Ubunzima be-Airway Pressure Versus CPAP
Uxinzelelo lwe-Bi-positive olungenayo umoya (BiPAP) luhlobo lokungenwa kwemimoya engavumelekiyo ekunceda ukugcina umoya ophezulu wamaphaphu uvule ngokubonelela ukuhamba kwemoya ekhutshwe ngumzobo. Umoya ucindezelwa ngumshini, owuhambisa kwi-mask ebusweni ngokude, iplastiki ihamba.
Ukuqonda i-BiPAP
I-BiPAP yisistim esinika ukunikezelwa kwemoya ecinezelekileyo kwisixhobo setafile, ngokusebenzisa imaski yobuso ukuxhasa ukuphefumla.
Ngandlela-thile, ifana ne-CPAP, kodwa nge-BiPAP, ugqirha ukhankanya uxinzelelo oluthile olongezelelweyo: Umxinzelelo ophezulu usetyenziselwa ukuphefumula (obizwa ngokuba yi-inspiratory positive airway pressure, okanye i-IPAP) kunye nengcinezelo esezantsi isetyenziswa xa iphefumula ( kuthiwa yi-expiratory pressureway, okanye i-EPAP).
Indlela i-BiPAP inceda ngayo ngeCOPD
Abantu abaneCOPD banenkinga yokuphefumla, okusoloko kubi kakhulu ebusuku. Ebusuku, izihlunu ezisele zabuthathaka kumntu ono-COPD zingawa, zonakalise ukuphazamiseka komoya okuqhubekayo nesifo. Xa oko kwenzeka, kunokuba nzima kubagulana ukugcina i-airways yabo ivule ngokwaneleyo ukugcina amanqanaba abo okwenzela i- oksijeni , kwaye ngexesha elinye ligcine iqondo le-carbon dioxide egazini layo phantsi ( gwema ukuxhamla .) I-BiPAP inokukunceda ngoku ihlale ixinzelelwe emoyeni ngokusebenzisa imaski eyanciphisa umsebenzi omele wenziwe ngokuchithwa kwe-gas okwaneleyo kunye ne-carbon dioxide eyenzekayo kwi- alveoli .
Kucingelwa ukuba i-BiPAP inokukunceda ngokuvumela ukuba sele iyanciphisa imisipha yokuphefumula ukuze uphucule ixesha elithile ebusuku.
BiPAP vs CPAP
Kwizigulane zeCOPD, i-BiPAP yindlela ekhethiweyo yokonyango kwi- CPAP (ukuqhubeka kwengcinezelo ehamba phambili ) kuba kulula ukuba ezi gulane zikhuphe ukuxhomekeka kweengcinezelo eziphantsi.
Kunokuba nzima ukuba nabani na ukuba baphumelele ekuchaseni uxinzelelo (yiyo ke i-BiPAP isetyenziswe ngamanye amaxesha esikhundleni se-CPAP ye-apnea yokulala), kodwa oku kunokuba nzima kakhulu kwi-COPD, apho ukuphuma komlilo kunengxaki kunokuba kuphuculwe. I-BiPAP ibuye ivumeleke utshintsho kwixesha, elona luncedo kakhulu kulabo abaneCOPD ekuphumeni kwayo.
Xa isetyenziswe ngeCOPD
Kukho izicwangciso ezininzi apho i-BiPAP ingasetyenziselwa abantu abaneCOPD. Ezi ziquka:
- Ngokwehluleka ukuphefumula ukuphefumula (uhlobo lokuphefumula oluphefumulayo II apho uphawu oluphambili lugcinwa kwekhabhoni dioxide) njengenye indlela yokuphuphuma umoya.
- Kwabantu abanomdareyitha obunzima kwi-dyspnea (ukuvakalelwa komphefumlo omncinci), i-tachypnea (ukuphefumula okukhawulezayo kodwa okungapheliyo), ukwanda kwamazinga e-carbon dioxide egazini (hypercapnia) negazi pH ka-7.25 ukuya ku-7.35 .
Iinzuzo zeBiPAP
Ukusetyenziswa kwe-BiPAP, xa kubonisiwe, kunokunciphisa inani le-COPD ekukhusheni komnye umntu, kunye nokunciphisa imfuno yokupakisha umoya (inkxaso yokuphefumula). I-BiPAP inokukwenza ukubahluko phakathi kwexesha lokuphila kwaye lufunyenwe ukunciphisa kakhulu ingozi yokufa kwesi sifo.
Ukuqapha kunye neengxaki
Ukusetyenziswa kwe-non-vasive ventilation kwi-COPD kusekho kumanyathelo okuqala okuvandlakanywa ngeendlela ezininzi, kwaye indima yayo efanelekileyo kwizigulane ngeCOPD isagqitywa.
Nangona kunokuba luncedo kakhulu kwabanye abantu abanesi sifo, akunakunceda wonke umntu. Ngeli xesha, akufanele isetyenziswe kubantu abangenasisigxina sempilo, njengalezo ezinexinzelelo lwegazi okanye izifo ezinzulu. Izigulane ezine-acidosis ezinzulu (i-PH ephantsi) kunye nabanentsholongwane yentliziyo (i-tachycardia) ngokukodwa, kubonakala bengenzi kakuhle kule nyango.
> Imithombo:
> Ankaergaard, K., Tonnesen, P., Laursen, L. et al. I-Home NonInvasive Ventilation (NIV) Ukunyangwa kwezilwanyana ze-COPD ezineMbali ye-NIV-Treatment exaceration; UFundo oluPhuhlileyo, oluPhezulu, oluPhakathi. BMC Pulmonary Medicine . 2016. 16 (1): 32.
> Duiverman, M., Windisch, W., Storre, J., noP. Wijkstra. Indima ye-NIV kwi-COPD engapheliyo ye-Chronic Personnel emva kokuqhaqhaqhaqha okukhulu: ukubaluleka kokukhethwa komonde. Uphuhliso lwezeMpilo kwizifo eziphefumulayo . 2016. 10 (2): 149-57.
> I-Gay, P. Ebusuku I-Ventilatory Support kwiCOPD. Isemgangathweno.
> Ko, B., Ahn, S., Lim, K. et al. Ukungaphumeleli kokuqala koMoya ongenaMoya ongenakunqandwa kwezifo eziPhephayo eziPhezulu ezingapheliyo kunye ne-Hypercapnic Respiratory Failure. I-Medicine yangaphakathi kunye noXakeka . 2015. 10 (7): 855-60.