Sonke sizwile ngomfutho wegazi ophakeme. Kodwa bewazi ukuthi umfutho wegazi ophansi ungaba yingozi efanayo, futhi mhlawumbe ube yingozi nakakhulu? Cishe uke wezwa ngomuntu ogula kakhulu ngokuzumayo bese engeniswa e-Intensive Care Unit (ICU). Ngezikhathi ezinjalo, umfutho wegazi walowo muntu kungenzeka ukuthi wehle kakhulu. Uma lokhu kwenzeka, izitho zomzimba ezibaluleke kakhulu, njengobuchopho, inhliziyo, nezinso, zincishwa igazi elicebile ngomoya-mpilo elidingekayo. Namuhla, sizokhuluma ngohlobo lomuthi olukhethekile nolunamandla kakhulu olusetshenziswa odokotela ukusindisa izimpilo ezimweni eziphuthumayo ezisongela ukuphila. Lokhu yilokho okubizwa ngokuthi ama-Vasopressors kwezokwelapha.
Ziyini nje izicindezelo ze-vasopressor?
Kalula nje, i-vasopressor uhlobo lomuthi odokotela abalusebenzisayo ukusiza abantu abanomfutho wegazi ophansi kakhulu ukuthi bawubuyisele esimweni esijwayelekile. Le mithi isebenza ngokuncipha, noma ukunciphisa, imithambo yegazi emzimbeni wethu.
Cabanga ngale ndlela. Igazi elijikeleza emizimbeni yethu lifana nohlelo lwamapayipi amanzi. Uma la mapayipi (imithambo yegazi) eba makhulu noma ekhululeka ngokuzumayo, umfutho wamanzi (igazi) ogeleza kuwo uyancipha. Lokhu yilokho esikubiza ngokuthi isimo sokushaqeka. Ngezikhathi ezinjengalezi, igazi liyayeka ukugeleza liye ezithweni ezibalulekile zomzimba. Ngaphandle komoya-mpilo, lawo malungu ayayeka ukusebenza, futhi impilo yalowo muntu ingaba sengozini.
Ngokuvamile, uma ingcindezi yehla kanje, into yokuqala okufanele yenziwe ukunikeza usawoti (i-IV fluids). Kodwa uma ingcindezi ingabuyeli esimweni sayo esijwayelekile ngisho nange-saline, khona-ke into elandelayo odokotela abayenzayo ukusebenzisa uhlobo lomuthi olubizwa ngokuthi i-vasopressor. Lena imithi efakwa ngqo emthanjeni. Ngokuvamile inikezwa ngethubhu ekhethekile efakwa emthanjeni omkhulu entanyeni noma esifubeni, ebizwa ngokuthi i-central venous catheter. Bese umuthi uya ngokushesha enhliziyweni futhi usakazeke kuwo wonke umzimba.
Lo muthi usebenza kanjani emzimbeni?
Imithi yokucindezela imithambo yegazi yenza izinto ezimbili eziyinhloko uma ingena emzimbeni.
1. Ukunciphisa imithambo yegazi: Lokhu kuyinto eyinhloko. Kunciphisa imithambo yegazi emzimbeni wonke. Njengoba nje ukucindezela ipayipi lamanzi kwenza amanzi ageleze ngokushesha, lapho imithambo yegazi incipha, umfutho wegazi ngaphakathi kwayo uyanda.
2. Yandisa ukufinyela kwenhliziyo: Amanye ama-vasopressor asebenza enhliziyweni, andise inani legazi elimpompayo ngokushaya ngakunye. Lokhu kusho ukuthi andisa okwesikhashana ikhono lenhliziyo lokupompa.
Zombili lezi zindlela zibuyisela ngokushesha umfutho wegazi ophansi futhi zibuyisele ukugeleza kwegazi ezithweni ezibalulekile njengobuchopho, inhliziyo nezinso .
Yiziphi izinhlobo ezivame ukusetshenziswa kakhulu ze-vasopressors?
Ama-vasopressor asetshenziswa emagunjini okunakekela abagula kakhulu (ama-ICU) ukwelapha umfutho wegazi ophansi ngenxa yezizathu ezahlukahlukene. Udokotela ukhetha umuthi ofanele kakhulu ngokusekelwe esimweni sesiguli.
| Igama Lomuthi | Amanye Amagama Omkhiqizo |
|---|---|
| I-Norepinephrine | I-Levophed® |
| I-Epinephrine | I-Adrenalin®, i-EpiPen® |
| I-Vasopressin | I-Pitressin®, i-Vasostrict® |
| I-Dopamine | I-Intropin® |
| I-Phenylephrine | I-Biorphen®, i-Vazculep® |
| I-Angiotensin-II | I-Giapreza® |
Ingabe siyalusebenzisa lolu hlobo lomuthi ekuphileni kwansuku zonke?
Yebo. Sisebenzisa eminye imithi nsuku zonke esebenza ngendlela efanayo nalena, yize ingenawo amandla njengalena.
- Ama-Decongestant Amakhala: Uma unomkhuhlane, ikhala lakho liyavaleka. Amanye amaconsi noma ama-lozenges ekhala esiwasebenzisayo aqukethe izinto ezifana ne-`(Ephedrine)` kanye ne-`(Pseudoephedrine).` Lokhu kusebenza ngokucindezela imithambo yegazi ngaphakathi kwekhala, ukunciphisa ukuvuvukala, nokwenza kube lula ukuphefumula.
- I-EpiPen®: I -EpiPen®, esetshenziswa ezimweni zokungezwani komzimba okukhulu, njenge-anaphylaxis ebangelwa ukugwazwa yizinyosi noma i-wasp, noma ukudla ukudla okuthile, iqukethe umuthi ofanayo obizwa ngokuthi i-Epinephrine.
- Eminye imithi yomkhuhlane: Amanye amaphakethe emithi yomkhuhlane angase aqukathe `(i-Phenylephrine)`. Nalokho kungokwesigaba salesi sicindezelo semithambo yegazi.
Ingabe ama-Vasopressor nama-Inotropes ayinto efanayo?
Yebo, lezi yizinhlobo ezimbili zemithi. Kodwa odokotela bavame ukusebenzisa zombili lezi zinhlobo ndawonye. Ake siqonde umehluko kalula.
Ake sithi inhliziyo yethu iyinjini yamanzi, futhi imithambo yegazi yethu iyipayipi lapho amanzi ageleza khona.
- Ama-Vasopressor: Le mithi isebenza ngokucindezela imithambo yegazi nokwandisa umfutho wegazi.
- Ama-Inotropes: Le mithi yandisa amandla enjini yamanzi (inhliziyo) , okwenza ukuthi ikwazi ukupompa amanzi amaningi ngesikhathi esisodwa.
Ngakho-ke, uma umfutho wegazi womuntu uphansi futhi inhliziyo yakhe ibuthakathaka, odokotela banikeza yomibili le mithi ndawonye, bandise ingcindezi ngokucindezela ipayipi ohlangothini olulodwa, futhi bandise amandla omshini ngakolunye uhlangothi ukuze kupompelwe igazi emzimbeni ngendlela ephumelelayo ngangokunokwenzeka.
Kukuziphi izimo lapho kudingeka khona ama-vasopressor?
Ama-vasopressor awuhlobo lomuthi osindisa impilo onikezwa isiguli esiphakathi kokuphila nokufa. Lena akuyona imithi enikezwa isifo esivamile. Nazi ezinye zezimo eziyinhloko lapho idingeka khona.
| Isimo | Incazelo elula |
|---|---|
| Ukushaqeka | Umfutho wegazi ungehla kakhulu ngenxa yezimo ezinjengokutheleleka okukhulu (i-sepsis), ukopha okukhulu, kanye nokuhlaselwa yinhliziyo. |
| Isifo senhliziyo | Ngenxa yokuvaleka komthambo wegazi ohambisa igazi enhliziyweni, ukusebenza kwenhliziyo kuyaphazamiseka futhi umfutho wegazi uyehla. |
| Ukwehluleka Kwenhliziyo | Inhliziyo ayikwazi ukupompa igazi elanele emzimbeni. |
| I-Anesthesia Yomgogodla | Ngesikhathi sokuhlinzwa okuthile, imithi yokubulala izinzwa enikezwa umgogodla ingabangela ukwehla okungazelelwe komfutho wegazi. |
| Ukusabela okukhulu kwezidakamizwa | Ukusabela okukhulu kokungezwani komzimba nemithi ethile kungabangela umfutho wegazi ophansi. |
| Izingozi nokuhlinzwa | Umfutho wegazi ophansi ngenxa yokopha okukhulu. |
Ingabe ikhona imiphumela emibi kulo muthi?
Yebo. Ama-vasopressor ayimithi enamandla kakhulu . Ngakho-ke, angabangela imiphumela emibi. Ngenxa yalesi sizathu, le mithi inikezwa egunjini lokunakekelwa okujulile (ICU), kuyilapho iqapha njalo isimo sesiguli . Odokotela nabahlengikazi bahlala beqapha izinga lokushaya kwenhliziyo yesiguli, umfutho wegazi, kanye namazinga omoya-mpilo.
Eminye imiphumela emibi engaba khona yile:
- Ukukhathazeka nokungaphumuli
- Ikhanda elibuhlungu
- Ubuhlungu besifuba
- Ubunzima bokuphefumula
- Isilinganiso senhliziyo esihamba kancane ngendlela engavamile (i-Bradycardia)
- Ukwanda kwesilinganiso senhliziyo okungajwayelekile (i-Tachycardia)
- Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia)
- Umfutho wegazi ophakeme kakhulu kunokudingekile. (Lokhu kungaholela ngisho nasesimeni esibucayi njengokuphuma kwegazi ebuchosheni)
- Ukuminyana okukhulu kwemithambo yegazi kubangela ukwehla kokugeleza kwegazi ezinzwaneni nasezinzwaneni, okubangela ukuthi lezo zindawo zibe mnyama.
Nakuba le miphumela emibi iyingozi, kubalulekile ukukhumbula ukuthi le mithi inikezwa ezimweni eziyingozi nakakhulu, ezisongela ukuphila. Odokotela bahlala bezama ukulinganisa izinzuzo nezingozi futhi benze okungcono kakhulu ngesiguli.
Kuthatha isikhathi esingakanani ukululama?
Kunzima ukunikeza impendulo eyodwa kulo mbuzo, ngoba isikhathi esithathayo ukuze ululame asinqunywa umuthi wokucindezela imithambo yegazi owunikiwe, kodwa sinqunywa yisimo sezempilo esiyisisekelo esiholele ekutheni umuthi unikezwe .
Isibonelo, umuntu ohlaselwa yisifo sofuba ngenxa yokutheleleka okukhulu kungadingeka ahlale esibhedlela amasonto, ngisho nezinyanga, ukuze alulame. Kodwa-ke, umuntu onikezwa lo muthi isikhashana ngesikhathi sokuhlinzwa ukuze anciphise ingcindezi ebangelwa ukubulala izinzwa angalulama ngokushesha.
Into ebalulekile ukuthi iqiniso lokuthi kwadingeka unikezwe umuthi onamandla kangaka lisho ukuthi usululame ekuguleni okubi kakhulu. Ngakho-ke, udinga ukunikeza umzimba wakho isikhathi osidingayo sokululama.
Ngemva kokufika ekhaya usuka esibhedlela, ungasheshi ukubuyela esimisweni sakho esijwayelekile. Thatha imithi udokotela wakho ayinikezile ngesikhathi. Futhi, qiniseka ukuthi uyayigcina imihlangano yakho yokulandelela. Uma uzizwa ungaphilile futhi, isibonelo, uma unenkinga yokuphefumula, ubuhlungu besifuba, noma uzizwa ungaphilile, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
Umlayezo Wokuya Nawe Ekhaya
- Ama-vasopressor ayiqembu lemithi enamandla kakhulu esetshenziselwa ukusindisa izimpilo ezimweni eziphuthumayo, njengokushaqeka, lapho umfutho wegazi wehla ngendlela eyingozi.
- Umsebenzi wazo oyinhloko ukucindezela imithambo yegazi, ukwandisa umfutho wegazi, nokuqinisekisa ukuthi igazi ligeleza ezithweni ezibalulekile.
- Ngenxa yamandla ayo kanye nemiphumela emibi engaba khona, le mithi inikezwa kuphela emayunithi okunakekelwa okujulile (ama-ICU), ngaphansi kokuqashwa njalo kodokotela nabasebenzi abahlengikazi.
- Uma wena noma othile oseduze nawe enikezwe lolu hlobo lokwelashwa, kusho ukuthi uyalulama ekuguleni okubi kakhulu. Kubalulekile ukulandela iseluleko sezokwelapha ngokucophelela ngemva kokuphuma esibhedlela.
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