Ukushaqeka Hypovolemic

Ukushaqeka kwe-hypovolemic yisimo esiphuthumayo lapho igazi elibi noma okunye ukulahleka koketshezi kwenza inhliziyo ingakwazi ukupompa igazi elanele emzimbeni. Lolu hlobo lokushaqeka lungadala ukuthi izitho eziningi ziyeke ukusebenza.

Ukulahlekelwa cishe ingxenye eyodwa yesihlanu noma ngaphezulu yegazi elijwayelekile emzimbeni wakho kubangela ukushaqeka okukhulu.

Ukwehla kwegazi kungaba ngenxa yalokhu:

• Ukopha kusuka ekusikeni
• Ukopha ngokunye ukulimala
• Ukopha kwangaphakathi, njengasemgodini wamathumbu

Inani legazi elijikelezayo emzimbeni wakho nalo lingase lehle lapho ulahlekelwa uketshezi lomzimba oluningi kakhulu kwezinye izimbangela. Lokhu kungabangelwa:

• Kushe
• Uhudo
• Ukujuluka okweqile
• Ukuhlanza

Izimpawu zingafaka:

• Ukukhathazeka noma ukuphazamiseka
• Isikhumba esipholile, esikhanyayo
• Ukudideka
• Ukwehla komchamo noma kunciphile
• Ubuthakathaka obujwayelekile
• Umbala wesikhumba okhanyayo (i-pallor)
• Ukuphefumula ngokushesha
• Ukujuluka, isikhumba esimanzi
• Ukungazi lutho (ukuntuleka kokuphendula)

Ukwehla kwegazi kukhulu futhi kushesha ngokwengeziwe, ziba zimbi kakhulu izimpawu zokushaqeka.

Ukuhlolwa ngokomzimba kuzokhombisa izimpawu zokwethuka, kufaka phakathi:

• Umfutho wegazi ophansi
• Izinga lokushisa lomzimba eliphansi
• Ishayela ngokushesha, imvamisa ibuthakathaka futhi ivuthiwe

Ukuhlolwa okungenziwa kufaka phakathi:

• I-chemistry yegazi, kufaka phakathi ukuhlolwa kwezinso zokusebenza kwalezo zivivinyo ezifuna ubufakazi bokulimala kwemisipha yenhliziyo
• Qedela ukubalwa kwegazi (CBC)
• I-CT scan, i-ultrasound, noma i-x-ray yezindawo ezisolwayo
• I-Echocardiogram - ukuhlolwa kwegagasi lomsindo lesakhiwo senhliziyo nokusebenza
• I-Electrocardiogram
• I-Endoscopy - ithubhu efakwa emlonyeni iya esiswini (i-endoscopy ephezulu) noma i-colonoscopy (ithubhu ebekwe nge-anus kuya emathunjini amakhulu)
• Inhliziyo efanele (Swan-Ganz) catheterization
• I-catheterization ye-Urinary (ishubhu efakwa esinyeni ukukala ukuphuma komchamo)

Kwezinye izimo, ezinye izivivinyo zingenziwa futhi.

Thola usizo lwezokwelapha ngokushesha. Okwamanje, landela lezi zinyathelo:

• Gcina umuntu ekhululekile futhi efudumele (ukugwema i-hypothermia).
• Yenza umuntu alale phansi izinyawo ziphakanyiswe cishe ngamasentimitha ayi-12 (30 cm) ukukhulisa ukusakazwa kwegazi. Kodwa-ke, uma umuntu enekhanda, intamo, iqolo, noma ukulimala emlenzeni, ungaguquli isikhundla somuntu ngaphandle kwalapho esengozini ngokushesha.
• Unganiki uketshezi ngomlomo.
• Uma umuntu enenkinga yokungezwani nezinto ezithile, phendula ukusabela okweqile, uma wazi kanjani.
• Uma umuntu kufanele athwelwe, zama ukumgcina eyisicaba, ikhanda liphansi nezinyawo ziphakanyisiwe. Qinisa ikhanda nentamo ngaphambi kokuhambisa umuntu olimale umgogodla osolwayo.

Inhloso yokwelashwa esibhedlela ukufaka esikhundleni segazi noketshezi. Kuzofakwa ulayini ngaphakathi (IV) engalweni yomuntu ukuvumela ukunikezwa kwegazi noma imikhiqizo yegazi.

Imithi efana ne-dopamine, i-dobutamine, i-epinephrine, ne-norepinephrine ingadingeka ukukhulisa umfutho wegazi kanye nenani legazi elikhishwe enhliziyweni (ukuphuma kwenhliziyo).

Izimpawu nemiphumela ingahluka, kuya nge:

• Inani levolumu yegazi / uketshezi elahlekile
• Izinga lokulahleka kwegazi / uketshezi
• Ukugula noma ukulimala okubangela ukulahleka
• Izimo zezokwelapha ezingapheli, njengesifo sikashukela nenhliziyo, amaphaphu, nesifo sezinso, noma okuhlobene nokulimala

Ngokuvamile, abantu abaneziqu ezishaqisayo zokuthuka bavame ukwenza kangcono kunalabo abanokushaqeka okukhulu. Ukushaqeka okukhulu kwe-hypovolemic kungaholela ekufeni, noma ngabe unakekelwa ngokushesha. Abantu abadala abadala banamathuba amaningi okuthola imiphumela emibi ngenxa yokwethuka.

Izinkinga zingafaka:

• Ukulimala kwezinso (kungadinga ukusetshenziswa kwesikhashana noma unomphela komshini we-dialysis dials)
• Ukulimala kobuchopho
• Ukuqothuka kwezingalo noma imilenze, kwesinye isikhathi kuholele ekunqunyweni komzimba
• Isifo senhliziyo
• Okunye ukulimala komzimba
• Ukufa

Ukushaqeka kwe-Hypovolemic kuyisimo esiphuthumayo sezokwelapha. Shayela inombolo yendawo ephuthumayo (efana no-911) noma umhambise egumbini labezimo eziphuthumayo.

Ukuvimbela ukwethuka kulula kunokuzama ukuselapha uma sekwenzekile. Ukwelapha imbangela ngokushesha kuzonciphisa ubungozi bokushaqeka okukhulu. Usizo lokuqala lokuqala lungasiza ekulawuleni ukushaqeka.

Ukushaqeka - ukuzenzisa

I-Angus DC. Sondela esigulini ngokwethuka. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 98.

UDries DJ. I-Hypovolemia nokwethuka okuhlukumezayo: ukuphathwa kokuhlinzwa. Ku: Parrillo JE, Dellinger RP, ama-eds. Imithi Yokunakekelwa Okubalulekile: Izimiso Zokuxilongwa Nokuphathwa Kwabantu Abadala. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2019: isahluko 26.

Maiden MJ, Peake SL. Sibutsetelo sokushaqeka. Ku: Bersten AD, Handy JM, eds. Ibhukwana Lokunakekela Abagula Ngokujulile. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 15.

IPuskarich MA, uJones AE. Ukushaqeka. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 6.