhipera.
💬 Comments (0)
Kaore ano kia tukuna he korero. Tāpirihia to korero ki konei mo te wa tuatahi.
Tāpirihia to korero