Ngaba unengxaki yokuphefumla? Masithethe ngokusilela kokuphefumla

Ngaba ngamanye amaxesha uziva ngathi kunzima ukuphefumla? Okanye uziva ngathi awukwazi ukuphefumla? Akulunganga ukungazinaki ezi zinto. Kuba, oku kungaba luphawu lwemeko enzima ebizwa ngokuba yiRespiratory Failure . Namhlanje, siza kuthetha ngale nto ngendlela elula onokuyiqonda. Oku kungaba yingxamiseko yezonyango, ngoko ke kubalulekile ukukwazi oku.

Siphefumla njani? Kwenzeka ntoni ukuba oku kungasebenzi kakuhle?

Cinga ngayo, ioksijini emizimbeni yethu ifana nepetroli emotweni, okanye ifana namafutha esiwadingayo ukuze siqhube ubomi bethu. Xa siphefumla, le gesi ixabisekileyo ebizwa ngokuba yioksijini ingena emiphungeni yethu. Ngokuchanekileyo, le oksijini ingena kwiingxowa zomoya ezincinci ezikwimiphunga, ezibizwa ngokuba yi-alveoli . Ifana nebhasi efika kwindawo yokumisa ibhasi.

Ukusuka apho, igazi "lithwala" le oksijini liyise kuwo onke amalungu omzimba, kuquka ingqondo yethu, intliziyo, izihlunu, kunye nezinye izitho. Ukuba le oksijini ayifiki kwezo ndawo, iiseli zomzimba wethu aziyi kukwazi ukusebenza, njengemoto engenamafutha.

Ngoku, emva kokuba ioksijini "ithunyelwe" kwezo ndawo, iiseli zegazi, njengoko zibuya, ziqokelela i-carbon dioxide, igesi engeyonto iluncedo emzimbeni kunye nenkunkuma. Oku kufana nokuthatha ukutya evenkileni uze ubuyisele iibhokisi ezingenanto. Ukuba le carbon dioxide iqokelelana emzimbeni, nayo loo nto yingxaki. Kuba akukho ndawo yaneleyo yokuba igazi lithwale ioksijini entsha. Ngoko ke, le carbon dioxide ibuyela emiphungeni ize ikhutshwe emzimbeni xa sikhupha umoya. Kulapho ke sinendawo yokufumana ioksijini entsha kwakhona.

Ukuba nayiphi na inxalenye yale nkqubo yonke ihamba kakubi, izicubu zomzimba wethu azifumani ioksijini eyaneleyo. Yiloo nto siyibiza ngokuba yiRespiratory Failure .

Ngaba kukho iintlobo zokungasebenzi kakuhle kokuphefumla?

Ewe, kukho iintlobo ezahlukeneyo zale meko, kuxhomekeke kwindlela eyenzeka ngayo kunye nokuba yintoni echaphazela kakhulu. Ngamanye amaxesha ingenzeka ngequbuliso (ngokukhawulezileyo) , kwaye ngamanye amaxesha inokukhula kancinci kancinci ngokuhamba kwexesha (engapheliyo) . Iintlobo ezimbini eziphambili zezi:

1. Ukusilela kokuphefumla okungaphantsi koxinzelelo lwegazi - Uhlobo 1

Ngamafutshane, le yimeko apho igazi lakho linamanqanaba aphantsi eoksijini (`hypoxemia`) . Oku kwenzeka xa uphefumla kodwa igazi lakho lingafumani oksijini eyaneleyo. Isifo sentliziyo kunye nesifo semiphunga zezona zinto zibangela oku. Abanye abantu bakwabiza ngokuba kukusilela kokuphefumla okungenaoksijini.

2. Ukusilela kokuphefumla okunamandla kakhulu - Uhlobo 2

Kulapho ke inani lekhabhoni dayokhsayidi (CO2) egazini lakho linyuka khona.. Xa imizimba yethu ingakwazi ukususa i-carbon dioxide ngokufanelekileyo, inkunkuma ebizwa ngokuba yi-CO2, iqokelelana egazini. Emva koko, njengoko bekutshiwo ngaphambili, akukho ndawo yeoksijini egazini. Le meko inokubangelwa zizifo zentliziyo, imiphunga, izihlunu, kunye nenkqubo yemithambo-luvo (ingqondo kunye nomqolo). Amanye amayeza anokubangela oku.

Kukho ezinye iintlobo:

• Ukusilela kokuphefumla okuhamba notyando (Uhlobo 3): Oku kunokwenzeka ngexesha lotyando. I-anesthesia esetyenziswa ngexesha lotyando ngamanye amaxesha inokwenza kube nzima ukuphefumla. Kwakhona, iingxowa zomoya ezikwimiphunga zinokuwa (i-atelectasis), nto leyo ethintela ioksijini ukuba ingafiki egazini.
• Ukungaphumeleli kokuphefumla ngenxa yoMngxunya (Uhlobo 4): Umothuko yimeko enzima apho kukho ukwehla ngequbuliso koxinzelelo lwegazi kunye neengxaki ezifana nokudumba kwamaphaphu. Oku kunokubangela nokungaphumeleli kokuphefumla. Umothuko unokubangelwa zizinto ezifana ne-sepsis ( usulelo olunzima olusasazeka emzimbeni wonke), ukuhlaselwa yintliziyo ngequbuliso, kunye nokopha kakhulu.

Zithini iimpawu zale meko?

Iimpawu zokungasebenzi kakuhle kokuphefumla zingahluka ngokuxhomekeke kwisizathu. Nangona kunjalo, kukho iimpawu eziqhelekileyo:

• Ubunzima bokuphefumla okanye ukuziva uphelelwa ngumphefumlo (ukuphelelwa ngamandla).
• Ukuphefumla ngokukhawuleza (i-tachypnea).
• Ndiziva ndidiniwe kakhulu (ndidiniwe).
• Ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza okanye ukubetha kwentliziyo yakho akulunganga.
• Ukukhohlela i-mucus okanye igazi (i-hemoptysis).
• Ukubila okugqithisileyo.
• Ukungazoli, ukuphazamiseka.
• Ulusu oluphaphathekileyo.
• Ukutshintsha kombala oluhlaza okwesibhakabhaka kolusu, imilebe, okanye iinzipho (i-cyanosis) - Olu luphawu olukhulu lokunqongophala kweoksijini.
• Intloko ebuhlungu .
• Umbono ofipheleyo.
• Ixhala, ukudideka, ukungakwazi ukucinga kakuhle.
• Utshintsho kwindlela yokuziphatha, kungekhona njengesiqhelo.

Kubalulekile: Ukuba unayo nayiphi na kwezi mpawu, kufuneka ufune ingcebiso kagqirha ngoko nangoko , kuba oku kungaba yingxamiseko.

Zithini izizathu zokungasebenzi kakuhle kokuphefumla?

Ngamafutshane, le meko yenzeka xa amandla emizimba yethu okungenisa ioksijini nokukhupha ikharbon diokside ephazamiseka ngesizathu esithile. Izinto ezinokuchaphazela oku ziquka:

• Ukungabikho komoya owaneleyo okanye ukuncipha kokunikezelwa kwegazi emiphungeni.
• Ukuvaleka, amanxeba, okanye ukwakheka kolwelo emiphungeni.
• Ukungakwazi ukuphefumla kakuhle okanye nzulu.Oku kunokubangelwa zizifo ezichaphazela imiphunga, iingxaki zemithambo-luvo okanye izihlunu ezikunceda ukuphefumla, okanye ukwenzakala esifubeni.
• Ukungaqheleki kokuhamba kwegazi entliziyweni.

Ngubani osengozini enkulu? (Izinto Ezinobungozi)

Abanye abantu basengozini enkulu yokungaphumeleli kokuphefumla. Nazi:

• Abantu abanezifo zemiphunga: Umzekelo, izifo ezifana ne- acute respiratory distress syndrome (ARDS) , isifo semiphunga esingapheliyo (COPD) , i-pneumonia , i-asthma , i-cystic fibrosis , i-pulmonary edema (ulwelo olusemiphungeni) , i-pulmonary embolism (igazi eliqhekekileyo kwityhubhu yemiphunga) , kunye ne -pulmonary fibrosis (ukuvaleka kwemiphunga) .
• Abantu abanezifo zentliziyo okanye zenkqubo yokujikeleza kwegazi: ezifana nokuhlaselwa yintliziyo , isifo sentliziyo sokuzalwa , ukusilela kwentliziyo , kunye nokothuka .
• Abantu abanezifo ezichaphazela imithambo-luvo kunye nemisipha ezinceda ekuphefumleni: iimeko ezifana ne-muscular dystrophy , i-amyotrophic lateral sclerosis (ALS) , i-scoliosis enzima (ukugoba komqolo) , kunye ne-Guillain-Barré syndrome .
• Ukwenzakala esifubeni, emgogodleni, okanye engqondweni (kuquka istroke).
• Ukutshaya okanye ukuvezwa kwezinye izinto ezibangela ukurhawuzelelwa yimiphunga: umsi weekhemikhali, uthuli, ungcoliseko lomoya (njengokukhutshwa kwegesi ephuma kwiimoto ezinkulu ezindleleni zethu, umsi wefektri, nothuli oluvela kwiindawo zokwakha), kunye ne-asbestos.
• Utyando olufuna i-anesthesia.
• Ukusetyenziswa kweziyobisi okanye ukusela utywala kakhulu.
• Ubudala: Iintsana ezisandul’ ukuzalwa (ingakumbi ezo zizelwe zinokukhula okuncinci) kunye nabantu abadala abangaphezu kweminyaka engama-65 ubudala basengozini enkulu.

Oogqirha bayixilonga njani le nto?

Ugqirha uza kujonga ukuba akukho mpilo ifanelekileyo na ngokujonga ubungakanani beoksijini kunye nekhabhoni dayokhsayidi egazini lakho . Baza kujonga noxinzelelo lwegazi lakho baze basebenzise isixhobo esincinci esibizwa ngokuba yi-'pulse oximeter' okanye i-'pulse ox') ukujonga inqanaba leoksijini egazini lakho. Baza kumamela nentliziyo yakho kunye nemiphunga yakho baze bakuhlole. Ukuba kukho ukrokrelo lokuba le meko, banokwenza olunye uvavanyo oluninzi.

Ziziphi ezo mvavanyo?

• I-pulse oximetry:Oku kuquka ukubeka inzwa emnweni wakho ukulinganisa ubungakanani beoksijini egazini lakho. Oku kudla ngokwenziwa xa usiya kugqirha.
• Uvavanyo lweArterial Blood Gas (ABG): Isampuli encinci yegazi ithathwa ngenaliti esihlahleni, engalweni engentla, okanye emqolo kwaye amanqanaba eoksijini kunye nekhabhoni diokside ayalinganiswa. Oku kunokubonelela ngolwazi oluchanekileyo kakhulu.
• Uvavanyo Lokusebenza Kwemiphunga (PFT): Kolu vavanyo, ucelwa ukuba uphefumle ngaphakathi nangaphandle ngomlomo oqhagamshelwe kumatshini. Oku kunokujonga ukuba imiphunga yakho isebenza kakuhle kangakanani na.
• Uvavanyo lwemifanekiso: Ii-X-reyi kunye nee-CT scans zithatha imifanekiso yangaphakathi yomzimba. Nangona ezi zingenakukwazi ukubona ngokuthe ngqo ukungasebenzi kakuhle kokuphefumla, zinokunceda ekufumaniseni ukuba yintoni ebangela oko.
• I-Electrocardiogram (EKG): Le yindlela elinganisa ngayo ukusebenza kakuhle kwentliziyo. Ukuba ugqirha ucinga ukuba ingxaki ibangelwa sisifo sentliziyo, uza ku-odola i-EKG.

Iphathwa njani le nto?

Unyango lokusilela kokuphefumla luxhomekeke kubukhali balo kunye nesizathu salo . Iinjongo eziphambili zonyango kukuphatha unobangela oyintloko, ukukunika ioksijini engaphezulu, okanye ukusebenzisa umatshini wokuphefumla (`umoya womoya`) ude ukwazi ukuphefumla ngokwakho kwakhona.

Ukungaphumeleli kokuphefumla ngokukhawuleza yimeko engxamisekileyo kwaye kufuneka inyangwe ngoko nangoko. Nangona kunjalo, ukungaphumeleli kokuphefumla okuncinci, okuhlala ixesha elide (okungapheliyo) ngamanye amaxesha kunokunyangeka ekhaya ngokulawula imeko engundoqo.

Ziziphi iindlela zonyango ezithile?

• Umoya womoya osetyenziswa ngoomatshini: Oku kuquka ukukudibanisa nomatshini wokuphefumla kunye nombhobho ofakwe kwindlela yakho yomoya, ophefumla kwaye ukhuphe umoya emiphungeni yakho.
• I-Extracorporeal Membrane Oxygenation (ECMO): Olu lunyango oluntsonkothileyo kancinci. Lubandakanya ukusebenzisa umatshini we-bypass ukususa igazi emzimbeni, ukongeza ioksijini kuwo, ukususa i-carbon dioxide, uze ungene kwakhona emzimbeni.
• Unyango lweoksijini: Umatshini uhambisa ioksijini eyongezelelweyo ngemaski yokuphefumla okanye ngetyhubhu encinci (i-cannula) efakwe empumlweni. Oku kungenziwa esibhedlele okanye ekhaya.
• Ulwelo: Ulwelo lunikwa ngemithambo yegazi (IV - ngqo emthanjeni). Oku kuphucula ukujikeleza kwegazi emzimbeni kwaye kunceda ukuthwala ioksijini engaphezulu ukuya kwizicwili.
• Ukunyanga iimeko zempilo ezifihlakeleyo: Ngokuxhomekeke kwisizathu sokungakwazi ukuphefumla, ugqirha unokucebisa amanye amayeza okanye unyango.

Ngaba ikho indlela yokuthintela oku?

Ukungaphumeleli kokuphefumla akunakuthintelwa rhoqo. Nangona kunjalo, unganciphisa umngcipheko wakho wokuba nokungaphumeleli kokuphefumla okungapheliyo ngokulawula naziphi na iimeko zentliziyo, zemiphunga, okanye zenkqubo yemithambo-luvo onokuba nazo. Ukuba unobungozi bale meko, thetha nogqirha wakho ngeendlela zokunciphisa umngcipheko wakho.

Ngaba ukungakwazi ukuphefumla kuyanyangeka?

Le yimeko enzima kakhulu. Uninzi lwabantu luyaphola kuyo. Ixhomekeke kwisizathu sesifo, ubukhali baso, kunye nokuba sinyangwa ngokukhawuleza kangakanani.

Nangona izizathu ezininzi zokungaphumeleli kokuphefumla ngokukhawuleza zinokunyangwa, kodwa zinokubulala ukuba azinyangwa ngokukhawuleza. Malunga nesithathu kwisithathu sabantu abalaliswe esibhedlele ngenxa yokungaphumeleli kokuphefumla ngokukhawuleza bayafa. Ukungaphumeleli kokuphefumla okungapheliyo kudla ngokubangelwa sisifo esiba mandundu ngokuhamba kwexesha.

Ndifanele ndimbone nini ugqirha?

Ukuba unesifo esingapheliyo esikubeka emngciphekweni wokungasebenzi kakuhle kokuphefumla, thetha nogqirha wakho. Angakuxelela ukuba zeziphi iimpawu zokungasebenzi kakuhle kokuphefumla ekufuneka uziqaphele kunye nendlela yokulawula imeko yakho.

Ndingaya nini kwiSebe leeNgxamiseko (i-ETU) ?

Ukuba uneempawu zokungakwazi ukuphefumla, yiya kwigumbi likaxakeka elikufutshane ngoko nangoko, okanye utsalele umnxeba ku-911. Oku kunokuba yingozi ukuba akunyangeki ngokukhawuleza.

Ndimele ndibuze ntoni kugqirha wam?

Kunganceda ukubuza ugqirha wakho imibuzo efana nale:

• Ziziphi iindlela zonyango endinazo?
• Yintoni isizathu soku?
• Ndingawasebenzisa njani amayeza am?
• Ndingayisebenzisa njani le sixhobo (umz., umatshini weoksijini)? Ungandibonisa ukuba ndiyisebenzisa njani?
• Ndingalindela nini ukuba ndiphile?
• Ndingabuya nini ndize kukubona kwakhona?

Umyalezo Wokuya Ekhaya

Ukungaphumeleli kokuphefumla yimeko embi kakhulu, ngamanye amaxesha ebulalayo. Ukuba ucinga ukuba unengxaki yokuphefumla ngokukhawuleza, nceda utsalele umnxeba ku-911 ngoko nangoko okanye ufumane uncedo lwezonyango olungxamisekileyo. Ukuba unengxaki yokuphefumla engapheliyo, okanye ukuba uneemeko ezikwandisa umngcipheko wakho, thetha nogqirha wakho malunga nonyango olufanelekileyo. Angachaza ukuba zeziphi iindlela zonyango onazo kunye noko unokukulindela ngokwemeko yakho. Lumka ukuphefumla kwakho, kuba bubomi bakho!

Ukungakwazi ukuphefumla kakuhle, ubunzima bokuphefumla, ioksijini, ikharbon diokside, imiphunga, ukhathalelo olungxamisekileyo, i-ARDS, i-COPD