Ingabe amaphaphu akho anenkinga yokuphefumula? Ake sifunde ngale ARDS (Acute Respiratory Distress Syndrome) eyingozi!

Wake wakuthola kunzima kakhulu ukuphefumula ngokuzumayo, uzizwa sengathi isifuba sakho sinciphile? Noma uyakhumbula isikhathi lapho othile omaziyo egula kakhulu ngokuzumayo, engakwazi ukuphefumula kahle futhi wangeniswa egunjini lokunakekelwa okujulile (ICU) lesibhedlela? Mhlawumbe imbangela kwakuyisimo esibizwa ngokuthi i-ARDS (Acute Respiratory Distress Syndrome) . Lokhu kungathi sína kancane, kodwa uma unolwazi olufanele, kulula ukuqonda izinto eziningi. Ake sixoxe ngalokhu ngokuningiliziwe, akunjalo?

Kuyini i-ARDS? Masiyiqonde kalula.

Kalula nje, i-ARDS yisimo esibi esithinta amaphaphu ethu. Cabanga ngale ndlela: Amaphaphu ethu anezikhwama zomoya ezincane (ezibizwa ngokuthi i-alveoli). Zifana namagilebhisi amancane emvinini. Uma siphefumula, lezi zikhwama zomoya zithatha umoya-mpilo ovela emoyeni bese ziwudedela ungene egazini. Kodwa uma kwenzeka i-ARDS, lezi zikhwama zomoya zigcwala uketshezi. Kufana nebhaluni elinamanzi. Khona-ke amaphaphu awakwazi ukugcwala umoya kahle, futhi inani lomoya-mpilo oya egazini lehla kakhulu. Lokhu sikubiza ngokuthi i-hypoxia. Odokotela bavame ukuhlukanisa i-ARDS njengethambile , ephakathi nendawo, noma enzima . Kunqunywa ngokuqhathanisa izinga lomoya-mpilo egazini nenani lomoya-mpilo okudingeka ulethwe kulelo zinga. I-ARDS ingabangela nezinye izitho ezibalulekile njengobuchopho bethu, inhliziyo, izinso, namathumbu ukuthi zingawutholi umoya-mpilo eziwudingayo. Ngakho-ke, i-ARDS iyisimo esiyingozi esingaba yingozi ngisho nokuphila. I-ARDS ivame ukwenzeka lapho othile elashwa esibhedlela ngenxa yokutheleleka okunye, ukugula, noma ingozi. Kodwa-ke, uma uba nalezi zimpawu ekhaya, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.

Ingabe kunezigaba ezintathu ze-ARDS?

Odokotela ngezinye izikhathi bahlukanisa i-ARDS ngezigaba ezintathu: i-Exudative, i-Proliferative, kanye ne-Fibrotic. Lokhu kubhekisela kakhulu ezingeni lokuvuvukala kanye nokuqongelela koketshezi emaphashini, bese kuba yindlela amaphaphu aqala ngayo ukuphola. Akuwona wonke umuntu oqhubekela esigabeni sesi-3. Lesi sigaba sihilela ukushaqeka kwamaphaphu (`(Lung fibrosis)`) kanye nesidingo sokuphefumula okuqhubekayo.

Ivame kangakanani i-ARDS?

Lesi yisimo esibucayi. Sithinta abantu ababalelwa ku-200,000 ngonyaka e-United States kuphela. Emhlabeni jikelele, sithinta abantu ababalelwa ku-3 million ngonyaka. I-ARDS inesibopho cishe ku-10% wabo bonke abantu abangeniswa egunjini lokunakekelwa okujulile (i-ICU). Futhi inesibopho cishe ku-25% wabo bonke abantu abangeniswa esibhedlela ukuze bathole umoya ophefumulayo ngomshini.

Ziyini izimpawu ze-ARDS? Uzibona kanjani?

Izimpawu ze-ARDS zingahluka kuye ngokuthi imbangela, ubukhulu besimo, kanye nanoma yiziphi izimo zamaphaphu noma zenhliziyo ezikhona kakade onazo. Izimpawu eziyinhloko yilezi:

• Ubunzima obukhulu bokuphefumula :Kuzwakala sengathi awukwazi ukuphefumula, sengathi uyacinana.
• Ukuphefumula okusheshayo nokukhandlekayo: Ukuphefumula ngomzamo omkhulu, njengokungathi uphefumula kanzima.
• Isilinganiso senhliziyo siyanda.
• Ukushintsha kombala wezinzipho nezindebe okuluhlaza okwesibhakabhaka: Lokhu kubangelwa amazinga aphansi omoya-mpilo egazini.

Cabanga nje, uMnu. Nalin wayenomkhuhlane omkhulu kanye nokukhwehlela izinsuku ezimbili. Ngokungazelelwe, waba nobunzima bokuphefumula, isifuba sakhe saba lukhuni. Umkakhe waphawula ukuthi izinzipho zakhe zazishintsha zibe luhlaza okwesibhakabhaka. Lapho bephuthuma esibhedlela, odokotela bathi kungaba yi-ARDS .

I-ARDS ingakhula zingakapheli amahora kuya ezinsukwini zesigameko esibangela lesi simo, futhi ingaba yimbi kakhulu ngokushesha okukhulu.

Yiziphi izimbangela ze-ARDS?

Kunezimbangela eziningi ezingaba khona ze-ARDS. Ake sibheke eziyinhloko:

• I-Sepsis : Imbangela eyinhloko ye-ARDS yisimo esibizwa ngokuthi i-sepsis. Lesi simo singavela lapho ukutheleleka okukhulu emaphashini akho (njenge- pneumonia ) noma ukutheleleka kwesinye isitho kusakazeka emzimbeni wakho wonke, okubangela ukuvuvukala okukhulu.
• I-pneumonia yokuphefumula : Uma okuqukethwe yisisu (ukudla, uketshezi) kungena emaphashini, kungabangela umonakalo omkhulu emaphashini kanye ne-ARDS. Lokhu kwenzeka lapho okuthile esikudlayo noma esikuphuzayo kungena emigudwini yomoya. Lokhu kungenzeka kakhulu kumuntu ongazi lutho noma osekhulile.
• Ukumpontshelwa igazi: Kukhona ingozi ye-ARDS uma unikezwa amayunithi egazi angaphezu kuka-15 ngesikhathi esifushane.
• I-Covid-19 `( COVID-19 )`: Igciwane le-Covid-19 lingabangela i-ARDS embi kakhulu.
• I-Pancreatitis : Ukuvuvukala okukhulu kwe-pancreas.
• Izingozi ezinkulu noma ukusha: Izingozi nokuwa kungalimaza amaphaphu ngqo, noma kungalimaza ezinye izitho zomzimba futhi kubangele ukuvuvukala okukhulu emaphashini.
• Ukulimala kokuphefumula: Ukuphefumula umusi noma intuthu yamakhemikhali egxile kakhulu.
• Ukweqisa izidakamizwa: Ukuthatha izidakamizwa eziningi kakhulu, njenge-cocaine noma ama-opioid.
• Ukuminza noma ukusondela ekuminzeni: Uma uminza, amanzi angena emaphashini akho bese ewalimaza.

Ubani osengozini enkulu yokuthola i-ARDS?

I-ARDS ivame ukwenzeka kubantu asebevele bebhedlela ngenxa yengozi noma ukugula. Kodwa-ke, akusho ukuthi uzoyithola ngoba nje usesibhedlela. Kunezici eziningana ezandisa ingozi yakho:

• Ukuba neminyaka engaphezu kwengu-65 ubudala.
• Ukusetshenziswa kukagwayi (ukubhema ugwayi).
• Ukusetshenziswa kwezidakamizwa.
• Ukuba nesifo samaphaphu esivele sikhona.

Yiziphi izinkinga ezingaba khona ngenxa ye-ARDS?

I-ARDS ingabangela izinkinga ezahlukahlukene, kokubili ngesikhathi usesibhedlela nangemva kokuya ekhaya. Ezinye zazo yilezi:

• Amahlule egazi noma i-deep vein thrombosis (DVT).
• I-Pneumothorax: Lokhu kungenzeka ngenxa yokucindezela okwenziwa yi-ventilator ephashini elonakele, eliqinile.
• Ukuhlanya: Ukuphazamiseka kwengqondo.
• Ukwehluleka kwezitho eziningi .
• Ubuthakathaka bemisipha.
• Ukuvuvukala kwamaphaphu noma i-fibrosis.
• Isifo Sokucindezeleka Ngemva Kokuhlukumezeka (PTSD)
• Izinkinga zempilo yengqondo njengokukhathazeka nokucindezeleka .

Uyixilonga kanjani i-ARDS? (Ukuxilongwa)

Odokotela baxilonga i-ARDS ngokusekelwe ekuhlolweni ngokomzimba kanye nemiphumela yokuhlolwa okuningana. Ngenxa yokuthi izimpawu ze-ARDS zifana nezezimo zamaphaphu noma zenhliziyo ezingamahlalakhona, udokotela kumele futhi akhiphe ezinye izimbangela. Udokotela angase a-ode inhlanganisela yokuhlolwa, okufana nalokhu:

• I-X-ray yesifuba: Ukubona ukuthi kungakanani uketshezi olusemaphashini.
• Ukuhlolwa kwegazi: Kukala izinga lomoya-mpilo egazini bese kunquma ubukhali be-ARDS.
• I-Echocardiogram (ukuhlolwa kwenhliziyo nge-ultrasound): Bona ukuthi inhliziyo isebenza kanjani.
• I-Electrocardiogram (EKG): Ilinganisa umsebenzi kagesi wenhliziyo.
• Inzwa yomunwe `(I-Pulse oximetry)`: Qapha amazinga e-oxygen njalo.
• I-CT scan (i-Computed Tomography - i-CT scan): Thola ulwazi oluningiliziwe mayelana namaphaphu.
• Ukuthatha isampula yoketshezi oluphuma endleleni yokuphefumula: Thola imbangela yokutheleleka.

Yiziphi izindlela zokwelapha i-ARDS?

Umgomo oyinhloko wokwelapha i-ARDS ukwandisa amazinga omoya-mpilo egazini nokuvimbela ukwehluleka kwezitho zomzimba. Abantu abane-ARDS bangadinga umshini wokuphefumula kanye/noma ukwelashwa komoya-mpilo ukuze bandise amazinga omoya-mpilo egazini. Bangadinga nosizo ekuvuleni imigudu yokuphefumula evinjiwe umonakalo. Udokotela wakho angase athathe izinyathelo zokunciphisa izinkinga ze-ARDS, njenge:

• Ukunikeza amaphilisi okulala (i-sedation) ukusiza ukulawula ubuhlungu nokuhlala uzolile.
• Esikhundleni sokukuphendulela phansi, zibeke esimweni sokuthambekela. Lokhu kuthuthukisa ukugeleza komoya-mpilo.
• Yenza izivivinyo zokuphefumula bese unquma isikhathi esifanele sokukhipha ipayipi kanye nomshini wokuphefumula.
• Ukunikeza imithi yokunciphisa igazi ukuze kuvinjelwe ukuqhekeka kwegazi.
• Ukunikeza ama-diuretics ukuze kususwe uketshezi oluningi emzimbeni.
• Ukunikeza imithi yokunciphisa ukunqwabelana koketshezi emaphashini.
• Ama-antibiotic anikezwa ukuvimbela ukutheleleka noma ukwelapha ukutheleleka okukhona.
• Nikeza ukunyakaza okusebenzayo kanye nokwelashwa ngokomzimba ukuvimbela ubuthakathaka bemisipha.
• Ukudluliselwa ezinhlelweni zokuvuselela amaphaphu ukuze kuqiniswe amaphaphu futhi kwandiswe amandla amaphaphu.

Kuthatha isikhathi esingakanani ukululama ku-ARDS? Lingakanani izinga lokululama?

Kuncike ebunzimeni besimo nokuthi kuthatha isikhathi esingakanani ukuthi amaphaphu omuntu alulame. Ucwaningo oluningi lubonisa ukuthi ngokuvamile kuthatha izinyanga eziyisithupha kuya onyakeni ukuthi ukusebenza kwamaphaphu okuvamile kubuye ngemva kwe-ARDS. Kodwa-ke, abanye abantu abakaze balulame ngokugcwele. Izinga lokusinda kwe-ARDS lingaba ngu-55% kuya ku-70% , uma lelashwa ngokushesha. Izinga lokusinda liyehla uma ukwelashwa kubambezeleka noma uma ezinye izitho zomzimba ziqala ukwehluleka. Ukubikezela kwakho kunqunywa yizici ezifana nezimo zakho zezokwelapha eziyisisekelo, umlando wezokwelapha, kanye nobunzima bokucindezeleka kwakho kokuphefumula. Udokotela wakho uzoxoxa nawe ngalokhu.

Ingabe ama-ARDS angavinjelwa?

Ayikho indlela ethile yokuvimbela i-ARDS. Kodwa-ke, uma unezimpawu zokuphelelwa umoya, noma uma unomonakalo wamaphaphu noma esinye isimo, ukufuna usizo lwezokwelapha ngokushesha kungasiza ekuvimbeleni isimo ukuba singabi sibi kakhulu. Ukugwema ukubhema nokunciphisa ukusetshenziswa kotshwala kunganciphisa ingozi yokuthola i-ARDS embi kakhulu.

Impilo injani ngemva kwe-ARDS? Yini okufanele siyiqaphele?

I-ARDS ingaba yingozi empilweni futhi yesabise. Kodwa ngokwelashwa okuthuthukisiwe kanye nokusekelwa kokuphefumula (ikakhulukazi ukujikijela iziguli esiswini ukuze kuthuthukiswe ukulethwa komoya-mpilo), abantu abaningi manje bayasinda, futhi izinkinga ze-ARDS ziyancipha. Abantu abangaphansi kweminyaka engu-65 kanye nalabo abathola i-ARDS ngemuva kwengozi noma ukumpontshelwa igazi ngokuvamile banesimo esingcono sokubikezela. Ukululama ku-ARDS kungathatha isikhathi eside. Abantu abaningi abakhishwa kumshini wokuphefumula bayakwazi ukuphefumula ngokukhululeka. Abanye bayalulama ngokuphelele, kodwa abanye bangase babe nezinkinga zamaphaphu ezingamahlalakhona. Badinga ukunakekelwa kochwepheshe bamaphaphu (i-pulmonologist).

"Umama waba ne-ARDS futhi wayesesibhedlela izinyanga eziningi. Ngisho nangemva kokubuya ekhaya, wayekhathele kakhulu. Wayengakwazi ngisho nokwenza imisebenzi emincane kakhulu. Kodwa ngemva kokulandela imiyalelo yodokotela nokwenza ukwelashwa ngokomzimba, kancane kancane uba ngcono. Ngalesi sikhathi, ukwesekwa nothando lomndeni wakhe kubaluleke kakhulu."

Impilo ngemva kwe-ARDS ingaba yinselele. Yiba nesineke futhi ufune ukwesekwa emndenini nakubangane njengoba ululama. Ungase udinge usizo ngemisebenzi yansuku zonke kuze kube yilapho amaphaphu akho elulama. Khuluma nodokotela wakho ngamaqembu okusekela noma ezinye izinsiza ezingakusiza ukuthi uthole amandla akho kabusha.

Uyini uxhumano phakathi kwe-COVID-19 ne-ARDS?

Lokhu akufani. Umuntu one-COVID-19 angaba ne-ARDS lapho igciwane lifika emaphashini. Abacwaningi bathi izinga lokusinda komuntu one-COVID-19 kanye ne-ARDS licishe libe ngu-50% kuya ku-60%. Kodwa lokhu kuncike ezintweni eziningi, njengomlando wezempilo kanye nezinye izimo zezokwelapha. Ukuchitha isikhathi egunjini lokunakekelwa okujulile (ICU) kungaba yinto ebuhlungu futhi enzima. Abantu abalulama ku-ARDS bangase bangakwazi ukubuyela empilweni yabo evamile ngokushesha, ngakho-ke udinga ukwesekwa nakanjani. Kubalulekile ukuthola usizo lochwepheshe kanye neseluleko ngesikhathi sokululama kwakho ku-ARDS. Buza ithimba lakho lezokwelapha mayelana nezinhlelo zokululama ngemva kokunakekelwa okujulile kanye namaqembu okusekela aku-inthanethi endaweni yakini.

Okubaluleke Kakhulu: Izinto Okufanele Uzikhumbule (Umyalezo Ofanele Uwuthathe Uhambe Nawe Ekhaya)

Kulungile, ngakho-ke nazi izinto ezimbalwa okudingeka uzikhumbule kulokho esikhulume ngakho:

• I-ARDS yisimo esibi esibangela umonakalo emaphashini. Amasaka omoya emaphashini agcwele uketshezi, okunciphisa inani lomoya-mpilo ongafinyelela egazini.
• Uma uhlangabezana nezimpawu ezifana nobunzima obukhulu bokuphefumula, ukuphefumula okusheshayo, noma izinzipho/izindebe eziluhlaza okwesibhakabhaka, funa iseluleko sezokwelapha ngokushesha.
• I-ARDS ingaba nezimbangela eziningi. I-Sepsis, i-pneumonia, i-COVID-19, kanye nezingozi ezinkulu zimbalwa nje.
• Ukwelashwa kuhlanganisa kakhulu umoya-mpilo, ukwesekwa komoya-mpilo, kanye nokuphathwa kwezinkinga .
• Kuthatha isikhathi ukululama, futhi abanye abantu bangase babe nezinkinga zamaphaphu zesikhathi eside.
• Ukwelashwa okusheshayo kanye nokunakekelwa okuhle kwezokwelapha kubaluleke kakhulu ekusindiseni izimpilo kanye nokunciphisa izinkinga.
• Ukusekelwa okuvela emndenini nasemphakathini kubalulekile kumuntu oselulama kwi-ARDS.

Khumbula, kubalulekile ukuqaphela lesi simo. Uma wena noma othile omaziyo ehlangabezana nanoma yiziphi zalezi zimpawu, ungesabi noma ukhathazeke, kodwa bona udokotela ngokushesha. Ngaleyo ndlela, ungaqala ukwelashwa okudingekayo ngokushesha okukhulu.