Ingabe unenkinga yokuphefumula? Ake sixoxe ngokwehluleka kokuphefumula

Ingabe ngezinye izikhathi uzizwa sengathi uphefumula kanzima? Noma uzizwa sengathi awukwazi ukuphefumula? Akuwona umqondo omuhle ukungazinaki lezi zinto. Ngoba, lokhu kungaba uphawu lwesimo esibucayi esibizwa ngokuthi i-Respiratory Failure . Namuhla, sizoxoxa ngalokhu ngendlela elula ongayiqonda. Lokhu kungaba yisimo esiphuthumayo sezokwelapha, ngakho-ke kubalulekile ukuqaphela lokhu.

Siphefumula kanjani? Kwenzekani uma lokhu kungasebenzi kahle?

Cabanga ngakho, umoya-mpilo emizimbeni yethu ufana nophethiloli emotweni, noma ufana nophethiloli esiwudingayo ukuze silawule izimpilo zethu. Uma siphefumula, le gesi eyigugu ebizwa ngokuthi umoya-mpilo ingena emaphashini ethu. Uma sikhuluma iqiniso, lo moya-mpilo ungena ezikhwameni zomoya ezincane emaphashini, ezibizwa ngokuthi i-alveoli . Kufana nebhasi elima liye esitobhini sebhasi.

Ukusuka lapho, igazi "lithwala" lo moya liye kuzo zonke izingxenye zomzimba, okuhlanganisa ubuchopho bethu, inhliziyo, imisipha, nezinye izitho. Uma lo moya ungafiki kulezo zindawo, amangqamuzana omzimba wethu ngeke akwazi ukusebenza, njengemoto engenawo uphethiloli.

Manje, ngemva kokuba umoya-mpilo “usuthunyelwe” kulezo zindawo, amangqamuzana egazi, njengoba ebuya, aqoqa i-carbon dioxide, igesi engasebenzi emzimbeni kanye nomkhiqizo ongcolile. Lokhu kufana nokuyisa ukudla esitolo bese ubuyisela amabhokisi angenalutho. Uma le-carbon dioxide iqoqana emzimbeni, lokho nakho kuyinkinga. Ngoba-ke asikho isikhala esanele sokuba igazi lithwale umoya-mpilo omusha. Ngakho-ke, le-carbon dioxide ibuyela emaphashini bese ikhishwa emzimbeni lapho sikhipha umoya-mpilo. Yilapho-ke sinendawo yokungenisa umoya-mpilo omusha futhi.

Uma noma iyiphi ingxenye yale nqubo yonke ingahambi kahle, izicubu zomzimba wethu azitholi umoya-mpilo owanele. Yilokho esikubiza ngokuthi i-Respiratory Failure .

Ingabe kunezinhlobo zokwehluleka kokuphefumula?

Yebo, kunezinhlobo eziningana zalesi simo, kuye ngokuthi senzeka kanjani nokuthi sithinta ini kakhulu. Ngezinye izikhathi singavela ngokuzumayo (esibucayi) , kanti ngezinye izikhathi singakhula kancane kancane ngokuhamba kwesikhathi (esingamahlalakhona) . Izinhlobo ezimbili eziyinhloko yilezi:

1. Ukwehluleka Kokuphefumula Okungenayo I-Hypoxemia - Uhlobo 1

Kalula nje, lesi yisimo lapho igazi lakho linamazinga aphansi omoya-mpilo (`hypoxemia`) . Lokhu kwenzeka uma uphefumula kodwa igazi lakho lingatholi umoya-mpilo owanele. Isifo senhliziyo nesifo samaphaphu yizona zimbangela eziyinhloko zalokhu. Abanye abantu bakubiza nangokuthi ukwehluleka kokuphefumula okungenawo umoya-mpilo.

2. Ukwehluleka Kokuphefumula Okuphezulu - Uhlobo 2

Lokhu kwenzeka lapho inani le-carbon dioxide (CO2) egazini lakho landa.. Lapho imizimba yethu ingakwazi ukususa i-carbon dioxide ngendlela efanele, udoti obizwa ngokuthi i-CO2, uyanqwabelana egazini. Bese kuthi, njengoba kushiwo ngaphambili, asikho isikhala somoya-mpilo egazini. Lesi simo singabangelwa izifo zenhliziyo, amaphaphu, imisipha, kanye nesimiso sezinzwa (ubuchopho kanye nomgogodla). Eminye imithi ingabangela lokhu.

Kunezinye izinhlobo:

• Ukwehluleka Kokuphefumula Okuhambisana Nokuhlinzwa (Uhlobo 3): Lokhu kungenzeka ngesikhathi sokuhlinzwa. I-anesthesia esetshenziswa ngesikhathi sokuhlinzwa ngezinye izikhathi ingenza ukuphefumula kube nzima. Futhi, amasaka omoya emaphashini angawa (i-atelectasis), kuvimbele umoya-mpilo ukuthi ungafiki egazini.
• Ukwehluleka Kokuphefumula Ngenxa Yokwethuka (Uhlobo 4): Ukushaqeka yisimo esibi lapho kuba nokwehla okungazelelwe komfutho wegazi kanye nezinkinga ezifana nokuvuvuka kwamaphaphu. Lokhu kungabangela nokwehluleka kokuphefumula. Ukushaqeka kungabangelwa izinto ezifana ne-sepsis ( ukutheleleka okukhulu okusakazeka emzimbeni wonke), ukuhlaselwa yinhliziyo okungazelelwe, kanye nokopha ngokweqile.

Ziyini izimpawu zalesi simo?

Izimpawu zokwehluleka kokuphefumula zingahluka kuye ngembangela. Kodwa-ke, kunezimpawu ezithile ezivamile:

• Ubunzima bokuphefumula noma ukuzizwa uphelelwa umoya (ukuphelelwa umoya).
• Ukuphefumula okusheshayo (i-tachypnea).
• Ukuzizwa ukhathele kakhulu (ukukhathala).
• Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha noma ukushaya kwenhliziyo yakho akuvamile.
• Ukukhwehlela uketshezi noma igazi (i-hemoptysis).
• Ukujuluka ngokweqile.
• Ukungaphumuli, ukucasuka.
• Isikhumba esimpunga.
• Ukushintsha kombala wesikhumba, izindebe, noma izinzipho okwesibhakabhaka (i-cyanosis) - Lokhu kuyisibonakaliso esibi sokuntuleka komoya-mpilo.
• Ikhanda elibuhlungu .
• Umbono ofiphele.
• Ukukhathazeka, ukudideka, ukungakwazi ukucabanga kahle.
• Izinguquko ekuziphatheni, hhayi njengokujwayelekile.

Okubalulekile: Uma unezinye zalezi zimpawu, kufanele ufune iseluleko sezokwelapha ngokushesha , ngoba lokhu kungaba yisimo esiphuthumayo.

Yiziphi izimbangela zokwehluleka kokuphefumula?

Kalula nje, lesi simo senzeka lapho ikhono lemizimba yethu lokungenisa umoya-mpilo nokukhipha i-carbon dioxide liphazamiseka ngesizathu esithile. Izinto ezingathinta lokhu zifaka:

• Ukuntuleka komoya owanele noma ukuncipha kokunikezwa kwegazi emaphashini.
• Ukuvaleka, izibazi, noma ukwakheka koketshezi emaphashini.
• Ukungakwazi ukuphefumula kahle noma ngokujulile.Lokhu kungabangelwa yizifo ezithinta amaphaphu, izinkinga zemizwa noma imisipha ekusiza ukuphefumula, noma ukulimala esifubeni.
• Ukungahambi kahle kokugeleza kwegazi enhliziyweni.

Ubani osengozini enkulu? (Izici Eziyingozi)

Abanye abantu basengozini enkulu yokuthola ukwehluleka kokuphefumula. Yilaba:

• Abantu abanezifo zamaphaphu: Isibonelo, izifo ezifana ne- acute respiratory distress syndrome (ARDS) , isifo samaphaphu esingamahlalakhona (COPD) , i-pneumonia , i-asthma , i-cystic fibrosis , i-pulmonary edema (uketshezi emaphashini) , i-pulmonary embolism (igazi eligobile epayipini lamaphaphu) , kanye ne -pulmonary fibrosis (izibazi emaphashini) .
• Abantu abanezifo zenhliziyo noma zesimiso sokujikeleza kwegazi: njengokuhlaselwa yinhliziyo , isifo senhliziyo esizalwa naso , ukwehluleka kwenhliziyo , kanye nokushaqeka .
• Abantu abanezifo ezithinta imizwa nemisipha ezisiza ekuphefumuleni: izimo ezifana ne-muscular dystrophy , i-amyotrophic lateral sclerosis (ALS) , i-scoliosis enzima (ukugoba komgogodla) , kanye ne-Guillain-Barré syndrome .
• Ukulimala esifubeni, emgogodleni, noma ebuchosheni (kufaka phakathi isifo sohlangothi).
• Ukubhema noma ukuchayeka kwezinye izinto ezicasula amaphaphu: umusi wamakhemikhali, uthuli, ukungcola komoya (njengokukhishwa kwezimoto ezisindayo emigwaqweni yethu, umusi wasefektri, nothuli oluvela ezindaweni zokwakha), kanye ne-asbestos.
• Ukuhlinzwa okudinga i-anesthesia.
• Ukusebenzisa izidakamizwa noma ukuphuza utshwala ngokweqile.
• Ubudala: Izinsana ezisanda kuzalwa (ikakhulukazi lezo ezizalwa zinokukhula okuncane) kanye nabantu abadala abangaphezu kweminyaka engama-65 ubudala basengozini enkulu.

Odokotela bakuthola kanjani lokhu?

Udokotela uzohlola ukungasebenzi kahle kokuphefumula ngokuhlola inani lomoya-mpilo kanye ne-carbon dioxide egazini lakho . Bazohlola nomfutho wegazi lakho futhi basebenzise idivayisi encane yokuxhuma (ebizwa ngokuthi i-'pulse oximeter' noma i-'pulse ox') ukuhlola izinga lomoya-mpilo egazini lakho. Bazolalela nenhliziyo namaphaphu akho futhi bakuhlole. Uma kusolwa ukuthi lesi simo sikhona, bangenza ezinye izivivinyo eziningana.

Yiziphi lezo zivivinyo?

• I-oximetry ye-pulse:Lokhu kuhilela ukubeka inzwa emunweni wakho ukuze kulinganiswe inani lomoya-mpilo egazini lakho. Lokhu kuvame ukwenziwa uma uya kudokotela.
• Ukuhlolwa kwe-Arterial Blood Gas (ABG): Isampula encane yegazi ithathwa ngenaliti esihlakaleni, engalweni engenhla, noma esinqeni bese kulinganiswa amazinga e-oxygen ne-carbon dioxide. Lokhu kunganikeza ulwazi olunembile kakhulu.
• Ukuhlolwa Kokusebenza Kwephaphu (PFT): Kulolu vivinyo, ucelwa ukuthi uphefumulele ngaphakathi nangaphandle ngomshini womlomo oxhunywe emshinini. Lokhu kungahlola ukuthi amaphaphu akho asebenza kahle kangakanani.
• Ukuhlolwa kwezithombe: Ama-X-ray kanye nama-CT scan athatha izithombe zengaphakathi lomzimba. Nakuba lokhu kungakwazi ukuhlonza ngqo ukwehluleka kokuphefumula, kungasiza ekutholeni ukuthi yini ebangela lokhu.
• I-Electrocardiogram (EKG): Lokhu kulinganisa ukuthi inhliziyo isebenza kahle kangakanani. Uma udokotela ecabanga ukuthi inkinga ibangelwa yisifo senhliziyo, uzo-oda i-EKG.

Kuphathwa kanjani lokhu?

Ukwelashwa kokwehluleka kokuphefumula kuncike ebunzimeni kanye nembangela yako. Imigomo eyinhloko yokwelashwa ukwelapha imbangela eyisisekelo, ukukunikeza umoya-mpilo owengeziwe, noma ukusebenzisa umshini wokuphefumula (`umoya wokuphefumula wemishini`) uze ukwazi ukuphefumula wedwa futhi.

Ukwehluleka kokuphefumula okubukhali kuyisimo esiphuthumayo futhi kudinga ukwelashwa ngokushesha. Kodwa-ke, ukwehluleka kokuphefumula okufushane, kwesikhathi eside (okungapheli) ngezinye izikhathi kungelashwa ekhaya ngokulawula isimo esiyisisekelo.

Yiziphi izindlela zokwelapha ezithile?

• Umoya wokungenisa umoya ngomshini: Lokhu kuhilela ukukuxhumanisa nomshini wokuphefumula kanye nepayipi elifakwe endleleni yakho yokuphefumula, eliphefumula futhi likhiphe umoya emaphashini akho.
• Ukuphefumula Ngegazi Ngaphandle Kwesikhumba (ECMO): Lokhu kuyindlela yokwelapha eyinkimbinkimbi kancane. Kuhilela ukusebenzisa umshini wokukhipha igazi emzimbeni, ukufaka umoya-mpilo kuwo, ukususa i-carbon dioxide, bese ungena emzimbeni kabusha.
• Ukwelashwa nge-oxygen: Umshini uletha i-oxygen eyengeziwe nge-mask yokuphefumula noma ngethubhu elincane (i-cannula) elifakwa ekhaleni. Lokhu kungenziwa esibhedlela noma ekhaya.
• Uketshezi: Uketshezi lunikezwa ngemithambo yegazi (IV - ngqo emthanjeni). Lokhu kuthuthukisa ukujikeleza kwegazi emzimbeni futhi kusiza ukuthwala umoya-mpilo owengeziwe ezicutshini.
• Ukwelapha izimo zezokwelapha eziyisisekelo: Kuye ngokuthi imbangela yokwehluleka kokuphefumula ibangelwa yini, udokotela angase ancome eminye imithi noma ukwelashwa.

Ingabe ikhona indlela yokuvimbela lokhu?

Ukwehluleka kokuphefumula akukwazi ukuvinjelwa ngaso sonke isikhathi. Kodwa-ke, unganciphisa ingozi yakho yokuthola ukwehluleka kokuphefumula okungapheli ngokuphatha noma yiziphi izimo zenhliziyo, zamaphaphu, noma zesimiso sezinzwa ongase ube nazo. Uma unesifo esiyingozi salesi simo, khuluma nodokotela wakho ngezindlela zokunciphisa ingozi yakho.

Ingabe ukwehluleka kokuphefumula kungalapheka?

Lesi yisimo esibi kakhulu. Iningi labantu liyalulama kuso. Kuya ngembangela yesifo, ubukhulu baso, nokuthi sisheshe kangakanani selashwe.

Nakuba izimbangela eziningi zokwehluleka kokuphefumula okubukhali zingelashwa, zingabulala uma zingelashwa ngokushesha. Cishe ingxenye yesithathu yabantu abalaliswe esibhedlela ngenxa yokwehluleka kokuphefumula okubukhali bayafa. Ukwehluleka kokuphefumula okungapheli kuvame ukubangelwa yisifo esiba sibi ngokuhamba kwesikhathi.

Kufanele ngimbone nini udokotela?

Uma unesifo esingamahlalakhona esikubeka engcupheni yokwehluleka ukuphefumula, khuluma nodokotela wakho. Angakutshela ukuthi yiziphi izimpawu zokwehluleka ukuphefumula okufanele uziqaphele nokuthi ungasiphatha kanjani isimo sakho.

Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo (i-ETU) ?

Uma unezimpawu zokwehluleka kokuphefumula, iya ekamelweni eliphuthumayo eliseduze ngokushesha, noma ushayele u-911. Lokhu kungaba yingozi uma kungelashwa ngokushesha.

Yini okufanele ngiyibuze udokotela wami?

Kungaba usizo ukubuza udokotela wakho imibuzo efana nale:

• Yiziphi izindlela zokwelapha enginazo?
• Iyini imbangela yalokhu?
• Kufanele ngiyisebenzise kanjani imithi yami?
• Ngingayisebenzisa kanjani le divayisi (isb., umshini we-oxygen)? Ungangibonisa ukuthi kanjani?
• Ngingalindela nini ukuthi ngilulame?
• Kufanele ngize nini ukukubona futhi?

Umlayezo Wokuya Nawe Ekhaya

Ukwehluleka kokuphefumula kuyisimo esibi kakhulu, ngezinye izikhathi esibulalayo. Uma ucabanga ukuthi unenkinga yokuphefumula ebukhali, sicela ushayele u-911 ngokushesha noma ufune usizo lwezokwelapha oluphuthumayo. Uma unenkinga yokuphefumula engapheli, noma uma unezimo ezandisa ingozi yakho, khuluma nodokotela wakho mayelana nokwelashwa okufanele. Angachaza ukuthi yiziphi izinketho zakho zokwelashwa nokuthi yini ongayilindela ngokusekelwe esimweni sakho. Nakekela ukuphefumula kwakho, ngoba kuyimpilo yakho!

Ukwehluleka kokuphefumula, ubunzima bokuphefumula, umoya-mpilo, i-carbon dioxide, amaphaphu, ukunakekelwa okuphuthumayo, i-ARDS, i-COPD