Cishe uke waya kobona umuntu egunjini labagula kakhulu (ICU). Noma okungenani uke wabuka i-movie lapho isiguli sixhunywe khona emshinini onepayipi emlonyeni waso. Kungenzeka ukuthi uzizwe wesaba noma unelukuluku kancane lapho ubona lokho. Omunye wemishini ebaluleke kakhulu yi-ventilator. Nakuba abantu abaningi beyesaba, empeleni iyithuluzi elisindisa impilo. Ngakho-ke namuhla, ake sixoxe ngokuthi i-ventilator, noma ngokwezokwelapha, "Mechanical Ventilation" iyini, kungani idingeka, nakho konke okuhlobene nayo ngendlela elula kakhulu.
Kalula nje, iyini i-ventilator?
I-ventilator umshini okusiza ukuphefumula, noma othatha umsebenzi ngokuphelele, uma ungakwazi ukuphefumula wedwa. Njengoba nje izinduku zokubambelela zisekela isisindo sakho uma uphuke umlenze, i-ventilator isekela amaphaphu akho.
Lo mshini wenza izinto ezintathu eziyinhloko:
- Inikeza amaphaphu akho umoya-mpilo awudingayo.
- Kusiza amaphaphu akho ukususa i-carbon dioxide engafuneki eqongelela emzimbeni wakho.
- Amasaka amancane omoya (i-alveoli) angaphakathi kwamaphaphu akho anikeza ingcindezi edingekayo ukuze agcinwe evulekile ngaphandle kokuwa.
Odokotela bangalungisa izilungiselelo zalo mshini ukuze zivumelane nesimo sakho futhi bakunikeze ukwesekwa okudingayo.
Into ebaluleke kakhulu ukuthi umshini wokuphefumula awulona ikhambi lesifo. Umane ugcine ukuphefumula kwakho kuzinzile kuze kube yilapho umzimba wakho ulwa nesifo futhi ululama. Okwamanje, odokotela bakho bangakunikeza ezinye izindlela zokwelapha isimo sakho.
Ingabe "i-Intubation" kanye "ne-Ventilation" ziyizinto ezihlukene?
Yebo, nakuba lokhu kokubili kuvame ukwenzeka ndawonye, lokhu kubhekisela ezinqubweni ezimbili.
- Ukufakwa kwepayipi: Lokhu kwenzeka lapho udokotela efaka ipayipi ngomlomo noma ekhaleni lakho, phansi komphimbo wakho (i-trachea) bese emaphashini akho. Lokhu kubizwa nangokuthi ``ipayipi le-endotracheal`` noma ipayipi le-ET.
- Umoya Ongenisiwe: Lokhu kubhekisela enqubweni yokuxhuma ipayipi ebelifakwe ngaphambili emshinini womoya, okusiza ukuthi uphefumule.
Ngezinye izikhathi, esikhundleni sokufaka ipayipi elinjengaleli, ungaxhuma kumshini wokuphefumula nge-face mask elingana kahle ebusweni bakho. Sizoxoxa ngalokho kafushane.
Yiziphi izinhlobo eziyinhloko zokwelapha ngokuphefumula?
Ama-ventilator asetshenziswa namuhla asebenzisa ukucindezela okuhle ukuphoqa umoya ungene emaphashini. Lokhu kungenziwa ngezindlela ezimbili eziyinhloko.
| Uhlobo lokwelashwa | Kalula nje... |
|---|---|
| Umoya Wokungenisa Umoya Ohlaselayo | Lokhu kuhilela ukufaka ipayipi endaweni yakho yomoya bese ulixhuma kumshini wokuphefumula. Leli payipi lingafakwa ngomlomo wakho (intubation) noma ngokusikwa okuncane entanyeni yakho (tracheostomy) . |
| Umoya Ongangenisi Umoya | Lokhu kusebenzisa imaski efanela kahle ebusweni. Le maski iboshwe ekhanda ngezintambo. Umoya ovela kumshini wokuphefumula ungena emaphashini ngale maski. Amadivayisi anjenge- (CPAP) noma i-(BiPAP®) asetshenziswa ekhaya nawo angowalolu hlobo. |
Kunini lapho kudingeka khona umshini wokuphefumula?
Ungadinga usizo lomshini wokuphefumula kunoma yisiphi isimo esibucayi lapho ungakwazi ukuphefumula kahle wedwa. Isibonelo:
- Ngesikhathi sokuhlinzwa okukhulu: Uma ungaphansi kwe-anesthesia ejwayelekile, ikhono lakho lokuphefumula liyancishiswa. Ngakho-ke, uzonikezwa usizo lomshini wokuphefumula ngesikhathi sokuhlinzwa.
- Ukutheleleka noma izimo ezimbi kakhulu zamaphaphu: I-Pneumonia, i-COVID-19, i-Acute Respiratory Distress Syndrome (ARDS), kanye ne-Chronic Obstructive Pulmonary Disease (COPD) lapho izimo ziba zimbi kakhulu.
- Izimo eziphuthumayo noma zezokwelapha: Noma yisiphi isimo esiphuthumayo esivimba indlela yokuphefumula futhi senze ukuphefumula kube nzima. Isibonelo, ukusabela okukhulu kokungezwani komzimba (i-anaphylaxis).
- Ukulimala kobuchopho noma isifo: Ezimweni ezifana nesifo sohlangothi kanye nokulimala kobuchopho okubuhlungu, ubuchopho abukwazi ukuthumela izimpawu ezifanele emaphashini ukuze aphefumule.
- Izinguquko ekulinganisweni kwegesi egazini: Uma inani le-carbon dioxide egazini landa (i-hypercapnia) noma inani le-oxygen lehla (i-hypoxemia), kudingeka umshini wokuphefumula ukulawula lesi simo.
- Vikela indlela yakho yokuphefumula:Uma umuntu okwi-coma ehlanza amathe noma ukudla emlonyeni wakhe, kungangena emaphashini akhe. Ukuze kuvinjelwe lokhu, kufakwa ipayipi lokuphefumula ukuze kuvikelwe indlela yokuphefumula.
Kuzodingeka ube semshinini wokuphefumula isikhathi esingakanani?
Lokhu kuncike ngokuphelele esimweni esikubangele ukuthi udinge umshini wokuphefumula. Kungaba amahora ambalwa, izinsuku ezimbalwa, amasonto ambalwa. Ezimweni ezingavamile kakhulu, kungase kudingeke uhlale izinyanga noma ngisho neminyaka. Umgomo wethimba lezokwelapha ukukukhipha kumshini wokuphefumula ngokushesha nangokuphepha ngangokunokwenzeka . Kuze kube yileso sikhathi, bazoqapha isimo sakho njalo.
Ngokuvamile, uma kubonakala sengathi kuzodingeka ukuthi ube kumshini wokuphefumula isikhathi esingaphezu kwamasonto amabili, odokotela bazokhipha ipayipi emlonyeni wakho bese befaka ipayipi ngembobo encane entanyeni yakho (tracheostomy). Lena indlela ekhululekile futhi ehlala isikhathi eside yesiguli.
Kwenzekani uma uyixhuma kumshini wokuphefumula?
Le nqubo yenzeka egunjini lokunakekela abagula kakhulu (ICU).
1. Okokuqala, uzonikezwa umuthi wokudambisa ukuze uphumule futhi uzizwe ulele. Ngesikhathi esifanayo, uzonikezwa umuntu okhubazekile ukuze umzimba wakho ungashukumi ngenkathi ipayipi lifakwa.
2. Udokotela ufaka ipayipi (i-ET tube) ngomlomo wakho epayipini lakho lomoya.
3. Ekugcineni, ithubhu lixhunywe emshinini wokuphefumula. Bese umshini uqala ukuphefumula ngenxa yakho.
Esimweni esiphuthumayo, lokhu kungadingeka kwenziwe ngendlela ehlukile kancane, ngokushesha okukhulu.
Kwenzekani futhi uma usebenzisa umshini wokuphefumula?
Ngesikhathi usebenzisa umshini wokuphefumula, uzonakekelwa yithimba lodokotela abaqeqeshwe ngokukhethekile. Kunezinto ezimbalwa ezengeziwe ezenzekayo phakathi nalesi sikhathi.
Ukuqapha okuseduze
Uzoxhunywa kwezinye izikrini ukuze uqaphe umsebenzi womzimba wakho.
- Ukushaya kwegazi
- Isilinganiso senhliziyo
- Izinga lokuphefumula
- Amazinga e-oksijini egazini
Lezi zinto ziqashwa njalo. Ama-X-ray esifubeni nawo enziwa ukuhlola isimo samaphaphu kanye nokuhlolwa kwegazi okwenziwa ukuhlola amazinga omoya-mpilo egazini.
Ukumunca
Ipayipi lokuphefumula lingabangela ukwakheka kwamafinyila endleleni yakho yokuphefumula. Ngakho-ke, abahlengikazi bavame ukufaka elinye ipayipi elincane (i-catheter) epayipini ukuze basuse amafinyila aqoqana. Ungase ukhwehlele kancane futhi uzizwe ungakhululekile phakathi nalesi sikhathi. Lokhu kungaba yinto engakhululekile kancane kwababukele, kodwa kubalulekile ukugcina indlela yakho yokuphefumula ihlanzekile.
Ukudla okunempilo
Awukwazi ukudla noma ukuphuza ngoba unepayipi emlonyeni wakho. Ngakho-ke, uzonikezwa ukudla okunomsoco okuwuketshezi ngepayipi elincane elisuka ekhaleni lakho liye esiswini sakho. Okunye uketshezi kuzonikezwa ngesisombululo sikasawoti emithanjeni.
Ukushukunyiswa
Njengoba kungalungile ukuhlala embhedeni ngaso sonke isikhathi, ithimba lezokwelapha lizokugcina uhamba. Ngezinye izikhathi, uma usesimweni sokwenza kanjalo, bazozama ngisho nokukwenza uhambe kancane.
Ingabe uyaphaphama uma usebenzisa umshini wokuphefumula?
Lona umbuzo abantu abaningi abawubuzayo. Odokotela bazama ukukugcina ukhululekile futhi uzolile ngangokunokwenzeka, kuyilapho bekugcina uphapheme ngangokunokwenzeka. Kodwa-ke, uma isimo sakho sibi kakhulu, kungadingeka 'uphuze kakhulu' ukuze unike umzimba wakho isikhathi sokuphumula nokuphulukiswa. Ngezinye izikhathi, izingalo zakho zingase 'zivinjelwe' ukuze uvimbele ukuthi ungafaki ipayipi ngengozi. Lokhu kungenxa yokuphepha kwakho.
Yiziphi izinzuzo nezingozi?
Njenganoma yiluphi ukwelashwa kwezokwelapha, ukwelashwa ngomshini wokuphefumula kunezinzuzo kanye nezingozi.
| Izinzuzo | Izingozi |
|---|---|
| Awufuni ukusebenza kanzima ukuze uphefumule. Ngakho sebenzisa wonke amandla umzimba wakho onawo ukuze welaphe ukugula. | Amabhaktheriya angahamba ngemigudu yomoya aye emaphashini futhi abangele izifo (isib. i-pneumonia). |
| Ngokuqinisekile uzothola inani lomoya-mpilo olidingayo, futhi i-carbon dioxide izosuswa. | Ukucindezela okuvela kumshini wokuphefumula ngezinye izikhathi kungalimaza amaphaphu. |
| Kuvimbela amasaka omoya emaphashini ukuthi angavaleki. | Indawo ebuthakathaka emaphashini ingabhoboka, okubangela ukuthi iphaphu liwe (i-pneumothorax) . |
| Kugcina indlela yokuphefumula ivulekile futhi iphephile. | Ukusebenza kwenhliziyo kanye nomfutho wegazi kungathinteka. |
Kukhona iphuzu elilodwa elibalulekile. Ngezinye izikhathi isimo sesiguli singase sibe sibi kakhulu kangangokuthi akunakwenzeka ukululama. Esimweni esinjalo, ukuxhuma kumshini wokuphefumula kungandisa inqubo yokufa. Lokhu kungabangela ukuhlupheka okungadingekile kwesiguli nomndeni. Esimweni esinjalo, udokotela wakho uzoxoxa nawe ngalokhu futhi akuqondise ukuthi wenze isinqumo esingcono kakhulu.
Kuyini i-PEEP ne-CPAP?
Cishe uke wezwa womabili la magama.
- I-PEEP (Ukucindezela Okuhle Kokuphela Kokuphuma): Lokhu kuyindlela yokubeka umshini wokuphefumula. Kwezinye izimo zezokwelapha, lapho sikhipha umoya, amasaka omoya emaphashini (i-alveoli) avala ngokuphelele. Indlela yokubeka umoya igcina lawo masaka omoya evulekile ngokusebenzisa inani elincane lokucindezela ngisho nalapho ukhipha umoya. Lokhu kwandisa inani lomoya-mpilo ongena egazini.
- I-CPAP (Ukucindezela Komoya Okuhle Okuqhubekayo): Lokhu kuhilela ukuletha njalo inani elifanayo lokucindezela okuhle emigwaqweni yomoya ngenkathi uphefumula ungena futhi uphuma. Ivame ukusetshenziselwa izimo ezifana ne-sleep apnea, njengendlela yokungenisa umoya engangenisi umswakama (nge-mask).
Kalula nje, i-PEEP ingcindezi esetshenziswa esigulini esisebenzisa umshini wokuphefumula njengoba sikhipha umoya. I-CPAP ingcindezi eqhubekayo esetshenziswa kokubili phakathi nezinqubo zokuphefumula kanye nokukhipha umoya.
I-ventilator iyithuluzi elibalulekile elingasindisa impilo yakho uma kwenzeka ukugula noma isimo esiphuthumayo esingathi sína. Nakuba ingasiqedi lesi sifo, inikeza umzimba wakho isikhathi kanye nokusekelwa okudingayo ukulwa nesifo futhi ululame.
Umlayezo Wokuya Nawe Ekhaya
- I-ventilator iyimishini esindisa impilo ekusiza ukuphefumula uma ungakwazi ukuphefumula wedwa.
- Lokhu akusiqedi lesi sifo, kodwa kunikeza umzimba isikhathi nokuzinza okudingayo ukuze ulwe nesifo futhi ululame.
- Ungase uxhunywe kumshini wokuphefumula ngepayipi lokuphefumula (elihlaselayo) noma ngemaski (elingahlaseli).
- Ngesikhathi usebenzisa umshini wokuphefumula, ithimba lodokotela abangochwepheshe e-Intensive Care Unit (ICU) lizokunakekela kakhulu.
- Nakuba lokhu kwelashwa kunezingozi, ezimweni eziningi kuyindlela kuphela yokusindisa impilo.
- Uma wena noma omunye umuntu emndenini wakho enemibuzo noma ukukhathazeka ngalokhu, khuluma nodokotela wakho ngokukhululekile ngakho.
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