Tose takambonzwa nezveBP yakakwira. Asi waizviziva here kuti BP yakaderera inogona kuva nengozi yakafanana, uye pamwe kutowedzera kuipa? Pamwe wakambonzwa nezvemumwe munhu anongoerekana arwara zvakanyanya obva apinda muIntensive Care Unit (ICU). Panguva dzakadai, BP yemunhu iyeye inogona kunge yadzikira zvakanyanya. Kana izvi zvikaitika, nhengo dzemuviri dzakakosha, dzakadai seuropi, moyo, neitsvo, dzinoshaya ropa rakawanda reoxygen radzinoda. Nhasi, tichataura nezvemhando yemushonga unokosha, une simba unoshandiswa navanachiremba kuponesa hupenyu munguva dzakadai dzinotyisidzira hupenyu. Uyu ndiwo unonzi Vasopressors mukurapa.
Chii chinonzi vasopressors?
Muchidimbu, mushonga wevasopressor imhando yemushonga unoshandiswa navanachiremba kubatsira vanhu vane BP yakaderera kuti vadzorere pakare. Mishonga iyi inoshanda nekudzvanya, kana kuderedza, tsinga dzeropa mumuviri wedu.
Funga nezvazvo nenzira iyi. Ropa rinotenderera mumiviri yedu rakafanana nehurongwa hwemapaipi emvura. Kana mapaipi aya (tsinga dzeropa) akangoerekana akura kana kusuduruka, kumanikidzwa kwemvura (ropa) inoyerera nepakati pawo kunoderera. Izvi ndizvo zvatinodaidza kuti mamiriro ekuvhunduka. Dzimwe nguva dzakadai, ropa rinomira kuyerera richienda kunhengo dzinokosha dzemuviri. Pasina okisijeni, nhengo idzodzo dzinomira kushanda, uye hupenyu hwemunhu iyeye hunogona kutoiswa munjodzi.
Kazhinji, kana kumanikidzwa kwadzikira seizvi, chinhu chekutanga chekuita ndechekupa saline (IV fluids). Asi kana kumanikidzwa kukasadzokera pakuva kwakajairika kunyangwe nesaline, zvino chinotevera chinoitwa navanachiremba kushandisa mhando yemushonga unonzi vasopressor. Iyi mishonga inopinzwa zvakananga mutsinga. Inowanzopihwa kuburikidza nechubhu chaiyo inoiswa mutsinga huru mumutsipa kana pachipfuva, inonzi central venous catheter. Zvadaro mushonga unokurumidza kuenda kumoyo uye unopararira mumuviri wese.
Mushonga uyu unoshanda sei mumuviri?
Mishonga yeVasopressor inoita zvinhu zviviri zvikuru kana ichipinda mumuviri.
1. Kuomesa tsinga dzeropa: Ichi ndicho chinhu chikuru. Chinoita kuti tsinga dzeropa dziome mumuviri wese. Kungofanana nekudzvanya pombi yemvura kunoita kuti mvura ifambe nekukurumidza, kana tsinga dzeropa dziome, kumanikidzwa kweropa riri mukati madzo kunowedzera.
2. Kuwedzera kurova kwemoyo: Mimwe mishonga inodzvinyirira ropa inoshanda pamoyo, ichiwedzera huwandu hweropa rainopomba nekurova kwega kwega. Izvi zvinoreva kuti inowedzera kwenguva pfupi kugona kwemoyo kupomba.
Nzira idzi dzese dzinokurumidza kudzoreredza BP yakaderera uye kudzoreredza kuyerera kweropa munhengo dzinokosha dzakadai seuropi, moyo, neitsvo .
Ndedzipi mhando dzevasopressors dzinonyanya kushandiswa?
Mishonga yeVasopressor inoshandiswa mumakamuri ekuchengetwa kwevarwere vane chirwere chemwoyo (ICUs) kurapa BP yakaderera nekuda kwezvikonzero zvakasiyana-siyana. Chiremba anosarudza mushonga wakakodzera zvichienderana nemamiriro emurwere.
| Zita reMushonga | Mamwe Mazita Emhando |
|---|---|
| Norepinephrine | Levophed® |
| Epinephrine | Adrenalin®, EpiPen® |
| Vasopressin | Pitressin®, VasoDistrict® |
| Dopamine | Intropin® |
| Phenylephrine | Biorphen®, Vazculep® |
| Angiotensin-II | Giapreza® |
Tinoshandisa mushonga werudzi urwu muhupenyu hwezuva nezuva here?
Ehe. Tinoshandisa mimwe mishonga zuva nezuva inoshanda zvakafanana nemushonga uyu, kunyange zvazvo isina simba seuyu.
- Mishonga yekubvisa mhuno: Kana uine dzihwa, mhuno yako inovharika. Mamwe madonhwe emumhino kana marozenji atinoshandisa ane zvinhu zvakaita se `(Ephedrine)` uye `(Pseudoephedrine).` Izvi zvinoshanda nekudzvanya tsinga dzeropa dziri mukati memhino, zvichideredza kuzvimba, uye zvichiita kuti zvive nyore kufema.
- EpiPen®: EpiPen®, iyo inoshandiswa kana paine allergy yakanyanya, yakadai se anaphylaxis inokonzerwa nekuruma kwenyuchi kana gonye, kana kudya zvimwe zvekudya, ine mushonga mumwe chete unonzi Epinephrine.
- Mimwe mishonga yechando: Mamwe mapaketi emishonga yechando anogona kunge aine `(Phenylephrine)`. Iyowo iri muchikamu ichi chevasopressor.
Vasopressors neInotropes zvakafanana here?
Ehe, idzi mhando mbiri dzemishonga. Asi vanachiremba vanowanzoshandisa mhando idzi dzese pamwe chete. Ngatinzwisisei musiyano wacho zviri nyore.
Fungidzira kuti mwoyo wedu imota yemvura, uye tsinga dzedu dzeropa ndiwo mapaipi ayo mvura inoyerera.
- Vasopressors: Mishonga iyi inoshanda nekudzvanya tsinga dzeropa uye kuwedzera BP.
- Inotropes: Mishonga iyi inowedzera simba remota yemvura (moyo) , zvichiita kuti ikwanise kupomba mvura yakawanda panguva imwe chete.
Saka, kana BP yemunhu yakaderera uye mwoyo wake usina simba, vanachiremba vanopa mishonga iyi yese pamwe chete, vachiwedzera pressure nekudzvanya chubhu kune rumwe rutivi, uye vachiwedzera simba remota kune rumwe rutivi kuti ropa riendeswe mumuviri zvinobudirira sezvinobvira.
Mumamiriro ezvinhu api panodiwa mishonga yekuderedza ropa (vasopressors)?
Mishonga yeVasopressor imhando yemishonga inoponesa hupenyu inopiwa murwere ari pakati pehupenyu nerufu. Iyi haisi mishonga inopihwa chirwere chinowanzoitika. Heano mamwe emamiriro ezvinhu makuru ainodiwa.
| Mamiriro | Tsananguro iri nyore |
|---|---|
| Kushamisika | Kumanikidzwa kweropa kunogona kudzikira zvakanyanya nekuda kwezvirwere zvakaita sehutachiona hwakanyanya (sepsis), kubuda ropa rakawanda, uye kurwara nemoyo. |
| Kumira kurova kwemoyo | Nekuda kwekuvharika kwetsinga yeropa inoendesa ropa kumoyo, kushanda kwemoyo kunokanganiswa uye BP inoderera. |
| Kukundikana kweMwoyo | Moyo haugone kupomba ropa rakakwana mumuviri. |
| Anesthesia yemusana | Pakuvhiyiwa kumwe, mishonga inonyaradza marwadzo inopiwa kumusana inogona kukonzera kudzikira kweBP kamwe kamwe. |
| Kuita zvinodhaka zvakanyanya | Kurwara kwakanyanya kwemishonga kunogona kukonzera kuderera kweBP. |
| Njodzi nekuvhiyiwa | Kuderera kweropa nekuda kwekubuda ropa rakawanda. |
Pane mimwe migumisiro yakaipa pamushonga uyu here?
Ehe. Mishonga yeVasopressors ine simba guru . Saka, inogona kukonzera migumisiro yakaipa. Nekuda kweizvi, mishonga iyi inopihwa muchikamu chevarwere vanorwara zvakanyanya (ICU), ukuwo ichigara ichitarisa mamiriro emurwere . Vanachiremba nevashandi vekuchengeta varwere vanogara vachitarisa kurova kwemoyo wemurwere, BP, uye mwero weokisijeni.
Mimwe migumisiro inogona kuitika ndeiyi:
- Kunetseka uye kusagadzikana
- Musoro
- Kurwadziwa kwechipfuva
- Kuoma kufema
- Kurova kwemoyo kunonoka zvisingawanzoitiki (Bradycardia)
- Kumhanya kwemoyo kusingawanzoitiki (Tachycardia)
- Kurova kwemoyo kusina kurongeka (Arrhythmia)
- Kumanikidzwa kweropa kwakanyanya kupfuura zvinodiwa. (Izvi zvinogona kutokonzera chirwere chakakomba sekubuda ropa muuropi)
- Kuvharika kwetsinga dzeropa zvakanyanya kunokonzera kudzikira kweropa rinoenda kuminwe nezvigunwe, zvichiita kuti nzvimbo idzodzo dziite dema.
Kunyangwe migumisiro iyi ine njodzi, zvakakosha kuyeuka kuti mishonga iyi inopihwa mumamiriro ezvinhu ane njodzi zvikuru, anotyisidzira hupenyu. Vanachiremba vanogara vachiedza kuyera zvakanakira nezvakaipira uye kuita zvakanakira murwere.
Zvinotora nguva yakareba sei kuti munhu apore?
Zvakaoma kupa mhinduro imwe chete kumubvunzo uyu, nekuti nguva yaunotora kuti upore haibvi pamushonga wevasopressor wawakapihwa, asi pachirwere chaikonzera kuti upiwe mushonga wacho .
Semuenzaniso, munhu akabatwa nechirwere che septic shock nekuda kwehutachiona hwakanyanya angangoda kugara muchipatara kwemavhiki, kunyange mwedzi, kuti apore. Zvisinei, munhu anopiwa mushonga uyu kwenguva pfupi panguva yekuvhiyiwa kuderedza kumanikidzwa kunokonzerwa neanesthesia anogona kupora nekukurumidza.
Chinhu chakakosha ndechekuti kupiwa mushonga une simba kudaro zvinoreva kuti wapora kubva kuchirwere chakakomba. Saka, unofanira kupa muviri wako nguva yaunoda kuti upore.
Kana masvika kumba kubva kuchipatara, musakurumidza kudzokera kune zvamagara muchiita. Inwai mishonga yamakanyorerwa nachiremba nenguva. Uyewo, iva nechokwadi chekuti maita nguva yenyu yekutevera. Kana muchinzwa kusanzwa zvakanaka zvakare, semuenzaniso, kana muchinetseka kufema, kurwadziwa pachipfuva, kana kusanzwa zvakanaka, fonerai chiremba wenyu nekukasika kana kuti enda kuEmergency Department (ETU) yechipatara chiri pedyo.
Mharidzo Yekuenda Nayo Kumba
- Mishonga yeVasopressors imhando yemishonga ine simba inoshandiswa kuponesa hupenyu munguva dzenjodzi, dzakadai sekuvhunduka, apo BP inoderera zvine njodzi.
- Basa ravo guru nderekudzvanya mitsipa yeropa, kuwedzera BP, uye kuona kuti ropa rinoyerera richienda kunhengo dzakakosha.
- Nekuda kwesimba rayo uye migumisiro inogona kuitika, mishonga iyi inongopihwa mumakamuri ekuchengetwa kwakanyanya (ICUs), pasi pekutarisirwa nguva dzose navanachiremba nevashandi vekuchengeta varwere.
- Kana iwe kana mumwe munhu ari pedyo newe akapihwa mushonga uyu, zvinoreva kuti ari kupora kubva kuchirwere chakakomba. Zvakakosha kutevedzera mazano echiremba nekungwarira mushure mekubuda muchipatara.
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