Isifo sengcindezi ephathelene nenkinga yokuphefumula engamahlalakhona

Isifo sokuphefumula esibucayi (i-ARDS) yisimo samaphaphu esisongela impilo esivimbela umoya-mpilo owenele ukuthi ungangeni emaphashini nasegazini. Izinsana nazo zingaba nesifo sokuphefumula.

I-ARDS ingabangelwa noma yikuphi ukulimala okukhulu okuqondile noma okungaqondile emaphashini. Izimbangela ezivamile zifaka:

• Ukuhlanza okuphefumulayo emaphashini (ukufisa)
• Ukuhogela amakhemikhali
• Ukufakelwa komlenze
• Inyumoniya
• Ukushaqeka kwe-Septic (ukutheleleka emzimbeni wonke)
• Ukuhlukumezeka

Ngokuya ngenani leoksijini egazini nangesikhathi sokuphefumula, ubunzima be-ARDS buhlukaniswa njenge:

• Omnene
• Maphakathi
• Kakhulu

I-ARDS iholela ekwakhiweni koketshezi emasakeni emoyeni (alveoli). Lolu ketshezi luvimbela umoya-mpilo owanele ukuba ungadluleli egazini.

Ukwakhiwa koketshezi kwenza namaphaphu asinde futhi aqinise. Lokhu kunciphisa amandla amaphaphu okukhula. Izinga le-oxygen egazini lingahlala liphansi ngendlela eyingozi, noma ngabe umuntu ethola umoya-mpilo emshinini wokuphefumula (umshini wokuphefumula) ngepayipi lokuphefumula (i-endotracheal tube).

I-ARDS ivame ukwenzeka kanye nokwehluleka kwezinye izinhlelo zomzimba, njengesibindi noma izinso. Ukubhema ugwayi nokusebenzisa kakhulu utshwala kungaba yizici eziyingozi ekukhuleni kwayo.

Izimpawu zivame ukukhula phakathi kwamahora angama-24 kuya kwangu-48 wokulimala noma ukugula. Imvamisa, abantu abane-ARDS bagula kakhulu abakwazi ukukhononda ngezimpawu. Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukuphelelwa umoya
• Ukushaya kwenhliziyo okusheshayo
• Umfutho wegazi ophansi nokwehluleka komzimba
• Ukuphefumula ngokushesha

Ukulalela isifuba nge-stethoscope (auscultation) kuveza imisindo yokuphefumula engajwayelekile, njengama-crackles, okungaba yizimpawu zoketshezi emaphashini. Imvamisa umfutho wegazi uphansi. I-cyanosis (isikhumba esiluhlaza okwesibhakabhaka, izindebe nezinzipho ezibangelwa ukungabi nomoya-mpilo ezicutshini) kuvame ukubonwa.

Ukuhlolwa okusetshenziselwa ukuxilonga i-ARDS kufaka:

• Igazi legazi lomzimba
• Ukuhlolwa kwegazi, kufaka phakathi i-CBC (ukubalwa kwegazi okuphelele) kanye namakhemikhali egazi
• Amasiko egazi nomchamo
• I-Bronchoscopy kwabanye abantu
• I-x-ray yesifuba noma i-CT scan
• Amasiko wesikhohlela nokuhlaziywa
• Ukuhlolwa kokutheleleka okungenzeka

Kungadingeka i-echocardiogram ukukhipha ukwehluleka kwenhliziyo, okungabukeka kufana ne-ARDS ku-x-ray yesifuba.

Ama-ARDS kaningi adinga ukwelashwa egumbini labagula kakhulu (i-ICU).

Inhloso yokwelashwa ukuhlinzeka ukwesekwa kokuphefumula nokwelapha imbangela ye-ARDS. Lokhu kungabandakanya imithi yokwelapha izifo, ukunciphisa ukuvuvukala, nokususa uketshezi emaphashini.

I-ventilator isetshenziselwa ukuletha imithamo ephezulu ye-oxygen nengcindezi enhle emaphashini alimele. Abantu bavame ukudinga imishanguzo ngokujulile. Ngesikhathi sokwelashwa, abahlinzeki bezempilo benza yonke imizamo ukuvikela amaphaphu ekulimaleni okuqhubekayo. Ukwelashwa kusekela ikakhulukazi kuze kube yilapho amaphaphu elulama.

Kwesinye isikhathi, kwenziwa ukwelashwa okubizwa nge-extracorporeal membrane oxygenation (ECMO). Ngesikhathi se-ECMO, igazi liyahlungwa ngomshini ukuhlinzeka nge-oxygen nokususa isikhutha.

Amalungu amaningi omndeni wabantu abane-ARDS angaphansi kwengcindezi enkulu. Imvamisa bangakhulula lokhu kucindezeleka ngokujoyina amaqembu okusekela lapho amalungu abelana ngokuhlangenwe nakho okuvamile nezinkinga.

Cishe umuntu oyedwa kwabathathu abane-ARDS babulawa yilesi sifo. Labo abaphila kaningi babuyela emuva emisebenzini yabo ejwayelekile yamaphaphu, kepha abantu abaningi banomonakalo wamaphaphu unomphela (imvamisa omncane).

Abantu abaningi abasinda ku-ARDS banokulahleka kwememori noma ezinye izinkinga zekhwalithi yempilo ngemuva kokululama. Lokhu kungenxa yokulimala kobuchopho okwenzeka lapho amaphaphu engasebenzi kahle futhi nengqondo yayingatholi umoya-mpilo owenele. Abanye abantu bangaba nengcindezi ngemuva kokuhlukumezeka ngemuva kokusinda kuma-ARDS.

Izinkinga ezingabangelwa yi-ARDS noma ukwelashwa kwayo zifaka:

• Ukwehluleka kwezinhlelo eziningi zomzimba
• Ukulimala kwamaphaphu, njengephaphu eliwile (elibizwa nangokuthi i-pneumothorax) ngenxa yokulimala okuvela emshinini wokuphefumula odingekayo ukwelapha lesi sifo
• I-pulmonary fibrosis (ukusika kwamaphaphu)
• I-pneumonia ehambisana nomoya

I-ARDS ivame ukwenzeka ngesikhathi sesinye isifo, lapho umuntu esesivele esibhedlela. Kwezinye izimo, umuntu ophilile une-pneumonia enamandla eba yimbi kakhulu futhi ibe yi-ARDS. Uma unenkinga yokuphefumula, shayela inombolo yakho yendawo ephuthumayo (njenge-911) noma uye egumbini lezimo eziphuthumayo.

I-edema yamaphaphu engaphefumulwanga; Ukwanda-permeability edema yamaphaphu; I-ARDS; Ukulimala kwamaphaphu

• Imikhuhlane nomkhuhlane - yini ongayibuza udokotela wakho - umuntu omdala
• Imikhuhlane nomkhuhlane - yini ongayibuza udokotela - ingane yakho
• Lapho ingane noma usana lwakho lunomkhuhlane

• Amaphaphu
• Uhlelo lokuphefumula

U-Lee WL, uSlutsky AS. Ukwehluleka okuphefumulayo okuphefumulayo kwe-hypoxemic kanye ne-ARDS. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 100.

I-Matthay MA, i-Ware LB. Ukwehluleka okukhulu kokuphefumula. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 96.

Seigel TA. Ukungenisa umoya ngomshini nokuxhaswa komoya okungavumelekile. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 2.