Uyazi ngalesi simo esiphuthumayo esenzeka emaphashini ngemva kokunikela ngegazi? (TRALI)

Wake wampontshelwa igazi? Noma ingabe othile omaziyo wake wampontshelwa igazi? Ngokuvamile, ukunikela ngegazi kuyinto esiza ekusindiseni impilo. Kodwa akuvamile kakhulu, okungukuthi, akuvamile kakhulu, abanye abantu bangaba nenkinga yezempilo ephuthumayo ngenxa yalokhu kunikela ngegazi. Lesi ngesinye sezimo esizokhuluma ngazo namuhla, esibizwa ngokuthi i-TRALI. Leli gama lingase libe lisha kuwe, kodwa kubaluleke kakhulu ukulazi.

Kuyini (TRALI)? Masikuqonde kalula

Kalula nje, i-(TRALI) – emele i-Transfusion-Related Acute Lung Injury – yisimo esiphuthumayo esithinta amaphaphu akho, kungaba lapho umpontshelwa igazi noma zingakapheli amahora ayisithupha ulitholile. Amaphaphu ethu anezikhwama zomoya ezincane, njengezibhola ezincane ezimise okwegilebhisi. Ngokwezokwelapha sizibiza ngokuthi (alveoli) . Nokho, okwenzekayo kulesi simo (TRALI) ukuthi uhlobo oluthile loketshezi lugcwala ngaphakathi kwalezo (alveoli).

Cabanga ngakho, njengesiponji esimunca amanzi, kwenzekani uma lawa masaka omoya egcwele uketshezi? Kuba nzima ukuphefumula, akunjalo? Amaphaphu ayayeka ukusebenza kahle. Akukhona lokho kuphela, kodwa nomfutho wegazi lakho ungehla kakhulu ngendlela eyingozi. Lesi yisimo esiphuthumayo sezokwelapha esibucayi kakhulu . Ngakho-ke uma kwenzeka into efana nale, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha.

Ziyini izimpawu ze-(TRALI)? Uzibona kanjani?

Ngakho-ke, lesi simo (se-TRALI) sizwakala kanjani? Ziyini izimpawu? Ake siqaphele nalezi.

• Ungase uzizwe uphelelwa umoya noma ubunzima bokuphefumula (ukuphelelwa umoya) . Kungase kuzwakale sengathi uphefumula kanzima ngemva kokukhwela izitebhisi, noma sengathi isifuba sakho sinciphile.
• Ukukhwehlela kungase kuqale ngokuzumayo .
• Ngezinye izikhathi isikhumba sakho, izindebe, kanye nezinzipho zakho ziba luhlaza okwesibhakabhaka (i-cyanosis) . Lokhu kwenzeka ngoba igazi emzimbeni wakho alitholi umoya-mpilo owanele. Lokhu kuyisibonakaliso esethusayo kancane.
• Ungase uthole umkhuhlane , futhi ungase uzizwe sengathi unomkhuhlane.
• Ungase uzizwe unesiyezi noma unekhanda elibuhlungu .
• Abanye abantu bangase baquleke . Lokhu kwenzeka ngoba umfutho wegazi wabo wehla kakhulu.

Lezi zimpawu zingaqala ngesikhathi senqubo yokunikela ngegazi noma zingakapheli amahora ayisithupha ngemva kokuba iqediwe. Ngakho-ke, kubalulekile ukuqaphela kakhulu ngalesi sikhathi. Uma wena noma othile omaziyo engumnikeli wegazi, kubalulekile ukuqaphela lezi zimpawu.

Kungani lokhu (TRALI) kwenzeka? Iyini imbangela?

Kulungile, manje ake sibone ukuthi kungani le nto (ye-TRALI) yenzeka. Lokhu kungokwesayensi kancane, kodwa ngizokuchaza kalula ukuze uqonde.

Imizimba yethu inesimiso somzimba sokuzivikela. Yiso esisivikela ezifweni. Lolu hlelo lunezingxenye ezikhethekile ezifana 'namasosha' abizwa ngokuthi ama-antibodies.Umsebenzi wabo oyinhloko ukusivikela ngokuqaphela nokulwa nezinto eziyingozi njengamagciwane namagciwane avela ngaphandle komzimba.

Manje, uma uthola igazi, amanye ama-antibodies egazini lomnikeli angabopha amaseli abizwa ngokuthi amangqamuzana amhlophe egazi emzimbeni wakho, ikakhulukazi emaphashini akho. Lokhu kwenzeka ngephutha. Ngemuva kwalokho isimiso sakho somzimba sokuzivikela sicabanga ukuthi, "O, kukhona okubi okungene emzimbeni wakho, isitha singene!" Ngakho-ke, leso simiso siqala ukusebenza ngokuzumayo futhi sibangele ukuvuvukala . Lokhu kuvuvukala yikho okubangela imithambo yegazi emincane emaphashini akho, i-alveoli engikhulume ngayo ekuqaleni, ukuba yonakale, futhi uketshezi luvuza emaphashini. Kufana nokuthi isimiso sethu sokuzivikela siyasilimaza singazi. Kuyinkimbinkimbi kancane, kodwa uyawuthola umqondo, akunjalo?

Ubani osengozini enkulu yokutheleleka yi-TRALI?

Nakuba lesi simo (TRALI) singavela kunoma ubani othola ukumpontshelwa igazi, abanye abantu banamathuba amaningi okuba naso. Ake sibheke ukuthi bangobani:

• Abantu abaxhunywe kumshini wokuphefumula owenziwe (umoya womshini). Okusho ukuthi, iziguli ezithola usizo lokuphefumula emshinini osesibhedlela ngoba zinobunzima bokuphefumula zodwa.
• Abantu abalutha kakhulu utshwala (isifo sokusetshenziswa kotshwala). Ngoba ukusebenzisa utshwala ngokweqile kwenza buthaka izinhlelo ezahlukene emzimbeni.
• Abantu abavame ukusebenzisa imikhiqizo kagwayi. Lokho kusho izinto ezifana nogwayi nama-bidi. Siyazi ukuthi ukubhema kuyingozi emaphashini.
• Abantu asebevele benesifo sesibindi noma sezinso. Uma lezi zitho zingasebenzi kahle, ibhalansi yomzimba iyaphazamiseka.
• Iziguli esezigula kakhulu kakade. Isibonelo, lezo ezinezifo ezinzima, njengalezo ezingemva kokuhlinzwa.
• Le ngozi inganda nakubantu abathola igazi eliningi ngesikhathi esisodwa noma labo abathola imikhiqizo ethile yegazi (isib. i-plasma, ama-platelet) .

La maqiniso awasho ukuthi nakanjani uzoqala i-TRALI uma ungowaleli qembu, kodwa asho ukuthi ingozi iphakeme kancane.

Odokotela bayixilonga kanjani i-TRALI? (Ukuxilongwa)

Udokotela uyixilonga kanjani i-TRALI? Lokhu kungaba nzima kancane, njengoba izimpawu zingafana nezinye izinkinga zamaphaphu.

Okokuqala, bazozama ukugwema ezinye izinto ezingase zibangele izimpawu zakho, isibonelo, ukusabela okukhulu kokungezwani komzimba (i-anaphylaxis) , ukuvuvukala kwamaphaphu okubangelwa ukwehluleka kwenhliziyo, noma ukutheleleka okukhulu. Ukuze benze lokhu, bazokwenza okulandelayo:

• Sizokubuza ngokucophelela ngomlando wakho wezokwelapha kanye nokunikela ngegazi kwakamuva.
• Kuhlolwa umzimba .
• Kuye kwenziwa ukuhlolwa kwegazi okuningana. Lokhu kuhlola izinto ezifana namazinga omoya-mpilo kanye nesimo sokutheleleka.
• Ukuhlolwa kwezithombe kwenziwa esifubeni . Lokhu kuvame ukuhilela i -X-ray yesifuba . Endabeni ye-TRALI, lokhu kungabonisa ngokucacile uketshezi olugcwalisa amaphaphu womabili. Ngezinye izikhathi i-CT scan nayo ingenziwa. Funda kabanzi.
• Ungase futhi wenze ukuhlolwa kwenhliziyo okubizwa ngokuthi i-echocardiogram ukuze ubone ukuthi inhliziyo yakho isebenza kahle kangakanani. Lokhu kungasiza ekuvimbeleni izinkinga zamaphaphu ezibangelwa ukusebenza kwenhliziyo.

Ngemva kokwenza konke lokhu, odokotela bafinyelela esiphethweni sokuthi kunjalo (TRALI).

Yiziphi izindlela zokwelapha (i-TRALI)?

Ngeshwa, akukho 'khambi' eliqondile lalesi simo (TRALI), okusho ukuthi akukho muthi ongasilapha ngokuphelele okwamanje. Kodwa, ungesabi. Odokotela bangakugcina uzinzile futhi bakunakekele kahle kuze kube yilapho isimo sithuthuka ngokwaso. Lokhu kubizwa ngokuthi ukunakekelwa okusekelayo . Bangase bakunike ukwelashwa okufana nalokhu:

• Ukwelashwa nge-oxygen: I-oxygen inikezwa nge-mask noma i-nasal cannula ukusiza ekuphefumuleni nasekuhlinzekeni umzimba ngenani elidingekayo le-oxygen.
• Ama-Vasopressor: Lena imithi enikezwa ukubuyisela umfutho wegazi ophansi esimweni esijwayelekile. Le mithi inikezwa ngemithambo yegazi.
• Ama-diuretics noma ama-IV fluids: Kuye ngesimo sakho, ama-diuretics (imithi ekwenza ulahlekelwe uketshezi ngomchamo) anganikezwa ukunciphisa uketshezi oluningi emaphashini akho nasemzimbeni wakho. Noma, uma kudingeka, ama-IV fluids anganikezwa ukuze kugcinwe umfutho wegazi. Lokhu kunqunywa udokotela.
• Ukuphefumula ngomshini: Uma ukuphefumula kunzima kakhulu futhi ungakwazi ukuphefumula kahle wedwa, kungadingeka ukuthi unikezwe umoya ngomshini njengendlela yokusindisa impilo. Kulokhu, kufakwa ipayipi epayipini lomoya bese umshini ulawula inqubo yokuphefumula.

Ngale ndlela yokwelapha, izimo zeziguli eziningi ziyathuthuka kancane kancane.

Yini ongayilindela uma uthuthuka (i-TRALI)?

Kwenzekani uma uthola i-TRALI? Lokhu kubalulekile futhi ukwazi.

Esikhathini esiningi, i-TRALI iba ngcono zingakapheli izinsuku ezimbili kuya kwezine . Kwabanye abantu, kungathatha isikhathi eside, kuye ngokuthi isimo sibucayi kangakanani kanye nempilo yakho iyonke. Phakathi naleso sikhathi, odokotela nabahlengikazi bazokugcina esibhedlela, ngokuvamile egunjini lokunakekelwa okujulile (ICU), futhi bazohlala beqapha isimo sakho (ukuphefumula, amazinga omoya-mpilo, umfutho wegazi) futhi bakunikeze ukunakekelwa okusekelayo. Lokhu kusho ukuthi bazokwenza konke okusemandleni abo ukulawula izimpawu zakho nokuvimbela ezinye izinkinga ukuthi zingabi khona.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Lokhu kuyinto okufanele uyikhumbule nakanjani. Ngemva kokunikela ngegazi:

• Ubunzima bokuphefumula ngokuzumayo
• Ubuhlungu besifuba noma ukuqina
• Ukukhwehlela okukhulu
• Imfiva
• Isiyezi, umbono ofiphele
• Ukushintsha kombala wesikhumba nezindebe okuluhlaza okwesibhakabhaka

Uma uhlangabezana nanoma yiziphi zalezi zimpawu noma ezinye izimpawu ezingavamile, iya eMnyangweni Wezimo Eziphuthumayo (ETU) oseduze nawe ngokushesha, noma uma usesibhedlela, yazisa ithimba lezokwelapha ngokushesha. Ungachithi isikhathi. Lokhu kubaluleke kakhulu, ngoba ukuhlolwa kwasekuqaleni kanye nokwelashwa kungasindisa impilo.

Ingabe i-TRALI ingavinjelwa?

"Lokhu akukwazi yini ukuvinjelwa?" ungase uzibuze. Eqinisweni, okwamanje ayikho indlela yokuvimbela ngokuphelele i-TRALI. Kodwa-ke, abahlinzeki begazi nezibhedlela benza konke okusemandleni abo ukuhlola igazi elinikelwe, ikakhulukazi labo abanezinhlobo ezithile zama-antibodies, ukuze banciphise ingozi yezinkinga zokumpontshelwa igazi. Isibonelo, banaka kakhulu ukusetshenziswa kwe-plasma kwabesifazane abakhulelwe ngaphambili, ngoba banamathuba amaningi okuba nala ma-antibodies egazini labo.

Eqinisweni, kuyesabeka ukucabanga ukuthi okuthile okuhle kungase kusihambele kabi, akunjalo? Kodwa-ke, ukunikela ngegazi kuyindlela ejwayelekile yezokwelapha esindisa izimpilo eziningi emhlabeni jikelele. Ukusabela kokumpontshelwa igazi njenge-(TRALI) akuvamile kakhulu. Kodwa-ke, uma kwenzeka, kungaba yingozi empilweni. Ngakho-ke, uma uzizwa ungavamile ngemva kokunikela ngegazi, bheka udokotela ngaphandle kokungabaza. Into ebaluleke kakhulu ukuthola ukwelashwa ngokushesha okukhulu.

Yiziphi izinto okufanele sizikhumbule kule ndaba?

Kulungile, ngakho-ke, ngamafuphi, amaphuzu ayinhloko okufanele uwakhumbule nge-TRALI esikhulume ngawo yile:

• (TRALI) yisimo esibi kakhulu esenzeka ngokuzumayo (ngokuvamile zingakapheli amahora ayisithupha) ngemva kokumpontshelwa igazi, okubangela ubunzima bokuphefumula kanye nomfutho wegazi ophansi ngenxa yokuqongelela koketshezi emaphashini.
• Izimpawu ezifana nokuphelelwa umoya, ukukhwehlela, isikhumba esiluhlaza okwesibhakabhaka, umkhuhlane kanye nesiyezi zingase zibe khona. Qaphela lezi.
• Lokhu kuvame ukwenzeka lapho ama-antibodies egazini lomnikeli ebangela ukuthi amasosha omzimba omamukeli asebenze ngephutha futhi alimaze amaphaphu.
• Abanye abantu (isib. labo abasebenzisa imishini yokuphefumula, labo abanesifo sesibindi/izinso, kanye nalabo abaphuza kakhulu) basengozini enkulu yokuthuthukisa lokhu.
• Lesi yisimo esiphuthumayo sezokwelapha. Kubalulekile ukufuna iseluleko sezokwelapha ngokushesha uma kuvela izimpawu.
• Nakuba kungekho ukwelashwa okuqondile kwe-TRALI, abantu abaningi bayalulama ezinsukwini ezimbalwa ngokunakekelwa okusekelwayo okunikezwa esibhedlela.
• Nakuba i-TRALI iyisimo esingavamile kakhulu , kubalulekile ukuqaphela nokwazi izimpawu.

Uwazi kahle umzimba wakho. Uma uzizwa into engavamile, ehlukile, noma engakhululekile ngemva kokunikela ngegazi, ungakuthathi kalula. Tshela udokotela ngokushesha. Kungasindisa impilo yakho! Hlala uphilile!

Ukunikela ngegazi , amaphaphu, ubunzima bokuphefumula, i-TRALI, ukumpontshelwa igazi, ama-antibodies, ukunakekelwa okuphuthumayo