Mhlawumbi ubukhe waya kubona umntu okwigumbi labagula kakhulu (ICU). Okanye ubuncinci ubukhe wabukela imuvi apho isigulana siqhagamshelwe kumatshini onetyhubhu emlonyeni waso. Usenokuba uzive usoyika okanye unomdla xa uyibona loo nto. Enye yezona matshini zibalulekileyo yi-ventilator. Nangona abantu abaninzi beyoyika, eneneni sisixhobo esisindisa ubomi. Ke namhlanje, masithethe ngento i-ventilator, okanye ngokwezonyango, "Mechanical Ventilation", kutheni ifuneka, nayo yonke into enxulumene nayo ngendlela elula kakhulu.
Ngamafutshane, yintoni i-ventilator?
I-ventilator ngumatshini okuncedayo ukuphefumla, okanye othatha umsebenzi ngokupheleleyo, xa ungakwazi ukuphefumla wedwa. Njengokuba iintonga zixhasa ubunzima bakho xa umlenze wakho waphukile, i-ventilator ixhasa imiphunga yakho.
Lo matshini wenza izinto ezintathu eziphambili:
- Inika imiphunga yakho ioksijini eyifunayo.
- Inceda imiphunga yakho isuse igesi yekhabhoni dayokhsayidi engafunekiyo eqokelelana emzimbeni wakho.
- Iingxowa zomoya ezincinci (ii-alveoli) ezingaphakathi kwimiphunga yakho zinika uxinzelelo olufunekayo ukuze zihlale zivulekile ngaphandle kokuwa.
Oogqirha banokulungisa useto lwalo matshini ukuze luhambelane nemeko yakho baze bakunike inkxaso oyifunayo.
Eyona nto ibalulekileyo kukuba i-ventilator ayilonyango lwesifo. Igcina nje ukuphefumla kwakho kuzinzile de umzimba wakho ulwe nesifo kwaye uphile. Okwangoku, oogqirha bakho banokubonelela ngezinye iindlela zonyango zemeko yakho.
Ngaba "i-Intubation" kunye "ne-Ventilation" zizinto ezahlukeneyo?
Ewe, nangona ezi zimbini zidla ngokuvela kunye, oku kubhekisa kwiinkqubo ezimbini.
- Ukufakwa kwetyhubhu: Oku kwenzeka xa ugqirha efaka ityhubhu ngomlomo okanye empumlweni yakho, ezantsi kwi-windpipe (trachea) kwaye iye emiphungeni yakho. Oku kukwabizwa ngokuba yi-"endotracheal tube" okanye ityhubhu ye-ET.
- Umoya Ongenisiweyo: Oku kubhekisa kwinkqubo yokudibanisa ityhubhu efakwe ngaphambili kumatshini womoya, okuncedayo ukuphefumla.
Ngamanye amaxesha, endaweni yokufaka ityhubhu efana nale, ungaqhagamshela kwi-ventilator ngemaski yobuso ehambelana kakuhle ebusweni bakho. Siza kuthetha ngaloo nto kancinci.
Ziziphi iintlobo eziphambili zonyango lomoya?
Iiventilator ezisetyenziswa namhlanje zisebenzisa uxinzelelo oluhle ukunyanzela umoya ungene emiphungeni. Oku kungenziwa ngeendlela ezimbini eziphambili.
| Uhlobo lonyango | Kalula nje... |
|---|---|
| Umoya Ongenisa Umoya Ongena Ngoomatshini | Oku kubandakanya ukufaka ityhubhu kwindlela yakho yomoya uze uyidibanise ne-ventilator. Le tyhubhu ingafakwa ngomlomo wakho (intubation) okanye ngokusikwa okuncinci entanyeni yakho (tracheostomy) . |
| Umoya ongenasithintelo | Oku kusebenzisa imaski ehambelana kakuhle nobuso. Le maski ibotshelelwe entloko ngeentambo. Umoya ovela kwi-ventilator ungena emiphungeni ngale maski. Izixhobo ezifana ne- (CPAP) okanye (BiPAP®) ezisetyenziswa ekhaya nazo zezolu hlobo. |
Ifuneka nini i-ventilator?
Ungadinga uncedo lomatshini womoya xa imeko inzima apho ungakwazi ukuphefumla kakuhle wedwa. Umzekelo:
- Ngexesha lotyando olukhulu: Xa uphantsi kwe-anesthesia eqhelekileyo, amandla akho okuphefumla ayancitshiswa. Ke ngoko, uya kunikwa uncedo lomatshini womoya ngexesha lotyando.
- Usulelo okanye iimeko ezinzulu zemiphunga: I-Pneumonia, i-COVID-19, i-Acute Respiratory Distress Syndrome (ARDS), kunye ne-Chronic Obstructive Pulmonary Disease (COPD) xa iimeko zisiba mandundu.
- Iimeko ezingxamisekileyo okanye zonyango: Naluphi na ungxamiseko oluvala indlela yomoya kwaye lwenze kube nzima ukuphefumla. Umzekelo, i-allergy eqatha (i-anaphylaxis).
- Ukonakala okanye isifo sobuchopho: Kwiimeko ezifana nestroke kunye nokwenzakala kwengqondo okubuhlungu, ingqondo ayikwazi ukuthumela imiyalezo ngokufanelekileyo emiphungeni ukuze iphefumle.
- Utshintsho kwibhalansi yegesi egazini: Ukuba ubungakanani bekhabhoni diokside egazini buyanda (hypercapnia) okanye ubungakanani beoksijini buyancipha (hypoxemia), kufuneka i-ventilator ukulawula le meko.
- Khusela indlela yakho yomoya:Ukuba umntu okwi-coma uhlanza amathe okanye ukutya emlonyeni wakhe, kunokungena emiphungeni yakhe. Ukuthintela oku, kufakwa ityhubhu yokuphefumla ukukhusela indlela yomoya.
Kuza kufuneka ube kwi-ventilator ixesha elingakanani?
Oku kuxhomekeke ngokupheleleyo kwimeko ebangele ukuba udinge i-ventilator. Kungathatha iiyure ezimbalwa, iintsuku ezimbalwa, iiveki ezimbalwa. Kwiimeko ezingaqhelekanga kakhulu, kusenokufuneka uhlale iinyanga okanye iminyaka. Injongo yeqela lezonyango kukukukhupha kwi-ventilator ngokukhawuleza nangokukhuselekileyo kangangoko kunokwenzeka . Kude kube ngoko, baya kujonga imeko yakho rhoqo.
Ngokwesiqhelo, ukuba kubonakala ngathi kuya kufuneka ube kwi-ventilator kangangeeveki ezingaphezu kwezimbini, oogqirha baya kuyisusa ityhubhu emlonyeni wakho baze bafake ityhubhu nge-incision encinci entanyeni yakho (tracheostomy). Le yindlela ekhululekileyo nehlala ixesha elide kwisigulana.
Kwenzeka ntoni xa uyiqhagamshela kwi-ventilator?
Le nkqubo yenzeka kwiyunithi yokhathalelo olunzulu (ICU).
1. Okokuqala, uza kunikwa i-sedation ukuze uphumle kwaye uzive ulele. Kwangaxeshanye, uza kunikwa umntu okhubazekileyo ukuze umzimba wakho ungashukumi ngelixa umbhobho ufakwa.
2. Emva koko ugqirha ufaka ityhubhu (ityhubhu ye-ET) ngomlomo wakho kwi-windpipe yakho.
3. Ekugqibeleni, ityhubhu iqhagamshelwe kumatshini womoya. Emva koko umatshini uqala ukuphefumla ngenxa yakho.
Kwimeko engxamisekileyo, oku kusenokufuneka kwenziwe ngendlela eyahlukileyo kancinci, ngokukhawuleza kakhulu.
Kwenzeka ntoni kwakhona xa usebenzisa i-ventilator?
Ngelixa usebenzisa i-ventilator, uza kunyanyekelwa liqela loogqirha abaqeqeshwe ngokukodwa. Kukho ezinye izinto ezimbalwa ezenzekayo ngeli xesha.
Ukubeka esweni ngokusondeleyo
Uza kuqhagamshelwa kwezinye iimonitha ukuze ujonge umsebenzi womzimba wakho.
- Ifuthe legazi
- Inqanaba lentliziyo
- Izinga lokuphefumla
- Amanqanaba eoksijini egazini
Ezi zinto zijongwa rhoqo. Ii-X-ray zesifuba zenziwa ukujonga imeko yemiphunga kwaye kwenziwa uvavanyo lwegazi ukujonga amanqanaba eoksijini egazini.
Ukufunxa
Umbhobho wokuphefumla unokubangela ukuba i-mucus iqokeleleke kwindlela yakho yomoya. Ngoko ke, abahlengikazi badla ngokufaka enye i-tube encinci (i-catheter) kwi-tube ukuze basuse i-mucus eqokelelekayo. Usenokukhwehlela kancinci kwaye uzive ungakhululekanga ngeli xesha. Oku kunokuba yinto engathandekiyo kubabukeli, kodwa kubalulekile ukugcina indlela yakho yomoya icocekile.
Isondlo
Awunakutya okanye usele kuba unetyhubhu emlonyeni wakho. Ngenxa yoko, uza kunikwa isondlo solwelo ngetyhubhu encinci esuka empumlweni yakho iye esiswini sakho. Ezinye iziselo ziza kunikwa ngesisombululo setyuwa siye emthanjeni.
Ukuququzelela
Ekubeni kungalunganga ukuhlala ebhedini ngalo lonke ixesha, iqela lezonyango liza kukugcina ushukuma. Ngamanye amaxesha, ukuba unako ukwenza njalo, baya kuzama ukukunyanzela ukuba uhambe kancinci.
Ngaba uziva uphaphile xa usebenzisa i-ventilator?
Lo ngumbuzo obuzwa ngabantu abaninzi. Oogqirha bazama ukukugcina ukhululekile kwaye uzolile kangangoko kunokwenzeka, ngelixa bekugcina uphaphile kangangoko kunokwenzeka. Nangona kunjalo, ukuba imeko yakho imbi kakhulu, unokufuna 'ukuthomalalisa kakhulu' ukuze umzimba wakho ufumane ixesha lokuphumla nokuphiliswa. Ngamanye amaxesha, iingalo zakho zinokuthi 'zithintelwe' ukuthintela ukuba ungafaki ngengozi ityhubhu. Oku kungenxa yokhuseleko lwakho.
Zithini iingenelo kunye neengozi?
Njengalo naluphi na unyango lwezonyango, unyango lokungenisa umoya lunezibonelelo kunye neengozi.
| Iingenelo | Iingozi |
|---|---|
| Awufuni ukusebenza nzima ukuze uphefumle. Ngoko ke sebenzisa onke amandla omzimba wakho ukuze uphilise isifo. | Iintsholongwane zinokuhamba ngeendlela zomoya ziye emiphungeni zize zibangele usulelo (umz. i-pneumonia). |
| Ngokuqinisekileyo uza kufumana umlinganiselo weoksijini oyifunayo, kwaye ikharbon diokside iya kususwa. | Uxinzelelo oluvela kwi-ventilator ngamanye amaxesha lunokonakalisa imiphunga. |
| Ithintela ukuba iingxowa zomoya ezikwimiphunga zingavaleki. | Indawo ebuthathaka emphungeni inokugqobhoka, nto leyo ebangela ukuba umphunga ubhidlike (i-pneumothorax) . |
| Igcina indlela yomoya ivulekile kwaye ikhuselekile. | Ukusebenza kwentliziyo kunye noxinzelelo lwegazi kunokuchaphazeleka. |
Kukho ingongoma enye ebalulekileyo. Ngamanye amaxesha imeko yesigulana inokuba mandundu kangangokuba akunakwenzeka ukuba siphile. Kwimeko enjalo, ukunxibelelana ne-ventilator kunokwenza inkqubo yokufa ibe mfutshane. Oku kunokubangela ukubandezeleka okungeyomfuneko kwisigulana nakusapho. Kwimeko enjalo, ugqirha wakho uza kuxoxa nawe ngale nto aze akukhokele ukuba wenze isigqibo esifanelekileyo.
Zithini i-PEEP kunye ne-CPAP?
Mhlawumbi ukhe waweva omabini la magama.
- I-PEEP (Uxinzelelo Olupheleleyo Lokuphela Komoya): Olu lulungiselelo kumatshini womoya. Kwezinye iimeko zonyango, xa sikhupha umoya, iingxowa zomoya ezikwimiphunga (i-alveoli) zivaleka ngokupheleleyo. Ulungiselelo lwe-PEEP lugcina ezo ngxowa zomoya zivulekile ngokufaka uxinzelelo oluncinci nokuba ukhupha umoya. Oku kwandisa ubungakanani beoksijini engena egazini.
- I-CPAP (Uxinzelelo Lomoya Oluqhubekayo Olulungileyo): Oku kuquka ukuhambisa rhoqo inani elifanayo loxinzelelo oluhle kwimibhobho yomoya ngelixa uphefumla ngaphakathi nangaphandle. Idla ngokusetyenziselwa iimeko ezifana ne-sleep apnea, njengendlela yokuphefumla engangenisi umoya (ngemaski).
Ngamafutshane, i-PEEP luxinzelelo olufakwa kwisigulana esisebenzisa umoya xa siphefumla. I-CPAP luxinzelelo oluqhubekayo olufakwa ngexesha lokuphefumla nokuphefumla.
I-ventilator sisixhobo esibalulekileyo esinokusindisa ubomi bakho xa kukho isifo esinzima okanye imeko kaxakeka. Nangona ingasinyangi isifo, inika umzimba wakho ixesha kunye nenkxaso oyidingayo ukulwa nesifo kwaye uphile.
Umyalezo Wokuya Ekhaya
- I-ventilator yimatshini esindisa ubomi ekunceda uphefumle xa ungakwazi ukuphefumla wedwa.
- Oku akusinyangi isifo, kodwa kunika umzimba ixesha kunye nozinzo olufunekayo ukulwa nesifo nokuphiliswa.
- Usenokuqhagamshelwa kwi-ventilator ngetyhubhu yokuphefumla (invasive) okanye ngemaski (non-invasive).
- Ngelixa usebenzisa i-ventilator, iqela loogqirha abaziingcali kwiYunithi yoKhathalelo oluPhezulu (ICU) liza kukunyamekela kakhulu.
- Nangona olu nyango lunemingcipheko, kwiimeko ezininzi lolona khetho lokusindisa ubomi.
- Ukuba wena okanye nabani na kusapho lwakho unemibuzo okanye iinkxalabo malunga noku, thetha nogqirha wakho ngokukhululekileyo malunga nako.
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