Ngaba uyazi ngale meko ingxamisekileyo eyenzeka emiphungeni emva kokunikela ngegazi? (TRALI)

Ngaba wakha watofelwa igazi? Okanye ngaba kukho umntu omaziyo owakha walitofelwa? Ngokwesiqhelo, ukunikela ngegazi yinto enceda ekusindiseni ubomi. Kodwa kunqabile kakhulu, oko kukuthi, kunqabile kakhulu, abanye abantu banokuba nengxaki yempilo engxamisekileyo ngenxa yokunikela ngegazi. Le yenye yeemeko esiza kuthetha ngazo namhlanje, ebizwa ngokuba yiTRALI. Eli gama lisenokuba litsha kuwe, kodwa kubaluleke kakhulu ukulazi.

Yintoni (i-TRALI)? Masiyiqonde ngokulula

Ngamafutshane, i-(TRALI) – emele i-Transfusion-Related Acute Lung Injury – yimeko engxamisekileyo echaphazela imiphunga yakho, nokuba xa unikwa igazi okanye kwiiyure ezi-6 emva kokulifumana. Imiphunga yethu ineengxowa zomoya ezincinci, ezifana neebhola ezincinci ezimile okwediliya. Ngokwezonyango sizibiza ngokuba yi- (alveoli) . Ewe, okwenzekayo kule meko (TRALI) kukuba uhlobo oluthile lolwelo luzalisa ngaphakathi kwezo (alveoli).

Cinga ngako, njengesiponji esifunxa amanzi, kwenzeka ntoni xa ezi ngxowa zomoya zizele lulwelo? Kuba nzima ukuphefumla, akunjalo? Imiphunga iyeka ukusebenza kakuhle. Ayisiyiyo loo nto kuphela, kodwa uxinzelelo lwakho lwegazi lunokwehla ngendlela eyingozi. Le yingxamiseko enkulu yezonyango . Ngoko ke ukuba kwenzeka into efana nale, kubalulekile ukufuna ingcebiso yezonyango ngokukhawuleza.

Zithini iimpawu ze-(TRALI)? Uzibona njani?

Ngoko ke, le meko (ye-TRALI) ivakala njani? Zithini iimpawu? Masiqaphele nezi.

• Usenokuziva uphelelwa ngumoya okanye ubunzima bokuphefumla (ukuphelelwa ngamandla) . Usenokuziva ngathi uphefumla nzima emva kokunyuka izinyuko, okanye ngathi isifuba sakho sixinene.
• Ukukhohlela kungaqala ngequbuliso .
• Ngamanye amaxesha ulusu lwakho, imilebe, kunye neenzipho zakho zijika zibe luhlaza okwesibhakabhaka (i-cyanosis) . Oku kwenzeka kuba igazi emzimbeni wakho alifumani ioksijini eyaneleyo. Olu luphawu oluthusayo kancinci.
• Usenokuba nomkhuhlane , kwaye usenokuziva ngathi unomkhuhlane.
• Usenokuziva unesiyezi okanye unesizungu .
• Abanye abantu basenokufa isiqaqa . Oku kwenzeka kuba uxinzelelo lwabo lwegazi luyehla kakhulu.

Ezi mpawu zinokuqala ngexesha lenkqubo yokunikela ngegazi okanye zingadlulanga iiyure ezi-6 emva kokuba igqityiwe. Kungoko ke, kubalulekile ukuba ulumke kakhulu ngeli xesha. Ukuba wena okanye umntu omaziyo ungumnikeli wegazi, kubalulekile ukuba uzazi ezi mpawu.

Kutheni oku (TRALI) kusenzeka? Yintoni isizathu?

Kulungile, masibone ukuba kutheni le nto (yeTRALI) yenzeka. Oku kungokwesayensi kancinci, kodwa ndiza kukucacisa ngokulula ukuze uqonde.

Imizimba yethu inenkqubo yomzimba yokuzikhusela. Yiyo esikhusela kwizifo. Le nkqubo ineendawo ezikhethekileyo ezifana 'namajoni' abizwa ngokuba zii-antibodies.Umsebenzi wabo ophambili kukusikhusela ngokuqonda nokulwa nezinto eziyingozi ezifana neentsholongwane kunye neentsholongwane ezivela ngaphandle komzimba.

Ngoku, xa ufumana igazi, ezinye zee-antibodies egazini lomnikeli zinokubophelela kwiiseli ezibizwa ngokuba ziiseli ezimhlophe zegazi emzimbeni wakho, ingakumbi emiphungeni yakho. Oku kwenzeka ngempazamo. Emva koko inkqubo yakho yomzimba icinga ukuba, "Owu, kukho into embi engene emzimbeni wakho, kungene utshaba!" Ngoko ke, loo nkqubo ngequbuliso iqala ukusebenza kwaye ibangele ukudumba . Oku kudumba yikona okubangela ukuba imithambo yegazi emincinci emiphungeni yakho, i-alveoli endikhankanyileyo ngaphambili, yonakale, kwaye ulwelo luvuza emiphungeni. Kufana nokuba inkqubo yethu yokuzikhusela iyasenzakalisa ngokungazi. Kunzima kancinci, kodwa uyayiqonda le ngcamango, akunjalo?

Ngubani osengozini enkulu yokuhlaselwa sisifo (i-TRALI)?

Nangona esi sifo (i-TRALI) sinokuvela nakubani na ofumana utofelo-gazi, abanye abantu banokuba naso. Makhe sijonge ukuba bangoobani:

• Abantu abaqhagamshelwe kwisixhobo sokuphefumla esenziwe ngoomatshini (umoya woomatshini). Oko kukuthi, izigulane ezifumana uncedo lokuphefumla kumatshini esibhedlele kuba zinengxaki yokuphefumla zodwa.
• Abantu abaxhomekeke kakhulu kutywala (ingxaki yokusebenzisa utywala). Kuba ukusebenzisa utywala ngokugqithisileyo kunciphisa amandla eenkqubo ezahlukeneyo emzimbeni.
• Abantu abasebenzisa rhoqo iimveliso zecuba. Oko kuthetha izinto ezifana neecuba kunye ne-bidis. Siyazi ukuba ukutshaya kuyingozi emiphungeni.
• Abantu abasele benesifo sesibindi okanye sezintso. Xa la malungu engasebenzi kakuhle, ibhalansi yomzimba iyaphazamiseka.
• Izigulana ezisele zigula kakhulu. Umzekelo, ezo zinezifo ezinzulu, ezifana nezo emva kotyando.
• Le ngozi inokwanda nakubantu abafumana igazi elininzi ngaxeshanye okanye abo bafumana iimveliso ezithile zegazi (umz., iplasma, iiplatelets) .

Ezi nyaniso azithethi ukuba ngokuqinisekileyo uza kuba ne-TRALI ukuba ungomnye weli qela, kodwa zithetha ukuba umngcipheko uphezulu kancinci.

Oogqirha bayixilonga njani i-TRALI? (Ukuxilongwa)

Ugqirha uyixilonga njani i-TRALI? Oku kunokuba nzima kancinci, njengoko iimpawu zinokufana nezinye iingxaki zemiphunga.

Okokuqala, baza kuzama ukuthintela ezinye izinto ezinokubangela iimpawu zakho, umzekelo, i-allergy eqatha (i-anaphylaxis) , i-pulmonary edema ngenxa yokungasebenzi kakuhle kwentliziyo, okanye usulelo olukhulu. Ukuze benze oku, baza:

• Siza kukubuza ngononophelo ngembali yakho yezonyango kunye neminikelo yakho yegazi yakutshanje.
• Kuyenziwa uvavanyo lomzimba .
• Kwenziwa uvavanyo lwegazi oluninzi. Olu vavanyo lujonga izinto ezifana namanqanaba eoksijini kunye nemeko yosulelo.
• Uvavanyo lwemifanekiso lwenziwa esifubeni . Oku kudla ngokubandakanya i -X-ray yesifuba . Kwimeko ye-TRALI, oku kunokubonisa ngokucacileyo ulwelo oluzalisa imiphunga yomibini. Ngamanye amaxesha i-CT scan inokwenziwa. Funda ngakumbi.
• Usenokwenza ne-heart scan ebizwa ngokuba yi-echocardiogram ukuze ubone ukuba intliziyo yakho isebenza kakuhle kangakanani. Oku kunokunceda ekuthinteleni iingxaki zemiphunga ezibangelwa kukusebenza kwentliziyo.

Emva kokwenza konke oku, oogqirha bafikelela kwisigqibo sokuba yiyo (TRALI).

Ziziphi iindlela zonyango ze-(TRALI)?

Ngelishwa, akukho 'nyango' luthile lwale meko (TRALI), oko kuthetha ukuba akukho nyango linokuyinyanga ngokupheleleyo okwangoku. Kodwa, ungoyiki. Oogqirha banokukugcina uzinzile kwaye bakukhathalele kakuhle de imeko iphucuke ngokwayo. Oku kubizwa ngokuba lunyango oluxhasayo . Banokukunika unyango olufana nolu:

• Unyango lweoksijini: Ioksijini ifakwa ngemaski okanye nge-cannula yempumlo ukunceda ekuphefumleni nasekunikeni umzimba umlinganiselo ofunekayo weoksijini.
• IiVasopressors: La ngamayeza anikwa ukubuyisela uxinzelelo lwegazi oluphantsi kwimeko yesiqhelo. La mayeza anikwa ngemithambo yegazi.
• I-Diuretics okanye ii-IV fluids: Ngokuxhomekeke kwimeko yakho, ii-diuretics (amayeza akwenza ulahlekelwe lulwelo ngumchamo) zinokunikwa ukunciphisa ulwelo olugqithisileyo emiphungeni nasemzimbeni wakho. Okanye, ukuba kuyimfuneko, ii-IV fluids zinganikwa ukugcina uxinzelelo lwegazi. Oku kumiselwa ngugqirha.
• Ukuphefumla ngoomatshini: Ukuba ukuphefumla kunzima kakhulu kwaye awukwazi ukuphefumla kakuhle wedwa, kunokufuneka unikwe umoya ngoomatshini njengendlela yokusindisa ubomi. Kule nto, kufakwa ityhubhu kumbhobho womoya kwaye umatshini ulawula inkqubo yokuphefumla.

Ngolu nyango, iimeko zezigulane ezininzi ziyaphucuka kancinci kancinci.

Yintoni onokuyilindela ukuba uphuhlise isifo (i-TRALI)?

Kuza kwenzeka ntoni ukuba ufumana i-TRALI? Oku kubalulekile ukwazi.

Uninzi lwexesha, i-TRALI iba ngcono kwiintsuku ezimbini ukuya kwezine . Kwabanye abantu, kungathatha ixesha elide, kuxhomekeke kubunzima bemeko kunye nempilo yakho iyonke. Ngeli xesha, oogqirha kunye nabahlengikazi baya kukugcina esibhedlele, rhoqo kwigumbi lokhathalelo olunzulu (ICU), kwaye baya kuhlala bejonga imeko yakho (ukuphefumla, amanqanaba eoksijini, uxinzelelo lwegazi) kwaye bakunike ukhathalelo oluxhasayo. Oku kuthetha ukuba baya kwenza konke okusemandleni abo ukulawula iimpawu zakho kunye nokuthintela ezinye iingxaki ukuba zingabikho.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Le yinto ekufuneka uyikhumbule ngokuqinisekileyo. Emva kokuba unikele ngegazi:

• Ubunzima bokuphefumla ngequbuliso
• Intlungu yesifuba okanye ukuxinana
• Ukukhwehlela okukhulu
• Ifiva
• Ukudinwa, umbono ofipheleyo
• Ukutshintsha kombala oluhlaza okwesibhakabhaka kolusu kunye nemilebe

Ukuba ufumana naziphi na kwezi mpawu okanye ezinye iimpawu ezingaqhelekanga, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) elikufutshane ngoko nangoko, okanye ukuba usesibhedlele, yazisa iqela lezonyango ngoko nangoko. Musa ukuchitha ixesha. Oku kubaluleke kakhulu, kuba uvavanyo lwangethuba kunye nonyango lunokusindisa ubomi.

Ngaba i-TRALI ingathintelwa?

"Ngaba oku akunakuthintelwa?" usenokuba uzibuza. Enyanisweni, okwangoku akukho ndlela yokuthintela ngokupheleleyo i-TRALI. Nangona kunjalo, abathengisi begazi kunye nezibhedlele benza konke okusemandleni abo ukuhlola igazi elinikelweyo, ingakumbi abo baneentlobo ezithile zee-antibodies, ukunciphisa umngcipheko weengxaki zotofelo-gazi. Umzekelo, banikela ingqalelo engakumbi ekusebenziseni i-plasma evela kubafazi abakhulelweyo ngaphambili, kuba banamathuba amaninzi okuba nezi antibodies egazini labo.

Enyanisweni, kuyoyikisa ukucinga ukuba into elungileyo ingasihambela kakubi, akunjalo? Nangona kunjalo, ukunikela ngegazi yindlela eqhelekileyo yezonyango esindisa ubomi babantu abaninzi kwihlabathi liphela. Iimpendulo zotofelo-gazi ezifana ne-TRALI azixhaphakanga. Nangona kunjalo, ukuba ziyenzeka, zinokuba yingozi ebomini. Ke ngoko, ukuba uziva into engaqhelekanga emva kokunikela ngegazi, bonana nogqirha ngaphandle kokuthandabuza. Eyona nto ibalulekileyo kukufumana unyango ngokukhawuleza.

Zeziphi izinto esifanele sizikhumbule kweli bali?

Kulungile, ngoko ke, ngokufutshane, amanqaku aphambili ekufuneka uwakhumbule nge-TRALI esithethe ngayo zezi:

• (TRALI) yimeko embi kakhulu eyenzeka ngequbuliso (ngesiqhelo kwiiyure ezi-6) emva kokufakwa igazi, nto leyo ebangela ubunzima bokuphefumla kunye noxinzelelo lwegazi oluphantsi ngenxa yokwakheka kolwelo emiphungeni.
• Iimpawu ezinje ngokuphefumla kancinci, ukukhohlela, ulusu oluluhlaza okwesibhakabhaka, umkhuhlane, kunye nesiyezi zinokubakho. Ziqaphele ezi zinto.
• Oku kwenzeka rhoqo xa ii-antibodies egazini lomnikeli zibangela ukuba inkqubo yomzimba yokuzikhusela yomntu ofumana le ntsholongwane isebenze ngempazamo ize yonakalise imiphunga.
• Abanye abantu (umz., abo basebenzisa ii-ventilators, abo banesifo sesibindi/izintso, kunye nabo basela kakhulu) basengozini enkulu yokuhlaselwa yile meko.
• Le yingxamiseko yezonyango. Kubalulekile ukufuna ingcebiso yezonyango ngokukhawuleza ukuba iimpawu ziyavela.
• Nangona kungekho nyango luthile lwe-TRALI, uninzi lwabantu luyaphola kwiintsuku ezimbalwa ngoncedo oluxhaswayo olunikezelwa esibhedlele.
• Nangona i-TRALI yimeko engaqhelekanga , kubalulekile ukuyiqonda nokuyiqonda iimpawu zayo.

Uyazi kakuhle umzimba wakho. Ukuba uziva into engaqhelekanga, eyahlukileyo, okanye engakhululekanga emva kokunikela ngegazi, musa ukuyithatha njengento 'encinci.' Musa ukuyithatha lula. Xelela ugqirha ngoko nangoko. Ingasindisa ubomi bakho! Hlala usempilweni!

Ukunikela ngegazi , imiphunga, ubunzima bokuphefumla, i-TRALI, utofelo-gazi, ii-antibodies, ukhathalelo olungxamisekileyo