N’chifukwa chiyani zipatala zimasokoneza odwala? Tiyeni tikambirane za njira iyi yochepetsera nkhawa!

Kodi mudawonapo wodwala mu chipinda chosamalira odwala kwambiri (ICU) yemwe akuvutika kupuma kwambiri, akutembenuzidwa mosamala ndi madokotala ndi ogwira ntchito yosamalira ana? Mwina mudadzifunsapo chifukwa chake amachita izi, komanso ngati zingakhale zovuta kwa wodwalayo. Iyi ndi njira yofunika kwambiri yothandizira yomwe ingapulumutse moyo wa wodwalayo. Lero tikambirana za njira yapaderayi yomwe ndi yatsopano kwa anthu ambiri, koma yakhala ikugwiritsidwa ntchito mu zamankhwala kwa zaka zambiri. Izi zimatchedwa "Proning" mu zamankhwala.

Kodi kungoyang'ana pang'ono n'chiyani?

Mwachidule, kupendekera ndi njira yosinthira wodwala amene wagona chagada (chagada) kukhala wolunjika (chagada). M'mawu azachipatala, malo ogona awa amatchedwa ``Supine Position''. ``Prone Position'' imagwiritsidwa ntchito ndi madokotala kuthandiza odwala omwe ali ndi vuto lalikulu la kupuma omwe amavutika kupeza mpweya wokwanira m'thupi lawo.

Njira imeneyi nthawi zambiri imagwiritsidwa ntchito kwa odwala omwe ali ndi mpweya wopumira wamakina. Mwina munamvapo mawuwa panthawi ya mliri wa COVID-19 . Koma si chatsopano. Kafukufuku wapeza kuti ngati njira iyi igwiritsidwa ntchito koyambirira kwa odwala omwe ali ndi matenda oopsa a kupuma, chiopsezo cha imfa chingachepe kwambiri.

Kodi njira iyi imagwiritsidwa ntchito pa matenda amtundu wanji?

Njira yochepetsera mpweya imagwiritsidwa ntchito makamaka kwa anthu omwe ali ndi matenda oopsa a kupuma omwe ali mu mkhalidwe wa ``Hypoxia`` komwe thupi sililandira mpweya wokwanira. Komabe, njira iyi imagwiritsidwa ntchito kwambiri pa vuto lotchedwa Acute Respiratory Distress Syndrome (ARDS) .

Mwachidule, ARDS ndi vuto lomwe timatumba tating'onoting'ono ta mpweya (alveoli) m'mapapo mwathu timadzaza ndi madzi. Izi zimapangitsa kuti zikhale zovuta kwambiri kupuma. ARDS ndi vuto lalikulu la matenda oopsa opuma monga chibayo ndi COVID-19.

N’chifukwa chiyani mpweya umawonjezeka mukamatembenuza mutu wanu?

Chifukwa cha izi n'chosangalatsa kwambiri. Chifukwa chachikulu cha izi ndi chakuti matupi athu sali ofanana mokwanira. Kuyang'ana kwambiri kumachita zinthu ziwiri.

1. Kuchepetsa kulemera ndi kupanikizika m'mapapo

Taganizirani izi, chifukwa matupi athu adapangidwa kuti akhale ndi minofu yambiri ya m'mapapo kunja kuposa mkati mwa chifuwa chathu. Tikagona chagada, kulemera kwa mtima wathu ndi ziwalo zina za m'mimba kumagwera mwachindunji pa mapapo athu. Komanso, madzi omwe amasonkhana m'mapapo athu amakankhira pansi pa matumba a mpweya omwe ali kunja chifukwa cha mphamvu yokoka. Izi zimachepetsa malo oti mapapo adzaze ndi mpweya kwathunthu.

Koma tikatembenuza wodwala kuchoka pankhope yake pansi, kulemera kwa mtima ndi ziwalo za m'mimba kumachoka m'mapapo kupita pachifuwa. Kenako, mbali yakumbuyo, yomwe ili ndi minofu yambiri ya m'mapapo, imamasulidwa. Choncho mapapo amakula bwino ndipo amatha kutenga mpweya wambiri.

2. Kusinthana kwa Magesi Kumagwira Ntchito Mwanzeru

Mu ARDS, pali kusiyana pakati pa kuchuluka kwa mpweya wolowa m'mapapo (mpweya wopuma) ndi kuchuluka kwa mpweya womwe umalowa m'magazi (kutuluka kwa magazi). Mosasamala kanthu za malo omwe thupi lathu lili, kumbuyo kwa mapapo kumalandira magazi ambiri.

Tsopano taonani, tikatembenuza nkhope ya wodwalayo pansi, timalola mpweya wambiri kulowa m'mapapo mbali imodzi. Kumbali inayo, tikulozera mpweya umenewo ku gawo la mapapo lomwe lili ndi magazi ambiri . Izi zimapangitsa kuti kupuma kukhale kogwira mtima kwambiri. Mwachidule, njira iyi imatithandiza kutumiza mpweya kumene ukufunikira kwambiri.

Kodi mumatembenuza bwanji nkhope ya wodwala pansi?

Izi si chinthu chomwe munthu m'modzi kapena awiri angachite. Ichi ndi ntchito yokonzedwa bwino ya gulu. Dokotala wothandiza kupuma, madokotala, ndi anamwino, anthu osachepera 5-6, amagwira ntchito limodzi kuti achite izi.

Gawo loyamba ndikumanga machubu ndi mawaya onse olumikizidwa ku thupi la wodwalayo (monga chubu chopumira, chubu cha saline, EKG) kuti asamasulidwe. Katswiri wothandiza kupuma amagwira mosamala khosi la wodwalayo ndi chubu chopumira. Kenako, nthawi yomweyo, motsatira lamulo lomwelo, gulu lonse limatembenuza wodwalayo mosamala kwambiri, pogwiritsa ntchito mapilo ndi nsalu. Zonsezi zimachitika kuti wodwalayo asavulale.

Kawirikawiri, wodwala amaikidwa pamalo amenewa kwa maola 12 mpaka 18. Nthawi zambiri, maola osachepera 16 amathera nthawi imodzi, wodwalayo atagona chafufumimba kenako n’kutembenukira pansi.

Kodi pali zoopsa zilizonse pa njira iyi?

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa zina zomwe zimachitika mu njirayi. Komabe, zoopsazi zitha kuchepetsedwa mwa kukhala ndi gulu lachipatala lodziwa bwino ntchito lomwe limayang'anira mosamala zinthuzi.

• Kuchotsa mwangozi chubu cha endotracheal
• Kutayika kwa catheter ya mtsempha (monga saline):
• Mavuto a kuthamanga kwa magazi kapena kugunda kwa mtima: (`Hemodynamic Instability`, `Arrhythmia`)
• Kutsika kwakanthawi kwa mpweya m'thupi
• Kutsekeka kwa njira yopumira mpweya

Zoopsa izi ndizochepa kwambiri m'zipatala zomwe zili ndi zaka zoposa 5 zogwira ntchito pogwiritsa ntchito njira ya Proning.

Nthawi zina, odwala omwe ali ndi vuto lopuma pang'ono amalangizidwa ndi dokotala wawo kuti agone chafufumimba (`Awake Proning`). Izi zingawalepheretse kufunikira chopumira mpweya.