Kungokwemvelo ngokuphelele ukuzizwa ukhungathekile, ukhathazekile, noma wesaba lapho uzwa ukuthi othandekayo wakho oseGunjini Lokunakekelwa Okujulile (ICU) ufakwe 'kumshini wokuphefumula.' Okuningi kwalokhu kwesaba kuvame ukuvela kokungaziwa. Eqinisweni, lo mshini uyithuluzi elibalulekile ekulweni nokusindisa impilo. KwaNirogi Lanka, sifuna ukukusiza uqonde ukuthi iyini 'imshini wokuphefumula'—noma lokho ochwepheshe bezokwelapha abakubiza ngokuthi 'iMechanical Ventilation'—nokuthi isebenza kanjani, kuchazwe ngamagama alula nacacile.
Kalula nje, iyini i-ventilator?
I-ventilator umshini osekela ukuphefumula kwakho uma ungakwazi ukuphefumula kahle wedwa. Cabanga ngakho njengokusebenzisa izinduku zokusibekela umlenze ophukile; njengoba nje izinduku zokusibekela zisekela isisindo sakho ukuze zikusize ukunyakaza, i-ventilator ithatha ingxenye noma wonke umsebenzi wokuphefumula wamaphaphu akho.
Okubaluleke kakhulu, umshini wokuphefumula awulona ikhambi lesifo. Uyindlela yokusekela impilo . Usebenza ukuqinisa ukusebenza kokuphefumula kwakho kuyilapho ezinye izindlela zokwelapha kanye nemithi kusiza umzimba wakho ukuba ululame.
Ngokuyinhloko, umshini wokuphefumula wenza imisebenzi elandelayo:
- Iletha umoya-mpilo odingwa ngumzimba wakho emaphashini akho.
- Kusiza ukususa i-carbon dioxide eningi, igesi engcolile, ohlelweni lwakho.
- Inikeza ingcindezi edingekayo ukugcina amasaka amancane omoya emaphashini akho (i-alveoli) evulekile futhi esebenza kahle.
Odokotela bakho bangalungisa izilungiselelo zomshini ngokusekelwe ezidingweni zakho zezokwelapha.
Ingabe i-Intubation ne-Ventilation ziyafana?
Cha. Leli iphuzu elivamile lokudideka. Nakuba zivame ukwenzeka ndawonye, ziyizinqubo ezimbili ezihlukene.
- Ukufakwa kwepayipi: Lena inqubo yezokwelapha lapho udokotela edlulisa khona ipayipi ngomlomo wakho bese lingena emphinjeni wakho (i-trachea).
- Umoya Ongenisiwe: Lokhu kubhekisela esenzweni sokuxhuma lelo payipi emshinini womoya ukuze kusize ekuphefumuleni kwakho.
Ezimweni ezithile, umoya ungatholakala ngemaski yobuso eqina kakhulu, ngaphandle kwesidingo sepayipi elihlaselayo.
Yiziphi izinhlobo zokungenisa umoya?
Umshini wokuphefumula usiza ukuphefumula kwakho ngokufaka umoya emaphashini akho usebenzisa umfutho omuhle. Lokhu kungenziwa ngezindlela ezimbili eziyinhloko. Sikufingqe lokhu ngezansi ukuze ukuqonde kalula.
| Uhlobo Lokungenisa Umoya | Incazelo Elula |
|---|---|
| Umoya Wokungenisa Umoya Ohlaselayo | Le ndlela ihilela ukufaka ipayipi endleleni yakho yokuphefumula. Leli payipi lidluliselwa ngomlomo wakho (intubation) noma ngokuhlinzwa okuncane entanyeni (tracheostomy) bese lixhunywa kumshini wokuphefumula. |
| Umoya Ongangenisi Umoya | Ngale ndlela, imaski ifakwa kahle ebusweni bakho futhi ixhunywe kumshini wokuphefumula ukuze kufakwe umoya emaphashini akho. Amadivayisi afana ne-CPAP noma i-BiPAP®, avame ukusetshenziswa ngisho nasekhaya, awela kulesi sigaba. |
Ubani odinga ukwesekwa ngumshini wokuphefumula?
Kungadingeka umshini wokuphefumula noma nini lapho ungakwazi ukuphefumula kahle wedwa. Izimo ezivamile zifaka:
- Ngesikhathi Sokuhlinzwa: Imithi yokubulala izinzwa evamile ingakucindezela ukuphefumula kwakho. I-ventilator isiza ukugcina ukuphefumula okuqhubekayo nokuphephile phakathi nenqubo yakho.
- Ukutheleleka Okukhulu Kwamaphaphu Noma Izifo: Izimo ezifana ne-pneumonia, i-COVID-19, i-Acute Respiratory Distress Syndrome (ARDS), noma izimo zamaphaphu ezingamahlalakhona njenge-COPD.
- Izimo Eziphuthumayo: Uma indlela yakho yokuphefumula ivaliwe noma ukuphefumula kwehluleka ngenxa yokulimala noma izimo eziphuthumayo zezokwelapha, njenge-anaphylaxis enzima.
- Ukulimala Kobuchopho: Izimo ezifana nesifo sohlangothi noma i-coma zingaphazamisa izimpawu zobuchopho ezitshela amaphaphu akho ukuthi aphefumule.
- Ukungalingani Kwegesi: Uma unezinga eliyingozi le-carbon dioxide (i-hypercapnia) noma i-oxygen ephansi (i-hypoxemia) egazini lakho.
- Ukuvimbela Ukuphefumulela: Ukuvimbela ukudla, amathe, noma uketshezi ukuthi kungangeni emaphashini akho uma uphuze kakhulu ukuvikela indlela yakho yokuphefumula.
Kwenzekani uma usebenzisa umshini wokuphefumula?
Ngenxa yokuthi udinga ukubhekwa njalo nangokucophelela, ngokuvamile uzonakekelwa eYunithi Yokunakekelwa Okujulile (ICU) yithimba elikhethekile lodokotela, abahlengikazi kanye nabelaphi bokuphefumula.
Ukuqapha
Ungase uqaphele imishini eminingana exhunywe kuwe. Le mishini iqapha njalo umfutho wegazi lakho, izinga lokushaya kwenhliziyo, izinga lokuphefumula, kanye nokugcwala komoya-mpilo. Uzothola ne-X-ray yesifuba evamile kanye nokuhlolwa kwegazi.
Ukumunca
Ukuze ugcine indlela yakho yokuphefumula ihlanzekile, ithimba lakho labahlengikazi lizosebenzisa njalo ipayipi elincane (i-catheter) ukususa amafinyila amaningi. Lokhu kungabangela ukukhwehlela. Nakuba lokhu kungase kubonakale kungakhululekile kwabathandekayo bakho, kubalulekile ekugcineni indlela yakho yokuphefumula ihlanzekile futhi kuvimbele ukutheleleka.
Imithi, Ukudla Okunomsoco, kanye Nenhlanzeko
Imithi ethile ingalethwa ngqo emaphashini akho ngepayipi lokuphefumula (elifakwe umoya). Njengoba ungakwazi ukudla, uzothola ukudla okunomsoco okuwuketshezi ngepayipi le-nasogastric (ipayipi elidlula ekhaleni liye esiswini). Uketshezi oludingekayo lunikezwa ngemithambo yegazi.
Uvukile?
Umgomo wethu ukukugcina ukhululekile, uzolile, futhi uqaphile ngangokunokwenzeka. Kodwa-ke, kuye ngesimo sakho, kungadingeka sikugcine usesimweni sokuphumula kakhulu ukuze umzimba wakho uthole ukuphumula okudingekayo ukuze ululame. Ngezinye izikhathi, ukuze sivimbele ukulimala ngengozi —njengokukhipha ipayipi lakho lokuphefumula—kungadingeka sibambe izandla zakho ngobumnene. Lokhu kwenzelwa ukuphepha kwakho kuphela.
Yiziphi izinzuzo nezingozi?
Njenganoma yikuphi ukungenelela kwezokwelapha, ukusetshenziswa komshini wokuphefumula kuza nezinzuzo kanye nezingozi ezihambisana nakho.
| Izinzuzo | Izingozi |
|---|---|
| Kuqeda umzamo wokuphefumula ngokomzimba, okuvumela umzimba wakho ukuthi ugxile amandla ekulweni nokutheleleka kanye nokuphulukiswa. | Amabhaktheriya angahamba ngepayipi lokuphefumula aye emaphashini, okungase kubangele izifo ezifana ne-pneumonia ehlobene nokuphefumula. |
| Kuqinisekisa ukuthi umzimba wakho uthola umoya-mpilo owanele futhi kususa i-carbon dioxide eningi. | Ingcindezi edingekayo ukuze kufuthwe amaphaphu, kwezinye izimo, ingabangela ukulimala kwamaphaphu okuhlobene nengcindezi. |
| Kugcina amasaka amancane omoya (i-alveoli) emaphashini akho evulekile futhi esebenza. | Kungenzeka ukuthi umoya uvuza endaweni ezungeze amaphaphu, okubangela ukuthi liwe (i-Pneumothorax). |
| Igcina indlela yokuphefumula evikelekile nevulekile ngaso sonke isikhathi. | Kungacindezela ukusebenza kwenhliziyo futhi kuthinte umfutho wegazi lakho. |
Kwezinye izimo zezokwelapha ezinzima, isiguli singase silahlekelwe ikhono lokuphefumula ngokuzimela. Ngaphezu kwalokho, ukubeka isiguli esingenalo ithemba lokululama kumshini wokuphefumula kungandisa isikhathi sokufa ngokungadingekile. Ezimweni ezinjalo ezibucayi, kubalulekile ukuthi ube nengxoxo evulekile nodokotela wakho ukuze wenze isinqumo esingcono kakhulu ngothandekayo wakho.
Isiguli sikhishwa kanjani kumshini wokuphefumula?
Uma isimo somuntu omthandayo sesingcono futhi odokotela beqinisekisa ukuthi sebekulungele ukuphefumula bodwa, inqubo "yokulumula" iyaqala. Sinciphisa kancane kancane ukwesekwa komshini ukuze sihlole ukuthi isiguli singakwazi yini ukuqhubeka nokuphefumula kwaso. Uma konke kuqhubeka kahle, ipayipi le-endotracheal (ET) liyasuswa ngokuphephile.
Sicela uqaphele ukuthi kuyinto evamile ukuthi isiguli sibe nomphimbo obuhlungu noma izwi elihoshozelayo izinsuku ezimbalwa ngemva kokukhishwa kwepayipi.
Izinto Ezibalulekile Okufanele Uzicabangele ENirogi Lanka
- Ukuphefumula ngomshini akulona ikhambi lesifo; kuyisistimu yokusekela impilo esiza ngokuphefumula ngenkathi umzimba uphulukiswa.
- Asikho isidingo sokwesaba. Othandekayo wakho uqashwe ngokucophelela yithimba elikhethekile lochwepheshe eYunithi Yokunakekelwa Okujulile (ICU).
- Njenganoma iyiphi inqubo yezokwelapha, kunezingozi, kodwa ithimba lethu lezokwelapha lizinikele ekunciphiseni kuzo zonke izinyathelo.
- Uma unemibuzo noma ukukhathazeka, sicela ukhulume ngokukhululekile nodokotela wakho. Bakhona ukukuchazela yonke imininingwane.
- Okokugcina, sikhuthaza wonke umuntu ukuba axoxe ngezifiso zakhe siqu mayelana nokwelashwa nomndeni wakhe ngenkathi ephilile, ukuze izintandokazi zakho zaziwe uma kuvela isimo esibucayi sezokwelapha.
I-ventilator, ukuphefumula ngomshini, ukwesekwa kokuphila, i-ICU, iyunithi yokunakekelwa okujulile, ukuphefumula, ukufakwa kwe-intubation, i-tracheostomy, i-ARDS, i-pneumonia, ukucindezeleka kokuphefumula, ukunakekelwa okuphuthumayo
