Cabanga ngomuntu oseduze nawe ngokuzumayo egula kakhulu bese engeniswa e-Intensive Care Unit (ICU). Odokotela bathi, 'Umfutho wegazi (BP) uphansi kakhulu, futhi kudingeka kuqalwe umuthi okhethekile ukuze ukhuliswe.' Kungenzeka ukuthi uke wezwa amagama anjengokuthi 'ama-pressors' eqalwa. Ama-Vasopressors ayiqembu elibaluleke kakhulu lemithi esetshenziswa empini esindisa impilo kangaka. Kubaluleke kakhulu ukwazi ukuthi iyini ngempela le mithi. Ngakho ake sixoxe ngalokhu namuhla.
Kalula nje, ziyini lezi Vasopressors?
Ama-vasopressor ayimithi enamandla esetshenziswa odokotela ukwandisa umfutho wegazi owehle kakhulu. Ngokuvamile anikezwa iziguli ezishaqekile . Kulesi simo sokushaqeka, umfutho wegazi wehla kakhulu kangangokuthi izitho ezibalulekile zomzimba, njengobuchopho, inhliziyo nezinso, zincishwa igazi elicebile ngomoya-mpilo ezilidingayo. Lokhu kungalimaza lezo zitho futhi kube yingozi ngisho nokuphila.
Ngokuvamile, lapho umfutho wegazi womuntu wehla, into yokuqala abayenzayo ukunikeza usawoti (i-IV fluids). Kodwa-ke, uma umfutho wegazi ungakhuphuki ufike ezingeni elifunekayo ngisho nangemva kokunikeza usawoti, odokotela basebenzisa lawa ma-vasopressor njengesinyathelo esilandelayo.
Le mithi inikezwa kanjani emzimbeni?
Ngenxa yokuthi le mithi inamandla kakhulu, ayivame ukunikezwa nge-cannula efakwe emthanjeni engalweni. Inikezwa nge -'central venous catheter' . Lena yipayipi ekhethekile efakwa emthanjeni omkhulu wegazi entanyeni, esifubeni noma endukwini. Ngale ndlela, umuthi ungena ngqo emthanjeni omkhulu oseduze nenhliziyo, okwenza kube okuphephile futhi okusheshayo ukusebenza.
Kwenzekani emzimbeni nge-vasopressors?
Le mithi inemisebenzi emibili eyinhloko:
1. Ukuminyana: Cabanga ngepayipi lamanzi. Uma sicindezela ipayipi kancane, isivinini kanye nokucindezela kwamanzi kuzokhula, akunjalo? Ama-vasopressor enza into efanayo. Le mithi ibangela ukuthi imithambo yegazi emincane emzimbeni wethu iminyane okwesikhashana. Lokhu kubangela ukuthi umfutho wegazi ukhuphuke.
2. Ukwandisa ukusebenza kwenhliziyo: Ezinye izinhlobo ze-vasopressor zithinta imisipha yenhliziyo, zisize inhliziyo ukuthi ipompe igazi ngamandla amakhulu.
Ngalezi zindlela zombili, umfutho wegazi ophansi uyakhula futhi igazi liqala ukugeleza kahle ezithweni ezibalulekile futhi.
Into ebalulekile ukuthi le mithi ayisetshenziselwa ukwelapha isifo. Isetshenziselwa ukulawula umfutho wegazi nokuvikela izitho zomzimba ngenkathi kwelashwa isimo esiyisisekelo (isib. ukutheleleka okukhulu, ukuhlaselwa yinhliziyo).
Izinhlobo Nezibonelo Ze-Vasopressor Ezisetshenziswa Kaningi
Izinhlobo ezahlukene zokucindezela imithambo yegazi zisetshenziswa emagunjini okunakekela abagula kakhulu. Udokotela ukhetha umuthi ofanele kakhulu ngokusekelwe esimweni sesiguli.
| Igama Elijwayelekile | Inothi |
|---|---|
| I-Norepinephrine | Kungumuthi ovame ukusetshenziswa ezimweni eziningi zokushaqeka. |
| I-Epinephrine (i-Adrenaline) | Isetshenziswa ezifweni zokungezwani komzimba okukhulu (i-anaphylaxis) kanye nokuhlaselwa yinhliziyo. |
| I-Vasopressin | Ngokuvamile kusetshenziswa kanye ne-Norepinephrine. |
| I-Dopamine | Imithamo ephansi ithinta izinga lokushaya kwenhliziyo kanye nomfutho wegazi. |
| I-Phenylephrine | Ivame ukusetshenziswa ekucindezelekeni kwegazi okuphansi okubangelwa yi-anesthesia. |
Ingabe nathi sisebenzisa ama-vasopressor ngokungazi?
Yebo, ngezinga elithile. Ama-decongestant ekhala, asetshenziselwa ukunciphisa ukuminyana kwamakhala uma unomkhuhlane, nawo aqukethe umuthi ominyanisa imithambo yegazi. Lokhu kuqinisa imithambo yegazi ngaphakathi kwekhala, kunciphisa ukuvuvukala futhi kwenze kube lula ukuphefumula. Futhi, i-EpiPen® , eyisicindezeli esinamandla se-vasopressor okufanele abantu abane-allergies enzima bayigcine eduze, iqukethe i-epinephrine.
Kukuziphi izimo zezokwelapha lapho le mithi idingeka khona?
Ama-vasopressor ayindlela yokwelapha yokusekela impilo. Ayadingeka ezimweni ezibucayi kakhulu nezisongela impilo.
- Ukushaqeka: Ukushaqeka okubangelwa ukutheleleka okukhulu (ukushaqeka kwe-septic), ukwehluleka kwenhliziyo (ukushaqeka kwenhliziyo), noma ukopha ngokweqile.
- I-Sepsis:Njengoba ingakwazi ukulawula ukutheleleka okungene emzimbeni, wonke umzimba usabela ngendlela engavamile, okubangela ukwehla komfutho wegazi.
- Ukuhlaselwa Yinhliziyo Nokwehluleka Kwenhliziyo: Lapho inhliziyo ingakwazi ukupompa igazi ngendlela efanele.
- Ngesikhathi sokuhlinzwa: Ikakhulukazi uma umfutho wegazi wehla ngenxa yokuhlinzwa komgogodla.
- Ukusabela okukhulu kwezidakamizwa noma ukulunywa yinyoka.
- Ngesikhathi sokuvuselelwa kwenhliziyo okuphuthumayo (CPR).
Ingabe ama-vasopressor anemiphumela emibi?
Yebo. Lezi izidakamizwa ezinamandla kakhulu futhi kunengozi yemiphumela emibi. Yingakho zinikezwa kuphela egunjini lokunakekelwa okujulile (ICU), ngaphansi kokuqashwa njalo kodokotela nabahlengikazi. Konke kusukela ekushayeni kwenhliziyo yesiguli, umfutho wegazi, kanye namazinga omoya-mpilo kubhekwa njalo ngabaqaphi.
Eminye yemiphumela emibi engaba khona:
- Ukukhathazeka kanye nekhanda elibuhlungu.
- Ubuhlungu besifuba.
- Ukuphazamiseka kwesilinganiso senhliziyo - isivinini esikhulu (i-Tachycardia) noma isivinini esinciphile (i-Bradycardia).
- Ukwanda ngokweqile komfutho wegazi.
- Ukuncipha kokunikezwa kwegazi ezinzwaneni ngenxa yokucinana okukhulu kwemithambo yegazi.
- Ingozi yokuqhekeka kwegazi (i-thromboembolism).
Ithimba lezokwelapha lihlala liqapha isiguli ukuze linciphise le miphumela emibi. Bahlala belungisa umthamo womuthi njengoba kudingeka.
Isikhathi sokutakula
Ama-vasopressor ayisimo esibucayi kakhulu sezokwelapha esidinga ukuthi uwasebenzise. Isikhathi sokululama sizoncika esimweni esiyisisekelo esibangele ukuthi unikezwe le mithi. Kungase kudingeke uhlale esibhedlela amasonto noma izinyanga. Ngisho nangemva kokufika ekhaya, udinga ukuzinika isikhathi sokubuyela esimisweni sakho esijwayelekile.
Uma usubuyile ekhaya, kubaluleke kakhulu ukuphuza yonke imithi oyinikezwe udokotela wakho ngesikhathi, ngesilinganiso esifanele, nokuya emihlanganweni yakho yasemtholampilo ngesikhathi. Uma uhlangabezana nanoma yiziphi izimpawu ezifana nokuzizwa ungaphilile, ubuhlungu besifuba, noma ubunzima bokuphefumula, xhumana nodokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
Umlayezo Wokuya Nawe Ekhaya
- Ama-vasopressor ayiqembu lemithi enamandla engasiza ekusindiseni izimpilo ngokwandisa umfutho wegazi ophansi kakhulu.
- Lokhu kusebenza ngokunciphisa imithambo yegazi nokwandisa ukusebenza kwenhliziyo.
- Le mithi inikezwa kuphela emagunjini okunakekela abagula kakhulu (i-ICU), ngaphansi kokuqashwa njalo kodokotela.
- Nakuba lokhu kunemiphumela emibi, amaqembu ezokwelapha asebenza njalo ukuze akulawule.
- Kuthatha isikhathi ukululama ngokuphelele ngemva kokuthola lolu hlobo lokwelashwa, futhi kubaluleke kakhulu ukulandela iseluleko sezokwelapha.
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