Cabanga ngomuntu osesimweni esibucayi kakhulu, inhliziyo namaphaphu akhe akungasebenzi kahle. Sebefinyelele eqophelweni lapho imithi evamile noma ama-ventilator esiwaziyo sonke engenakumsindisa. Ngezinye izikhathi ezinjengalezi odokotela bacabanga ngalobu buchwepheshe obubizwa nge-ECMO njengesixazululo sokugcina. Nakuba abantu abaningi bengakakuzwa, lokhu kuyithuluzi elimangalisayo ngempela elingasindisa izimpilo. Namuhla, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.
Kuyini i-ECMO ngamagama alula?
Kalula nje, i-ECMO umshini osebenza njengenhliziyo namaphaphu okwenziwa ngaphandle komzimba. Uma inhliziyo namaphaphu akho ebuthaka kakhulu ukuba enze umsebenzi wawo kahle, lo mshini uthatha izintambo okwesikhashana.
Uma sichaza incazelo yegama elithi ECMO, kuba kanje:
- Ngaphandle komzimba - Lokhu kusho "ngaphandle komzimba".
- Ukuphefumula kwe-oxygen - Lokhu kusho "ukunikeza umoya-mpilo nge-membrane ekhethekile."
Uyaqonda manje? Okwenzekayo lapha ukuthi igazi elikhishwa emzimbeni lifakwa umoya-mpilo ngaphakathi komshini one-membrane ekhethekile bese liphonswa emzimbeni. Lo mshini wenza lokho kanye okwenziwa amaphaphu ethu. Ngezinye izikhathi wenza umsebenzi wokupompa owenziwa yinhliziyo.
Abantu abaningi bacabanga ukuthi lokhu kufana nomshini wokuphefumula. Kodwa lokho akulungile. Umshini wokuphefumula uphusha umoya ungene futhi uphume emaphashini kuphela. Kodwa umshini we-ECMO wengeza umoya-mpilo ngqo egazini futhi ususe i-carbon dioxide egazini. Kuyinqubo eyinkimbinkimbi kakhulu kunalokho.
Ngokunika inhliziyo namaphaphu "ikhefu" ngale ndlela, bayakwazi ukulungisa umonakalo abawenzile. Okwamanje, umshini we-ECMO uhlinzeka ngokuhlinzekwa okuqhubekayo komoya-mpilo emzimbeni.
Ingabe zikhona izinhlobo ze-ECMO?
Yebo, kunezinhlobo ezimbili eziyinhloko ze-ECMO. Odokotela banquma ukuthi yiluphi uhlobo okufanele balusebenzise ngokusekelwe esimweni sesiguli.
| Uhlobo lwe-ECMO | Ubani osizayo? | Kalula nje... |
|---|---|---|
| I-ECMO ye-Venoarterial (VA) | Kwenhliziyo namaphaphu | Lolu hlobo lomshini luthatha umsebenzi wenhliziyo namaphaphu akho. Lokhu kusho ukuthi lo mshini wenza kokubili ukupompa igazi kanye nokufaka umoya-mpilo egazini. |
| I-ECMO ene-Venovenous (VV) | Kuphela ngamaphaphu | Lokhu kusiza amaphaphu kuphela. Lolu hlobo lusetshenziswa uma inhliziyo yakho isebenza kahle, kodwa amaphaphu akho engasebenzi kahle. Lapha, inhliziyo yakho iyona epompa igazi. |
Kumaphi amacala lapho kusetshenziswa khona i-ECMO?
I-ECMO akuyona into oyisebenzisela umkhuhlane ovamile noma umkhuhlane. Iyindlela esindisa impilo esetshenziselwa iziguli ezigula kakhulu lapho kungekho okunye ukwelashwa okuphumelelayo.
- I-Acute Respiratory Distress Syndrome (ARDS): Lapho amaphaphu onakele kakhulu ngenxa yezimo ezifana ne-pneumonia enzima, ukusha, noma ukuminza, futhi umzimba ungakwazi ukuthola umoya-mpilo. I-ECMO isize abantu abaningi abanalesi simo ngesikhathi sobhubhane lwe-COVID-19.
- I-Pulmonary Embolism: Ihlule legazi elakheka emzimbeni (ngokuvamile emilenzeni) liyaqhekeka bese lihlala emthanjeni wegazi omkhulu emaphashini. Lesi yisimo esiyingozi kakhulu futhi esingaba yingozi.
- Ukulimala Kwenhliziyo: Lapho imisipha yenhliziyo yonakele ngenxa yokuhlaselwa yinhliziyo okukhulu, ingozi, noma ukuwa, futhi ingakwazi ukupompa igazi kahle.
- Kwabasanda kuzalwa: I-ECMO isetshenziselwa ukusindisa izimpilo zezingane ezincane kakhulu ezinezinkinga ezinkulu zenhliziyo noma zamaphaphu lapho zizalwa, ikakhulukazi lezo ezizalwa ngaphambi kwesikhathi.
- Ukufakelwa kwezitho zomzimba kanye nokuhlinzwa: I-ECMO isetshenziselwa ukusiza isiguli esilinde ukufakelwa inhliziyo noma amaphaphu, noma ukusiza umzimba ukuthi ululame ngemva kokuhlinzwa okukhulu.
Ukwelashwa kwe-ECMO kusebenza kanjani?
Le nqubo yenzeka egunjini lokunakekelwa okujulile (ICU) ngaphansi kokuqondisa kwethimba lodokotela nabahlengikazi abaqeqeshwe ngokukhethekile.
1. Ukukhipha indle: Okokuqala, isiguli siphuzwa ngokuphelele. Lokhu kusho ukuthi ngeke sizizwe ubuhlungu. Ngemuva kwalokho, udokotela ohlinzayo ufaka amapayipi amakhulu (amapayipi noma ama-cannula) emthanjeni wegazi omkhulu noma emthanjeni osentanyeni, esifubeni, noma esinqeni sesiguli.
2. Ukuxhuma emshinini: Ithubhu elilodwa lidonsa igazi lomzimba eliphelelwe umoya-mpilo lingene emshinini we-ECMO.
3. Ukwengeza umoya-mpilo:Njengoba leli gazi lidlula emaphashini okwenziwa (i-oxygenator) ngaphakathi komshini, i-carbon dioxide ekuwo iyasuswa bese kufakwa umoya-mpilo.
4. Ukumpompa emzimbeni: Igazi elihlanzekile, elinomoya-mpilo limpompa emzimbeni ngenye ipayipi.
Phakathi nale nqubo yonke, isiguli singase sibe siqaphile noma silale. Ithimba le-ECMO liqapha isiguli kanye nomshini eduze amahora angama-24.
Uzisusa kanjani ku-ECMO?
Uma inhliziyo namaphaphu akho sezizizwa zingcono futhi usukwazi ukusebenza wedwa futhi, odokotela bakho bazoqala kancane kancane ukukukhipha emshinini. Lokhu kubizwa ngokuthi "ukukhumula." Ukusekelwa okuvela emshinini kuyancishiswa kancane kancane, okuvumela umzimba wakho ukuthi usebenze wedwa. Uma konke kuhamba kahle, amapayipi azosuswa ezinsukwini ezimbalwa bese izitishi zizobuyiselwa endaweni yazo.
Yiziphi izinzuzo kanye nezingozi ezinkulu ze-ECMO?
Njenganoma yiluphi uhlobo lokwelashwa oluyinkimbinkimbi, i-ECMO inezinzuzo ezinkulu kanye nezingozi ezinkulu. Kuyisinqumo esithinta ukufa nokuphila.
| Izinzuzo | Izingozi |
|---|---|
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Ungawusiza kanjani umndeni wesiguli?
Kunzima kakhulu emndenini ukubona othandekayo wakho exhunywe emshinini onjengalona. Kodwa kunezinto ongazenza. Kodwa ngaphambi kokwenza noma yini, qiniseka ukuthi uthola imvume kudokotela noma kubasebenzi bobuhlengikazi.
- Khuluma nesiguli: Ngisho noma bengazi lutho, bangase bakwazi ukukuzwa. Izwi lakho lizobaduduza.
- Funda incwadi noma ulalele umculo: Umculo ozolisayo noma umsindo wakho ufunda incwadi kungabaduduza.
- Letha futhi ugcine izithombe zomndeni: Gcina izithombe zomndeni wakho lapho zingabonwa khona.
- Faka umswakama esikhumbeni: Ukuze uvimbele ukoma kwesikhumba, ungacela udokotela wakho ukuthi afake i-lotion efanele.
Into ebaluleke kakhulu ukuthi ucabange nangempilo yakho. Lesi yisikhathi esicindezela kakhulu engqondweni. Ngakho-ke yidla kahle futhi uphumule. Uma uhlala unamandla kuphela lapho uzokwazi ukusiza isiguli.
Ingabe i-ECMO iyindlela yokugcina ngempela?
Yebo, i-ECMO ivame ukuba yindlela yokugcina . Odokotela benza lesi sinqumo ngemuva kokuba zonke ezinye izindlela zokwelapha zingaphumelelanga.
Futhi, i-ECMO isetshenziswa kuphela ezigulini ezinezimo eziguqukayo . Isibonelo, i-pneumonia enzima ingelapheka. I-ECMO inikezwa ukusiza amaphaphu aze aphole. Kodwa-ke, i-ECMO ayisetshenziselwa isifo esingelapheki, njengomdlavuza obulalayo.
Lokhu akulona ikhambi. Kusetshenziselwa ukuthenga isikhathi sokuba isiguli silulame ngaphandle kokulimaza ezinye izitho zomzimba. Ngakho-ke, isiguli singafa ngenkathi sise-ECMO uma isimo saso esingaphansi singenakulawuleka.
Umlayezo Wokuya Nawe Ekhaya
- I-ECMO umshini osindisa impilo osebenza njengenhliziyo namaphaphu okwenziwa ngaphandle komzimba.
- Lokhu kusetshenziselwa iziguli ezibucayi kakhulu ezinomsebenzi wenhliziyo noma wamaphaphu okhubazekile kakhulu.
- I-ECMO ayilaphi lesi sifo. Imane nje inika umzimba isikhathi sokululama noma kuze kube yilapho kutholakala olunye ukwelashwa (isib. ukufakelwa isitho).
- Nakuba lokhu kwelashwa kunamandla amakhulu okusindisa izimpilo, futhi kunezingozi ezinkulu ezifana nokopha, ukutheleleka, kanye nokukhubazeka.
- Isinqumo sokuhlinzeka ngokwelashwa kwe-ECMO senziwa ngemuva kokuhlolwa okujulile kwesimo sesiguli yithimba lodokotela abangochwepheshe.
- Uma udokotela ekhuluma ngalolu hlobo lokwelashwa kothandekayo, ungesabi, futhi lalela ngokucacile yonke imibuzo yakho.
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