Kuvamile ukuzizwa ukwesaba okukhulu nokukhathazeka uma uzwa ukuthi othile omaziyo e-Intensive Care Unit (ICU) ufakwe kumshini wokuphefumula. Lokhu kwesaba kwandiswa ukungazi okuningi ngalo mshini. Empeleni uwumshini owusizo kakhulu ongasiza empini phakathi kokuphila nokufa. Ngakho-ke namuhla, ake sixoxe ngokuthi umshini wokuphefumula uyini, noma njengoba ubizwa kanjalo kwisayensi yezokwelapha, nokuthi wenzani, ngolimi olulula kakhulu noluqondakalayo.
Kalula nje, iyini i-ventilator?
I-ventilator umshini osiza umuntu ukuba aphefumule lapho enenkinga yokuphefumula eyedwa. Cabanga ngakho njengokusebenzisa izinduku zokubambelela uma uphuke umlenze. Njengoba nje izinduku zokubambelela zikusiza ukuthi uhambe ngesisindo sakho, i-ventilator ithatha umsebenzi wokuphefumula wamaphaphu akho, ngokuphelele noma ngezinga elithile.
Into ebaluleke kakhulu ukuthi umshini wokuphefumula awulona ikhambi. Uwuhlelo lokusekela impilo. Okusho ukuthi, uyasiza ekugcineni inqubo yokuphefumula kuze kube yilapho umzimba ululama ngezinye izindlela zokwelapha kanye nemithi.
Lezi zinto zenzeka kakhulu ngomshini wokuphefumula:
- Inikeza amaphaphu akho umoya-mpilo awudingayo.
- Kuyasiza ukususa igesi eyingozi ye-carbon dioxide eqongelela emaphashini.
- Amasaka amancane omoya emaphashini, abizwa ngokuthi ama-alveoli, anikeza ingcindezi edingekayo ukuze ahlale evulekile ngaphandle kokuwa.
Odokotela bangashintsha izilungiselelo zalo mshini ngokwezidingo zesiguli.
Ingabe i-Intubation kanye ne-Ventilation ziyizinto ezihlukene?
Yebo. Yilapho abantu abaningi bedideka khona. Ngisho noma lokhu kwenzeka ndawonye, lezi yizinqubo ezimbili ezihlukene.
- Ukufakwa kwepayipi: Inqubo lapho udokotela efaka khona ipayipi embhobheni womoya wesiguli (i-trachea) ngomlomo wesiguli.
- Umoya Ongenisiwe: Lokhu kusho ukuxhuma ipayipi elifakwe ngale ndlela kumshini womoya osiza ekuphefumuleni.
Kwezinye izimo, kungenzeka ukuxhuma umshini wokuphefumula nemaski yobuso efanela kahle ebusweni, ngaphandle kokufaka ipayipi elinjengaleli.
Yiziphi izindlela zokuphefumula ezitholakalayo?
Ama-ventilator afaka umoya emaphashini esebenzisa ukucindezela okuhle. Lokhu kungenziwa ngezindlela ezimbili eziyinhloko. Ukuze lolu lwazi lube lula ukuluqonda, ake sakhe ithebula elifana naleli.
| Uhlobo Lokungenisa Umoya | Incazelo elula |
|---|---|
| Umoya Wokungenisa Umoya Ohlaselayo (kufakwe ipayipi) | Kulokhu, kufakwa ipayipi endaweni yomoya. Leli payipi lifakwa ngomlomo (intubation) noma ngokuhlinzwa okuncane entanyeni (tracheostomy) bese lixhunywe kumshini wokuphefumula. |
| Umoya Ongangenisi Umoya | Lokhu kuhilela ukusebenzisa imaski elingana kahle ebusweni. Le maski ixhunywe kumshini wokuphefumula ofaka umoya emaphashini. Amadivayisi afana ne-CPAP noma i-BiPAP®, asetshenziswa ngisho nasekhaya, awela kulesi sigaba. |
Ubani odinga usizo lomshini wokuphefumula?
Usizo lomshini wokuphefumula lungadingeka noma nini lapho umuntu engakwazi ukuphefumula yedwa, ikakhulukazi ezimweni ezinjengalezi:
- Ngesikhathi sokuhlinzwa: Ukubulala izinzwa okuvamile kunciphisa ikhono lethu lokuphefumula. Ngakho-ke, umshini wokuphefumula usiza ukugcina ukuphefumula okuvamile phakathi nokuhlinzwa.
- Ukutheleleka noma izimo zamaphaphu ezinzima: Ezimweni ezifana ne-pneumonia, i-COVID-19, i-acute respiratory distress syndrome (ARDS), kanye nesifo samaphaphu esingamahlalakhona (i-COPD).
- Izingozi noma izimo eziphuthumayo zezokwelapha: Uma kwenzeka ingozi ebangela ukuvaleka komoya noma ukwehluleka kokuphefumula. Isibonelo, ukusabela okukhulu kokungezwani komzimba (i-anaphylaxis).
- Ukulimala kobuchopho: Ukulimala kobuchopho, njengokushaywa yisifo sohlangothi noma i-coma, kungavimbela umyalezo ovela ebuchosheni oya emaphashini ukuthi ungadluli kahle.
- Ukungalingani kwamazinga egesi egazini: Ezimweni ezifana nokwanda kwe-carbon dioxide egazini (hypercapnia) noma ukwehla komoya-mpilo (hypoxemia).
- Ukuvimbela ukudla noma amathe ukuthi angangeni emaphashini: Vimbela ukukhafulelwa kwezinto (amathe, ukudla) emlonyeni womuntu ongazi lutho futhi kubangele ukutheleleka.
Kwenzekani uma uxhunywe kumshini wokuphefumula?
Ngenxa yokuthi umuntu oxhunywe kumshini wokuphefumula udinga ukuqashelwa eduze kakhulu, ngokuvamile ugcinwa egunjini lokunakekelwa okujulile (ICU).Lapho, ithimba lodokotela abaqeqeshwe ngokukhethekile, abahlengikazi, kanye nabelaphi bokuphefumula banakekela isiguli.
Ukuqapha isiguli
Uzoqaphela ukuthi othandekayo wakho uneminye imishini eminingana exhunywe emzimbeni wakhe. Bahlala belinganisa izinto ezifana nomfutho wegazi, izinga lokushaya kwenhliziyo, izinga lokuphefumula, kanye namazinga omoya-mpilo egazini. Baphinde benze ama-X-ray esifubeni kanye nokuhlolwa kwegazi.
Ukumunca
Amafinyila anganqwabelana emzileni womoya. Ngakho-ke, abasebenzi abahlengikazi bavame ukufaka ipayipi elincane (i-catheter) ukuze kususwe amafinyila. Ngalesi sikhathi, isiguli singase sikhwehlele. Lokhu kungase kube yinto engakhululekile ukuthi uyibukele, kodwa lokhu kubalulekile ukuze kugcinwe umoya uhlanzekile.
Imithi, ukudla okunempilo kanye nenhlanzeko
Eminye imithi ifakwa emaphashini ngepayipi lokuphefumula. Njengoba ingakwazi ukudla noma ukuphuza, ukudla okunomsoco oketshezi kunikezwa ngepayipi elidluliselwa ekhaleni liye esiswini. Uketshezi oludingekayo lunikezwa ngemithambo yegazi nge-saline.
Ingabe isiguli sivukile?
Odokotela bazama ukugcina isiguli sikhululekile, sizolile, futhi siqaphile ngangokunokwenzeka. Kodwa-ke, kuye ngesimo sesiguli, kungadingeka ukunikeza isiguli ukuphumula nokuvumela umzimba ukuthi ululame, noma ukusenza silale ubuthongo obujulile (i-deep sedation). Ngezinye izikhathi, isiguli singadinga ukuvinjelwa ukuze sivinjwe ekuzilimazeni, isibonelo, ukuze sivinjwe ekuzameni ukususa ipayipi. Lokhu kwenzelwa ukuphepha kwesiguli.
Yiziphi izinzuzo nezingozi?
Njenganoma yiluphi ukwelashwa kwezokwelapha, ukusetshenziswa komshini wokuphefumula kunezinzuzo kanye nezingozi.
| Izinzuzo | Izingozi |
|---|---|
| Akudingeki usebenze kanzima ukuze uphefumule. Gxila ekwelapheni nasekulweni nanoma yiziphi izifo ezingatholwa ngumzimba wakho. | Amabhaktheriya angahamba nge-trachea aye emaphashini futhi abangele izifo (isib. i-pneumonia). |
| Umzimba uthola inani eliphelele lomoya-mpilo olidingayo. I-carbon dioxide iyasuswa. | Ukucindezela okuvela emshinini ngezinye izikhathi kungalimaza amaphaphu. |
| Kuvimbela amasaka omoya emaphashini ukuthi angawi. | Indawo ebuthakathaka emaphashini ingabangela ukuthi iphaphu liwe (i-pneumothorax). |
| Kusiza ukugcina indlela yokuphefumula ivulekile. | Ukusebenza kwenhliziyo kanye nomfutho wegazi kungathinteka. |
Kwezinye izimo ezibucayi kakhulu, isiguli singase singaphinde sikwazi ukuphefumula sodwa. Futhi, ukufaka isiguli kumshini wokuphefumula ongenalo ithuba lokululama kungandisa isikhathi sokufa ngokungadingekile. Ezimweni ezinjalo ezibucayi, kubalulekile ukukhuluma ngokukhululekile nodokotela wakho bese wenza isinqumo esingcono kakhulu sesiguli.
Uzikhipha kanjani kumshini wokuphefumula?
Uma isimo sesiguli sesingcono futhi odokotela sebeqiniseka ukuthi bangakwazi ukuphefumula ngokwabo, baqala inqubo "yokusikhipha" kumshini wokuphefumula. Okokuqala, banciphisa kancane kancane ukwesekwa okuvela emshinini bese bebona ukuthi isiguli singaziphefumula yini ngokwaso. Uma konke kulungile, "i-ET tube" iyasuswa.
Ngemva kokususwa kwepayipi, ungase ube nomphimbo obuhlungu kanye nokusha kwezwi izinsuku ezimbalwa. Lokhu kuvamile.
Umlayezo Wokuya Nawe Ekhaya
- Ukuphefumula ngomshini akuyona ikhambi lesifo, kuyindlela yokusekela impilo esiza umzimba ukuthi uphefumule uze ululame.
- Lokhu akusikho okufanele kukhathazeke ngakho. Ithimba lezokwelapha eliqeqeshwe egunjini lokunakekelwa okujulile linakekela isiguli ngokucophelela.
- Njengakuzo zonke izindlela zokwelapha, kunezingozi, kodwa ithimba lezokwelapha lihlala lizama ukunciphisa lezo zingozi.
- Khuluma nodokotela wakho ngokukhululekile nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Bazokuchazela isimo.
- Okokugcina, kubaluleke kakhulu ukuthi noma ubani axoxe ngezifiso zakhe nomndeni wakhe mayelana nokwelashwa okufanele akuthole uma eba nesifo esibi, ngisho noma ephilile.
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