Pamwe wakamboenda kunoona mumwe munhu ari muchikamu chevarwere vanorwara zvakanyanya (ICU). Kana kuti wakaona bhaisikopo apo murwere akabatanidzwa pamuchina une chubhu mumuromo make. Ungave wakatya kana kuda kuziva pawakaona izvozvo. Imwe yemichina inonyanya kukosha iyi imuchina wekufema. Kunyangwe vanhu vazhinji vachitya, chaizvoizvo mudziyo unoponesa hupenyu. Saka nhasi, ngatitaurei nezvekuti muchina wekufema, kana kuti mumashoko ekurapa, "Mechanical Ventilation" chii, nei uchidiwa, uye zvese zvine chekuita nawo nenzira iri nyore.
Zvichitaurwa zviri nyore, chii chinonzi mudziyo wekufema?
Muchina wekufema mweya muchina unokubatsira kufema, kana kuti unotora basa racho zvachose, kana usingakwanise kufema wega. Sekungofanana nemadondoro anotsigira uremu hwako kana uine gumbo rakatyoka, muchina wekufema mweya unotsigira mapapu ako.
Muchina uyu unoita zvinhu zvitatu zvikuru:
- Inopa mapapu ako okisijeni yaanoda.
- Inobatsira mapapu ako kubvisa gasi recarbon dioxide risingadiwe rinoungana mumuviri wako.
- Matumba madiki emhepo (alveoli) ari mumapapu ako anopa simba rinodiwa kuti arambe akavhurika asingaputsike.
Vanachiremba vanogona kugadzirisa marongero emuchina uyu kuti aenderane nemamiriro ako ezvinhu uye kukupa rutsigiro rwaunoda.
Chinhu chinonyanya kukosha ndechekuti mudziyo wekufema hausi mushonga wechirwere. Unongochengetedza kufema kwako kwakasimba kusvika muviri wako warwisa chirwere chacho wopora. Panguva ino, vanachiremba vako vanogona kukupa mamwe marapirwo echirwere chako.
"Intubation" ne "Ventilation" zvinhu zvakasiyana here?
Ehe, kunyangwe izvi zviviri zvichiwanzoitika pamwe chete, izvi zvinoreva maitiro maviri.
- Kupinza dumbu: Izvi zvinoitika kana chiremba akaisa chubhu kuburikidza nemuromo wako kana mumhino, achidzika nepaipi yemhepo (trachea) uye achiiisa mumapapu ako. Izvi zvinonziwo "endotracheal tube" kana kuti chubhu yeET.
- Kufema Kwemuchina: Izvi zvinoreva nzira yekubatanidza chubhu yakamboiswa pamuchina wekufema, iyo inokubatsira kufema.
Dzimwe nguva, pane kuisa chubhu yakaita seiyi, unogona kubatana nemhepo inofema uchishandisa mask inokwana zvakanaka pachiso chako. Tichataura nezvazvo munguva pfupi.
Ndedzipi mhando huru dzekurapa kweventilator?
Mafeteria anoshandiswa mazuva ano anoshandisa simba rakanaka rekumanikidza mweya kupinda mumapapu. Izvi zvinogona kuitwa nenzira mbiri huru.
| Rudzi rwekurapwa | Zvichitaurwa zviri nyore... |
|---|---|
| Kufefetera Kwemuchina Kunopinda Munzvimbo Dzepasi | Izvi zvinosanganisira kuisa chubhu mumhepo yako woibatanidza nemuchina wekufema. Chubhu iyi inogona kuiswa nemuromo wako (intubation) kana kuburikidza nekucheka kudiki pamutsipa wako (tracheostomy) . |
| Kufema kusingapindi mhepo | Izvi zvinoshandisa chifukidziro chinokwana zvakanaka kumeso. Chifukidziro ichi chakabatanidzwa mumusoro netambo. Mhepo inobva muchina wekufema inopinda mumapapu kuburikidza nechifukidziro ichi. Zvishandiso zvakaita se (CPAP) kana (BiPAP®) zvinoshandiswa kumba ndezverudzi urwu. |
Muchina wekufema unodiwa riini?
Ungangoda rubatsiro rwemuchina wekufema kana mamiriro ezvinhu akakomba aunenge usingakwanise kufema zvakanaka uri wega. Semuenzaniso:
- Panguva yekuvhiyiwa kukuru: Kana uri pasi peanesthesia, kugona kwako kufema kunodzikira. Saka, uchabatsirwa nemuchina wekufema panguva yekuvhiyiwa.
- Zvirwere kana zvirwere zvakakomba zvemapapu: Pneumonia, COVID-19, Acute Respiratory Distress Syndrome (ARDS), uye Chronic Obstructive Pulmonary Disease (COPD) kana mamiriro ezvinhu akanyanya kuipa.
- Dambudziko rekukurumidzira kana rehutano: Chero dambudziko ripi zvaro rinovhara nzira yekufema uye rinoita kuti kufema kuome. Semuenzaniso, chirwere chakakomba chinonzi anaphylaxis.
- Kukuvadzwa kwehuropi kana chirwere: Muzviitiko zvakaita sekurohwa nestroke uye kukuvara kwehuropi, uropi hahukwanisi kutumira zviratidzo zvakanaka kumapapu kuti akwanise kufema.
- Kuchinja kwegasi remuropa: Kana huwandu hwekabhoni dhayokisaidhi muropa hukawedzera (hypercapnia) kana huwandu hweokisijeni hukadzikira (hypoxemia), muchina wekufema unodiwa kudzora chirwere ichi.
- Dzivirira nzira yako yekufema:Kana munhu ari pakoma akarutsa mate kana chikafu mumuromo make, chinogona kupinda mumapapu ake. Kuti izvi zvisaitike, panopinda chubhu yekudzivirira mweya.
Uchafanira kugara pamudziyo wekufema kwenguva yakareba sei?
Izvi zvinoenderana chete nemamiriro ezvinhu akaita kuti ude muchina wekufema. Zvinogona kutora maawa mashoma, mazuva mashoma, mavhiki mashoma. Muzviitiko zvisingawanzoitiki, ungafanira kugara kwemwedzi kana kunyange makore. Chinangwa chechikwata chekurapa ndechekukubvisa muchina wekufema nekukurumidza uye zvakachengeteka sezvinobvira . Kusvika panguva iyoyo, vachagara vachitarisa mamiriro ako nguva dzose.
Kazhinji, kana zvikaonekwa kuti uchafanira kushandisa mudziyo wekufema kwemavhiki anopfuura maviri, vanachiremba vanobvisa chubhu iri mumuromo mako voisa chubhu nepaburi diki riri mumutsipa wako (tracheostomy). Iyi inzira yakasununguka uye inogara kwenguva refu kumurwere.
Chii chinoitika kana ukachibatanidza nemuchina wekufema?
Maitiro aya anoitika muchikamu chevarwere vane chirwere chakanyanya (ICU).
1. Kutanga, uchapihwa mushonga wekunyaradza kuti unzwe kugadzikana uye hope. Panguva imwe chete, uchapihwa munhu akaoma mitezo kuti muviri wako usafambe-fambe panguva iyo chubhu iri kuiswa.
2. Chiremba anoisa chubhu (ET tube) nemuromo wako mupaipi yemhepo.
3. Pakupedzisira, chubhu yacho yakabatana nemuchina wekufema. Ipapo muchina wacho unotanga kufema iwe.
Kana paine emergency, izvi zvingafanira kuitwa nenzira yakasiyana zvishoma, nekukurumidza zvikuru.
Chii chimwe chinoitika kana uri pamudziyo wekufema?
Paunenge uri pamuchina wekufema, uchatarisirwa nechikwata chevanachiremba vakadzidziswa zvine hunyanzvi. Kune zvimwe zvinhu zvishoma zvinoitika panguva ino.
Kutarisa kwepedyo
Uchabatanidzwa kune mamwe mamonitor kuti utarise mashandiro emuviri wako.
- Kumanikidzwa kweropa
- Kurova kwemoyo
- Kufema nekukurumidza
- Mwero weokisijeni muropa
Zvinhu izvi zvinoongororwa nguva nenguva. MaX-ray epachipfuva anoitwawo kuti paonekwe mamiriro emapapu uye kuongororwa kweropa kunoitirwa kuti paonekwe huwandu hweoxygen muropa.
Kubvisa
Chubhu yekufema inogona kukonzera kuti madzihwa aunganidzwe mumhepo yako yekufema. Saka, vanamukoti vanowanzoisa imwe chubhu yakatetepa (catheter) muchubhu kuti vabvise madzihwa aunganidzwa. Unogona kukosora zvishoma wonzwa kusagadzikana panguva iyi. Izvi zvinogona kushungurudza kune vanoona, asi zvakakosha kuti mhepo yako yekufema igare yakachena.
Kudya zvinovaka muviri
Haugone kudya kana kunwa nekuti une chubhu mumuromo mako. Saka, uchapihwa chikafu chemvura kuburikidza nechubhu diki inoenda mudumbu. Zvimwe zvinwiwa zvichapihwa kuburikidza nesaline solution ichipinda mutsinga.
Kufambisa
Sezvo zvisina kunaka kugara wakarara nguva dzese, timu yezvekurapa ichakubatsira kufamba-famba. Dzimwe nguva, kana uchikwanisa kudaro, vanotoedza kukuita kuti ufambe-fambe zvishoma.
Une pfungwa here paunenge uri pamuchina wekufema?
Uyu mubvunzo unobvunzwa nevanhu vazhinji. Vanachiremba vanoedza kukuchengetedza wakasununguka uye wakadzikama sezvinobvira, ukuwo uchiramba wakagadzikana sezvinobvira. Zvisinei, kana mamiriro ako akaoma, ungangoda 'kunwa mvura yakawanda' kuti muviri wako uwane nguva yekuzorora nekupora. Dzimwe nguva, maoko ako anogona 'kudziviswa' kudzivirira kuti usapinze chubhu netsaona. Izvi ndezvekuchengetedza kwako.
Ndezvipi zvakanakira uye njodzi dzacho?
Kufanana nechero nzira yekurapa, kurapwa kweventilator kune zvakanakira uye njodzi.
| Zvakanakira | Njodzi |
|---|---|
| Haudi kushanda nesimba kuti ufeme. Saka shandisa simba rese rine muviri wako kurapa chirwere chacho. | Mabhakitiriya anogona kufamba nemunzira dzekufema kuenda kumapapu uye kukonzera hutachiona (semuenzaniso pneumonia). |
| Zvechokwadi uchawana huwandu hweokisijeni hwaunoda, uye kabhoni dhayokisaidhi ichabviswa. | Kumanikidzwa kubva kumuchina wekufema kunogona kukuvadza mapapu dzimwe nguva. |
| Inodzivirira kuti mapapu asavhare mweya. | Nzvimbo isina kusimba mumapapu inogona kuboorwa, zvichiita kuti mapapu apere (pneumothorax) . |
| Inochengetedza nzira yekufema yakavhurika uye yakachengeteka. | Kushanda kwemoyo neBP zvinogona kukanganiswa. |
Pane chinhu chimwe chete chakakosha. Dzimwe nguva mamiriro emurwere anogona kunge akaoma zvekuti hazvigoneke kupora. Muchiitiko chakadaro, kubatana nemuchina wekufema kunogona kungowedzera nguva yekufa. Izvi zvinogona kukonzera kutambura kusingakoshi kumurwere nemhuri. Muchiitiko chakadaro, chiremba wako achakurukura izvi newe uye achakutungamira kuti uite sarudzo yakanakisisa.
Chii chinonzi PEEP neCPAP?
Pamwe wakambonzwa mashoko ese ari maviri aya.
- PEEP (Positive End-Expiratory Pressure): Uku ndiko kuiswa kwemuchina wekufema. Mune zvimwe zvirwere, patinoburitsa mweya, masaga emhepo ari mumapapu (alveoli) anovhara zvachose. Kuiswa kwePEEP kunochengetedza masaga emhepo iwayo akavhurika nekushandisa simba shoma kunyangwe paunoburitsa mweya. Izvi zvinowedzera huwandu hweokisijeni hunopinda muropa.
- CPAP (Continuous Positive Airway Pressure): Izvi zvinosanganisira kuramba uchipa simba rakaenzana remhepo inopinda neinobuda. Inowanzoshandiswa pakurapa zvirwere zvakaita sesleep apnea, senzira yekufema isina kupindira mumuviri (kuburikidza nemasiki).
Zvichitaurwa zviri nyore, PEEP idzvinyiriro inoiswa pamurwere ari pamuchina wekufema pavanenge vachifema. CPAP idzvinyiriro inoenderera mberi inoiswa panguva yekufema nekufema.
Muchina wekufema mweya unobatsira zvikuru kana paine chirwere chakakomba kana emergency. Kunyange zvazvo usingarape chirwere ichi, unopa muviri wako nguva nerutsigiro rwaunoda kuti urwise chirwere ichi uye upore.
Mharidzo Yekuenda Nayo Kumba
- Muchina wekufema mweya (ventilator) muchina unoponesa hupenyu unokubatsira kufema kana usingakwanise kufema wega.
- Izvi hazvirapi chirwere, asi zvinopa muviri nguva uye kugadzikana kwaunoda kuti urwise chirwere uye upore.
- Unogona kunge wakabatana nemuchina wekufema kuburikidza nechubhu yekufema (invasive) kana kuburikidza nemasiki (non-invasive).
- Paunenge uri pamuchina wekufema, chikwata chevanachiremba vane hunyanzvi muIntensive Care Unit (ICU) vachakutarisira zvakanyanya.
- Kunyange zvazvo kurapwa uku kune njodzi, kazhinji ndiyo chete nzira yekuponesa hupenyu.
- Kana iwe kana mumwe munhu mumhuri yako ane mibvunzo kana zvinokunetsa nezvenyaya iyi, taura nachiremba wako pachena nezvazvo.
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