Zonyango ze-ARDS
Unyango lwe ARDS
I-ARDS, okanye i-syndrome yesifo sokuphefumula, iyingozi enkulu yokuphefumula engakhokelela kwisifo esisongela ubomi. Ukuxilongwa kwangaphambili kunye nonyango kubalulekile ekumiseni i-ARDS ngaphambi kokuba kube nzima ukuba umonakalo wombutho okanye ukufa kungenakupheka. Ukuxilongwa kwangaphambili kunye nonyango kubalulekile ukugcina ubomi besigulane esinokufumana i-ARDS.
Iingonyango eziqhelekileyo kwi-ARDS
I-oksijeni: Unyango uqala ngokunika isigulane i-oksijeni ukunceda ukugcina amanqanaba afanelekileyo oksijini egazini. Oku kuqhutyelwa ngokufaka i-intubating isigulane kunye nokusebenzisa i- ventilator . Oku kwenza isigulane siphefumle, nangona xa bebuthathaka kakhulu ukuphefumula ngokwabo, kwaye banokukhupha oksijini ngakumbi kunokuba kutholakala nge- canal okanye kumaski.
I-Antibiotics: Iziza-antibiotics zinikezelwa kwizigulane ze-ARDs ngenxa yentsholongwane , njenge-pneumonia, okanye ezinye iintlobo zentsholongwane. Iimeko ezininzi ze-ARDS ziqala njenge-pneumonia okanye i-aspiration pneumonia, ukwenza i-antibiotics ibalulekile.
I-IV Fluids: Izifo zidlala indima ebalulekileyo ekuncedeni umzimba ukuxhasa yonke imisebenzi yayo ebalulekileyo, kodwa ukufumana umlinganiselo ochanekileyo wobuncitshi kunokuba nzima. Umnto omncinci omncinci kwaye umzimba uphelelwe amanzi, okwenza kube nzima ukuthumela igazi elaneleyo kunye ne-oksijini kumalungu nakwiimida. Uninzi oluninzi lwamanzi lungalimaza amandla omphunga okwenza i-oxygenate igazi.
Umzimba Ukubeka: Ngezinye iimeko kunokuncedisa i-oxygenation ukuba isigulane silale esiswini. Kodwa, ezininzi izigulane ze-ARDS zigule kangangokuthi nokuba utshintsho oluncinci kwisikhundla lunokwenza ukuba imeko yabo ibe yimbi, eyenza ukuba izibhengezo zabasebenzi zibe nzima kakhulu. Ibhedi ejika isigulane kwisisu sayo ngelixa kuvumela uxhaso lwe-IV kunye nokuxhaswa kwendiza yokuqhubeka yinto eqhelekileyo yonyango.
- Jonga iRotoProne, ibhedi esetyenziselwa unyango lwe-ARDS nezinye izifo zokuphefumula. Ukubonakala kombhedlana kuyinto engavamile kwaye inokumangalisa ngamalungu entsapho xa beqala ukumbona othandekayo wabo.
Ukunyangwa kwamayeza:
- I-oxide ye-nitric: I-Oxyde ye-Nitric, okanye i-INO, ifakwe igesi engenabalabala kunye nengenangqumbo edlalwa ngamanye amaxesha njengonyango kwizigulane ze-ARDS. Inikwe ukuphucula ukujikeleza ngaphakathi kwenkqubo yepommonary, eyenza ukwanda kwe-oxygenation. Izifundo azihambelani malunga nokusebenza kwe-INO.
- I-Albuterol: Iyeza zonyango, i-albuterol isetyenziselwa ukunyanga iimpawu ze-asthma ngokuvula i-bronchus. Ingasetyenziselwa kunyango lwe-ARDs ukunceda ukuvula umoya.
I-Steroids: Ukulawulwa kwe-IV steroids kwizigulane ezifunyaniswa ne-ARDS sihloko esicatshulwa ngokutsha kwimithi. Oogqirha bahlula ukuba ingaba i-steroids ayiyiyo yonyango ngempumelelo kwi-ARDS.
I-Levophed: Le nyeza inikwe ukuphucula uxinzelelo lwegazi ngokumisela imithwalo yegazi yomzimba. Izigulane ezininzi ezine-ARDS zinzima ukugcina uxinzelelo lwegazi; eli lonyango linika inkxaso yexinzelelo lwegazi kwaye liyizidakamizwa ezikhethiweyo ezigulane ezisezantsi kwaye zinobunzima be-oxygen.
I-Sedatives kunye ne-Paralytics: Izidalwa zenzelwe ukugcina isigulane sithulile kwaye sibancede ukuba banyamezele ekubeni se-ventilator, enokubangela ukuxhalaba okukhulu. I-paralytics, okanye iziyobisi ezonakalisa ubuninzi bemisipha yomzimba, zisetyenziselwa xa isigulane sichasa i-ventilator ukuvumela i-ventilator ukuba yenze umsebenzi wayo. I-paralytics ayisetyenziswanga ngaphandle kwe-sedation, kodwa i-sedation ingasetyenziswa ngaphandle kokukhubazeka.
I-Surfactant: I- Surfactant yinto enziwe ngamafutha kunye nama-proteins atholakala kwi-alveoli (i-air bags) yemiphunga. Umqhubi osebenzayo uphucula umsebenzi we-alveoli, ukuphucula i-oxygenation.
Umntu owenza i-surfactant udlalwa rhoqo kwiintsana ezisenakusana, ezingenako ukuvelisa ngokwaneleyo. La mayeza anikezelwa kwizigulane ze-ARD kwiimeko ezingaqhelekanga.
Emva kweARDS
Xa isiguli sifumaneka nge-ARDS, izinga lokufa liye lafikelela kuma-40%, oku kuthetha ukuba ezine ezilishumi kwizigulane ezifunyaniswe ne-ARDS ziyafa. Izigulane ezihlala zisenza njalo ngenxa yokuba zifumene unyango kwaye ziphathwa kakubi kakhulu nangonyango olufanelekileyo. Nangona iifomati zibuhlungu, unyango lwe-ARD luphucula unyaka ngamnye, kwaye izigulane ezininzi ziphila.
Kuqhelekile ukuba uzive uphelile, uphefumla kwaye ugule ngokubanzi emva kwe-ARDS. Kungathatha iiveki okanye iinyanga ukuba uzive eziqhelekileyo, nangemva kokukhutshwa esibhedlele. Kwezinye izigulane, ukutshatyalaliswa kwemiphunga kungathetha ukuba i-oxygenation ayilunganga njengoko yayingaphambi kokugula, kubangela ukuziva ukukhathala.
Imithombo:
I-Oxyde ye-Nitric Inhaled For Adult Respiratory Distress Syndrome. I-New England Journal of Medicine. Kufumaneka ngoJanuwari 2011. http://www.nejm.org/doi/full/10.1056/NEJM199307153290313
Iimali zokufa kubantu abagulayo abanezifo ezinzima zokulimala / i-ARDS ziye zadlula ixesha. UMnu Zambon, J. Vincent. Isifuba: Umbhalo we-American College of Lung Physicians. Julayi 2008.
Yintoni i-ARDS? I-Heart Heart Lung ne-Blood Institute. Kufike ngoJanuwari 2011. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhatIs.html