Yintoni i-ECMO (i-Extracorporeal Membrane Oxygenation)? Masifunde ngale teknoloji isindisa ubomi ngendlela elula!

Khawuthelekelele ukuba umntu ukwimeko embi kakhulu, intliziyo yakhe nemiphunga yakhe ayisebenzi kakuhle. Bafikelele kwinqanaba apho amayeza aqhelekileyo okanye ii-ventilators esizaziyo sonke zingenakumsindisa. Ngamaxesha anje apho oogqirha becinga ngale ndlela yobuchwephesha ebizwa ngokuba yi-ECMO njengesisombululo sokugqibela. Nangona abantu abaninzi bengazange beve ngayo, esi sisixhobo esimangalisayo ngokwenene esinokusindisa ubomi. Namhlanje, siza kuthetha ngale nto ngokulula, ngendlela onokuyiqonda.

Iyintoni i-ECMO ngokulula?

Ngamafutshane, i-ECMO ngumatshini osebenza njengentliziyo nemiphunga yokwenziwa ngaphandle komzimba. Xa intliziyo nemiphunga yakho ibuthathaka kakhulu ukuba yenze umsebenzi wayo ngokufanelekileyo, lo matshini uthatha indawo okwethutyana.

Ukuba sichaza intsingiselo yegama elithi ECMO, yile ilandelayo:

• Ngaphandle komzimba - Oku kuthetha "ngaphandle komzimba".
• Ukufakelwa kwe-oxygen kwi-membrane - Oku kuthetha "ukubonelela nge-oxygen nge-membrane ekhethekileyo."

Uyaqonda ngoku? Okwenzekayo apha kukuba igazi elikhutshwa emzimbeni lifakwa ioksijini ngaphakathi komatshini one-membrane ekhethekileyo lize liphinde limpompelwe emzimbeni. Lo matshini wenza kanye oko kwenziwa yimiphunga yethu. Ngamanye amaxesha wenza umsebenzi wokupompa owenziwa yintliziyo.

Ngokunika intliziyo nemiphunga "ikhefu" ngale ndlela, bayakwazi ukulungisa umonakalo abawenzileyo. Okwangoku, umatshini we-ECMO ubonelela ngobonelelo oluqhubekayo lweoksijini emzimbeni.

Ngaba kukho iintlobo ze-ECMO?

Ewe, zimbini iintlobo eziphambili ze-ECMO. Oogqirha bagqiba ukuba loluphi uhlobo abalusebenzisayo ngokuxhomekeke kwimeko yesigulana.

Kuxa kutheni apho kusetyenziswa i-ECMO?

I-ECMO ayisiyonto uyisebenzisela umkhuhlane okanye umkhuhlane oqhelekileyo. Yinkqubo esindisa ubomi esetyenziselwa izigulana ezigula kakhulu xa kungekho nyango luphumelelayo.

• I-Acute Respiratory Distress Syndrome (ARDS): Xa imiphunga yonakele kakhulu ngenxa yeemeko ezifana ne-pneumonia enzima, ukutsha, okanye ukurhaxwa, kwaye umzimba ungakwazi ukufumana ioksijini. I-ECMO incede abantu abaninzi abanengxaki ngale meko ngexesha lobhubhane we-COVID-19.
• I-Pulmonary Embolism: Ihlwili legazi elenzeka emzimbeni (ngesiqhelo emilenzeni) liyaqhekeka lize lihlale kwimithambo yegazi emikhulu emiphungeni. Le yimeko eyingozi kakhulu kwaye inokubulala.
• Ukulimala Kwentliziyo: Xa izihlunu zentliziyo zonakele ngenxa yokuhlaselwa yintliziyo, ingozi, okanye ukuwa, kwaye zingakwazi ukupompa igazi ngokufanelekileyo.
• Kwiintsana ezisandul’ ukuzalwa: I-ECMO isetyenziselwa ukusindisa ubomi beentsana ezincinci kakhulu ezineengxaki ezinkulu zentliziyo okanye zemiphunga ekuzalweni, ingakumbi ezo zizelwe ngaphambi kwexesha.
• Ukufakelwa amalungu omzimba kunye notyando: I-ECMO isetyenziselwa ukunceda isigulana esilinde ukufakelwa intliziyo okanye imiphunga, okanye ukunceda umzimba ukuba uphile emva kotyando olukhulu.

Lusebenza njani unyango lwe-ECMO?

Le nkqubo yenzeka kwiyunithi yokhathalelo olunzulu (ICU) phantsi kweliso leqela loogqirha nabahlengikazi abaqeqeshwe ngokukodwa.

1. Ukukhupha igazi: Okokuqala, isigulana sivalelwe i-anesthesia ngokupheleleyo. Oku kuthetha ukuba asiyi kuva ntlungu. Emva koko, ugqirha wotyando ufaka iityhubhu ezinkulu (iityhubhu okanye ii-cannula) kumthambo omkhulu wegazi okanye umthambo wegazi entanyeni, esifubeni, okanye emathunjini esigulana.

2. Ukudibanisa nomatshini: Umbhobho omnye utsala igazi eliphelelwe yioksijini emzimbeni uliyise kumatshini we-ECMO.

3. Ukongeza ioksijini:Njengoko eli gazi lidlula kwimiphunga yokwenziwa (i-oxygenator) ngaphakathi komatshini, ikharbon dioxide ekulo iyasuswa kwaye kongezwa ioksijini.

4. Ukumpompa kwakhona emzimbeni: Igazi elicocekileyo, elineoksijini limpompa kwakhona emzimbeni ngomnye umbhobho.

Ngethuba lale nkqubo yonke, isigulana sisenokuba siphilile engqondweni okanye sithomalalise umzimba. Iqela le-ECMO lijonga ngokusondeleyo isigulana kunye nomatshini kangangeeyure ezingama-24.

Uzikhupha njani kwi-ECMO?

Xa intliziyo yakho nemiphunga yakho iziva ingcono kwaye ukwazi ukusebenza wedwa kwakhona, oogqirha bakho baya kuqala kancinci kancinci ukukususa kumatshini. Oku kubizwa ngokuba "kukukhumula." Inkxaso evela kumatshini iyancitshiswa kancinci kancinci, okuvumela umzimba wakho ukuba usebenze wedwa. Ukuba yonke into ihamba kakuhle, iityhubhu ziya kususwa kwiintsuku ezimbalwa kwaye izitishi ziya kubuyiselwa endaweni yazo.

Zithini iingenelo kunye neengozi ezinkulu ze-ECMO?

Njengalo naluphi na unyango oluntsonkothileyo, i-ECMO ineengenelo ezinkulu kunye neengozi ezinkulu. Sisigqibo esithetha ubomi nokufa.

Ungalunceda njani usapho lomguli?

Kunzima kakhulu kusapho ukubona umntu omthandayo eqhagamshelwe kumatshini onje. Kodwa kukho izinto onokuzenza. Kodwa ngaphambi kokuba wenze nantoni na, qiniseka ukuba ufumana imvume kugqirha okanye kubasebenzi bomongikazi.

• Thetha nesigulana: Nokuba abakho zingqondweni, banokukwazi ukukuva. Ilizwi lakho liya kubathuthuzela.
• Funda incwadi okanye umamele umculo: Umculo ozolileyo okanye isandi sakho ufunda incwadi sinokubazisela intuthuzelo.
• Yiza nemifanekiso yosapho kwaye uyigcine: Gcina imifanekiso yosapho lwakho apho banokuyibona khona.
• Fumisa ulusu: Ukuze uthintele ukoma kolusu, ungacela ugqirha wakho ukuba akunike iloshini efanelekileyo.

Ngaba i-ECMO yeyona ndlela yokugqibela?

Ewe, i-ECMO idla ngokuba yindlela yokugqibela . Oogqirha benza esi sigqibo emva kokuba zonke ezinye iindlela zonyango ezinokwenzeka zingaphumelelanga.

Kwakhona, i-ECMO isetyenziswa kuphela kwizigulana ezineemeko eziguqukayo . Umzekelo, i-pneumonia enzima inokunyangeka. I-ECMO inikwa ukunceda imiphunga ide iphole. Nangona kunjalo, i-ECMO ayisetyenziselwa isifo esinganyangekiyo, njengomhlaza ongapheliyo.

Olu asilonyango. Lusetyenziselwa ukuphilisa isigulane ngaphandle kokulimaza amanye amalungu omzimba. Ngenxa yoko, isigulane sinokufa xa sikwi-ECMO ukuba imeko yaso engaphantsi ayinakulawulwa.