I-Sepsis

I-Sepsis ukugula lapho umzimba unempendulo ebukhali, yokuvuvukala kubhaktheriya noma amanye amagciwane.

Izimpawu ze-sepsis azibangelwa amagciwane uqobo. Esikhundleni salokho, amakhemikhali akhishwa ngumzimba abangela impendulo.

Ukutheleleka kwamagciwane noma yikuphi emzimbeni kungahle kususe impendulo eholela ku-sepsis. Izindawo ezivamile lapho ukutheleleka kungaqala khona kufaka phakathi:

• Ukugeleza kwegazi
• Amathambo (ajwayelekile ezinganeni)
• Isisu (esivame ukubonwa nge-peritonitis)
• Izinso (ukutheleleka okuphezulu komchamo, i-pyelonephritis noma i-urosepsis)
• Ulwelwesi lobuchopho (meningitis)
• Isibindi noma i-gallbladder
• Amaphaphu (i-pneumonia yebhaktheriya)
• Isikhumba (cellulitis)

Kubantu abasesibhedlela, izindawo ezivamile zokutheleleka zibandakanya imigqa efakwa emithanjeni, amanxeba okuhlinzwa, amadreyini okuhlinzwa, kanye nezindawo zokonakala kwesikhumba, ezaziwa njengezilonda zokulala noma izilonda zengcindezi.

I-Sepsis ivame ukuthinta izinsana noma abantu abadala asebekhulile.

Ku-sepsis, umfutho wegazi wehla, okuholele ekuthukeni. Izitho ezinkulu nezinhlelo zomzimba, kufaka phakathi izinso, isibindi, amaphaphu nohlelo lwemizwa oluphakathi zingayeka ukusebenza kahle ngenxa yokuhamba kwegazi okungafanele.

Ukushintsha kwesimo sengqondo nokuphefumula okusheshayo kungaba yizimpawu zokuqala ze-sepsis.

Ngokuvamile, izimpawu ze-sepsis zingabandakanya:

• Amakhaza
• Ukudideka noma i-delirium
• Imfiva noma ukushisa komzimba okuphansi (hypothermia)
• Ubumhlophe ngenxa yengcindezi yegazi ephansi
• Ukushaya kwenhliziyo okusheshayo
• Ukuqhuma kwesikhumba noma isikhumba esinamabala
• Isikhumba esifudumele

Umhlinzeki wezokunakekelwa kwempilo uzohlola lowo muntu bese ebuza ngomlando wezempilo womuntu.

Ukutheleleka kuvame ukuqinisekiswa ngokuhlolwa kwegazi. Kodwa ukuhlolwa kwegazi kungahle kungadaluli ukutheleleka kubantu abebethola ama-antibiotic. Ezinye izifo ezingadala i-sepsis azikwazi ukutholwa ngokuhlolwa kwegazi.

Olunye uvivinyo olungenziwa lubandakanya:

• Ukuhlukaniswa kwegazi
• Amagesi egazi
• Ukuhlolwa kokusebenza kwezinso
• Ukubalwa kweplatelet, imikhiqizo yokonakaliswa kwe-fibrin, nezikhathi ze-coagulation (PT ne-PTT) ukuhlola ubungozi bokuphuma kwegazi
• Isibalo samangqamuzana amhlophe egazi

Umuntu one-sepsis uzongeniswa esibhedlela, imvamisa egunjini labagula kakhulu (i-ICU). Imithi elwa namagciwane ivame ukunikezwa ngomthambo (ngemithambo yegazi).

Ezinye izindlela zokwelashwa zifaka:

• Oxygen ukusiza ngokuphefumula
• Uketshezi olunikezwa ngomthambo
• Imithi enyusa umfutho wegazi
• I-Dialysis uma kunokuhluleka kwezinso
• Umshini wokuphefumula (i-mechanical ventilation) uma kukhona ukwehluleka kwamaphaphu

I-Sepsis ivame ukusongela impilo, ikakhulukazi kubantu abanamasosha omzimba abuthakathaka noma abagula isikhathi eside (esingapheli).

Ukulimala okubangelwa ukwehla kokugeleza kwegazi kuya ezithombeni ezibalulekile ezinjengobuchopho, inhliziyo, nezinso kungathatha isikhathi ukuthuthuka. Kungaba nezinkinga zesikhathi eside ngalezi zitho.

Ubungozi be-sepsis bungancishiswa ngokuthola yonke imigomo enconywayo.

Esibhedlela, ukugeza izandla ngokucophelela kungasiza ekuvikeleni izifo ezitholwa ezibhedlela eziholela kwi-sepsis. Ukususwa ngokushesha kwama-catheters okuchama kanye nolayini be-IV lapho bengasadingeki nakho kungasiza ekuvimbeleni izifo eziholela ku-sepsis.

I-Septicemia; I-Sepsis syndrome; Isistimu yokuphendula evuthayo; SIRS; Ukushaqeka kwe-Septic

UShapiro NI, uJones AE. Ama-Sepsis syndromes. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 130.

Umculi M, Deutschman CS, Seymour CW, et al. Izincazelo zesithathu zokuvumelana kwamazwe omhlaba kwe-sepsis nokwethuka kwaseseptic (sepsis-3). JAMA. 2016; 315 (8): 801-810. I-PMID 26903338 pubmed.ncbi.nlm.nih.gov/26903338/.

van der Poll T, iWiersinga WJ. I-Sepsis nokwethuka okubucayi. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 73.