Cishe uke wezwa othile egunjini lokunakekelwa okujulile (ICU) ethi "baxhunywe emshinini." Ngokuvamile, lokhu kubhekisela kuma-ventilator, kodwa kukhona umshini okhethekile osetshenziswa ezimweni eziyinkimbinkimbi kakhulu, ezibucayi kakhulu. Yilokho okubizwa ngokuthi i-ECMO. Kulungile, ake sixoxe ngalokhu namuhla, ukuthi kuyini ngempela, kusebenza kanjani, nokuthi ubani ofanelekela lokho.
Iyini i-ECMO? Isebenza kanjani?
Kalula nje, i-ECMO (i-Extracorporeal Membrane Oxygenation) iyisistimu yokusekela impilo yokwenziwa engaphandle komzimba esiza inhliziyo namaphaphu omuntu ukuthi aphumule futhi alulame lapho kokubili kungasebenzi kahle.
Cabanga ngakho, amaphaphu ethu afaka umoya-mpilo egazini futhi asuse i-carbon dioxide engafuneki. Inhliziyo yethu ipompa leli gazi elinomoya-mpilo emzimbeni wonke. Manje, uma kokubili lokhu kungasebenzi kahle, izimpilo zethu zisengozini enkulu.
Nakhu okwenziwa umshini we-ECMO:
1. Ipayipi (i-cannula) lifakwa emthanjeni omkhulu wegazi entanyeni yakho, esifubeni, noma embotsheni, bese igazi likhishwa kancane kancane emzimbeni wakho ngalo.
2. Leli gazi lithunyelwa ngepompo liye emshinini okhethekile. Lo mshini ufana nephaphu lokwenziwa. Wengeza umoya-mpilo egazini futhi ususa i-carbon dioxide.
3. Bese igazi elihlanzekile, elinomoya-mpilo liphinde lifakwe emzimbeni wakho ngomunye umbhobho.
Ngale ndlela, umshini we-ECMO uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu. Lokhu kusho ukuthi inhliziyo namaphaphu agulayo nakhathele anikezwa isikhathi sokuphumula nokuphulukiswa ngaphandle komthwalo. Lokhu kufana nokufaka iplasta emlenzeni ophukile bese uwuphumuza.
I-ECMO iyinkimbinkimbi kakhulu kune-ventilator evamile. I-ventilator imane ipompe umoya emaphashini, kodwa i-ECMO ingangeza umoya-mpilo ngqo egazini.
Kunini lapho kudingeka khona ukwelashwa kwe-ECMO?
I-ECMO iyindlela yokugcina, esetshenziswa kuphela ezigulini eziyingozi kakhulu, ezisongela ukuphila. Odokotela bavame ukucabangela i-ECMO kulezi zimo.
| Isimo sezokwelapha | Incazelo |
|---|---|
| I-Acute respiratory distress syndrome (ARDS) |
|
| Ukulimala kwenhliziyo | |
| Izinsana ezisanda kuzalwa | |
| Ukuhlinzwa kanye nokufakelwa isitho somzimba |
Yiziphi izinzuzo nezingozi zokwelashwa nge-ECMO?
Nakuba i-ECMO iyithuluzi elimangalisayo elisindisa impilo, inezingozi nezinkinga ezithile. Kubalulekile ukuqaphela kokubili.
Izinzuzo eziyinhloko ze-ECMO
- Ukuphumula kwezitho zomzimba: Kunikeza inhliziyo namaphaphu agulayo isikhathi sokuphumula nesikhathi abasidingayo ukuze balulame.
- Ukusekela impilo: Kusiza ukugcina isiguli siphila kuze kube yilapho into efana nokufakelwa isitho ingenziwa.
- Ukusekelwa Kwezingane Ezisanda Kuzalwa: Izingane ezizalwa zinezinkinga zenhliziyo noma zamaphaphu zinikezwa ithuba lokululama.
Izingozi nezinkinga ze-ECMO
Iziguli ezithola ukwelashwa kwe-ECMO ziqashwe njalo odokotela abangochwepheshe kanye nabasebenzi abahlengikazi egunjini lokunakekelwa okujulile ngenxa yezingozi ezingaba khona ezihilelekile.
- Ukopha: Ukopha kungenzeka ngoba amapayipi afakwa emithanjeni yegazi emikhulu. Futhi, ingozi yokopha iyanda ngenxa yemithi enikezwa ukuvimbela ukuqhekeka kwegazi.
- Ukujiya kwegazi (Ukujiya kwegazi):Amahlule egazi angakheka ngaphakathi kwepayipi lomshini we-ECMO. Uma leli hlule lihamba liye ebuchosheni, lingabangela isimo esibi njengesifo sohlangothi.
- Ukutheleleka: Njengoba ipayipi lifakwa ngokubhoboza esikhumbeni, amagciwane angangena emzimbeni futhi abangele ukutheleleka okukhulu.
- Ukungasebenzi kahle komshini: Umshini we-ECMO uyithuluzi eliyinkimbinkimbi. Uma kukhona ukungasebenzi kahle kobuchwepheshe, kungaba yingozi empilweni yesiguli.
- Isifo sohlangothi: Kukhona ingozi yesifo sohlangothi ngenxa yokushintsha kokugeleza kwegazi ebuchosheni noma ukuqhekeka kwegazi.
Usunesikhathi esingakanani uxhumene ne-ECMO?
Ubude besikhathi umuntu exhunywe emshinini we-ECMO buyahlukahluka kuye ngesiguli. Kuya ngesimo sezokwelapha esiholele esidingweni se-ECMO. Abanye abantu kungadingeka babe se-ECMO izinsuku ezimbalwa, kanti abanye kungadingeka babe se-ECMO amasonto.
Odokotela bahlola njalo ukusebenza kwenhliziyo nephaphu lesiguli. Lapho izitho zomzimba zibonisa izimpawu zokuphulukiswa, kancane kancane ziqala ukukhipha isiguli emshinini we-ECMO. Le nqubo ivame ukuthatha izinsuku ezimbili kuya kwezinhlanu.
Into ebalulekile ukuthi i-ECMO ayilona ikhambi lomuntu ongenalo ithemba lokululama. Ingelamuntu onekhono lokululama, kodwa odinga isikhathi nokusekelwa.
Ingabe zikhona izimo lapho i-ECMO ingasetshenziswa khona?
Yebo. Ukwelashwa nge-ECMO akufaneleki kuwo wonke umuntu. Kwezinye izimo, izingozi zingase zibe zinkulu kunezinzuzo ze-ECMO. I-ECMO ayivame ukusetshenziswa ezimweni ezinjalo.
- Kulabo abanezifo zenhliziyo noma zamaphaphu ezingelapheki noma ezingasetshenziswa ukufakelwa.
- Uma kukhona umonakalo ongenakulungiseka ebuchosheni noma kwezinye izitho ezibalulekile, njengesibindi.
- Uma unomdlavuza osakazeke emzimbeni wonke.
- Uma kukhona ukopha okungalawuleki emzimbeni, ikakhulukazi ukopha ngaphakathi ekhanda.
Lolu hlobo lwesinqumo lwenziwa yithimba lodokotela abangochwepheshe ngemuva kokutadisha ngokucophelela isimo sesiguli. Uma othandekayo enalesi simo, kungcono ukucela udokotela noma udokotela olaphayo ulwazi oluningiliziwe.
Umlayezo Wokuya Nawe Ekhaya
- I-ECMO uhlelo olusindisa impilo olusebenza njengenhliziyo namaphaphu okwenziwa ngaphandle komzimba.
- Lokhu kusetshenziswa kuphela ezigulini ezibucayi kakhulu ezinhliziyo namaphaphu angasebenzi kahle okwesikhashana.
- Umshini we-ECMO unikeza izitho ezigulayo ukuphumula, uzinika isikhathi nethuba lokuphulukiswa.
- Nakuba lokhu kuyindlela yokwelapha ewusizo kakhulu, futhi kunezingozi ezinkulu njengokuphuma kwegazi, ukuqhekeka kwegazi, kanye nokutheleleka.
- Noma yiziphi izinqumo mayelana nokwelashwa kwe-ECMO zenziwa odokotela abangochwepheshe. Uma unenkinga, khuluma nodokotela wakho ngokukhululekile.
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