Ukuhlolwa Kwegazi le-CO2

-Delile

• Kuyini ukuhlolwa kwegazi kwe-CO2?
• Kungani ukuhlolwa kwegazi kwe-CO2 kuyaliwe
• Isampuli yegazi ithathwa kanjani
• Isampula yegazi le-Venipuncture
• Isampula yegazi
• Ukulungiselela kanjani ukuhlolwa kwegazi lakho
• Izingozi zokuhlolwa kwegazi le-CO2
• Imiphumela yokuhlola
• I-bicarbonate ephansi (HCO3)
• I-bicarbonate ephezulu (HCO3)
• Umbono wesikhathi eside

Kuyini ukuhlolwa kwegazi kwe-CO2?

Ukuhlolwa kwegazi kwe-CO2 kukala inani le-carbon dioxide (CO2) ku-serum yegazi, okuyingxenye yegazi ewuketshezi. Isivivinyo se-CO2 singabizwa futhi:

• ukuhlolwa kwesikhutha
• isivivinyo se-TCO2
• ukuhlolwa okuphelele kwe-CO2
• ukuhlolwa kwe-bicarbonate
• ukuhlolwa kwe-HCO3
• i-CO2 test-serum

Ungase uthole ukuhlolwa kwe-CO2 njengengxenye yephaneli yemethabolic. Iphaneli yemetabolism yiqembu lezivivinyo ezilinganisa ama-electrolyte namagesi egazi.

Umzimba uqukethe izinhlobo ezimbili ezinkulu ze-CO2:

• I-HCO3 (i-bicarbonate, ifomu eliyinhloko le-CO2 emzimbeni)
• I-PCO2 (isikhutha)

Udokotela wakho angasebenzisa lokhu kuhlola ukuthola ukuthi kukhona yini ukungalingani phakathi kwe-oxygen ne-carbon dioxide egazini lakho noma ukungalingani kwe-pH egazini lakho. Lokhu kungalingani kungaba izimpawu zesifo sezinso, sokuphefumula, noma se-metabolic.

Kungani ukuhlolwa kwegazi kwe-CO2 kuyaliwe

Udokotela wakho uzoku-oda ukuhlolwa kwegazi le-CO2 ngokuya ngezimpawu zakho. Izimpawu zokungalingani kwe-oxygen ne-carbon dioxide noma ukungalingani kwe-pH kufaka:

• ukuphelelwa umoya
• obunye ubunzima bokuphefumula
• isicanucanu
• ukuhlanza

Lezi zimpawu zingakhomba ukungasebenzi kahle kwamaphaphu okubandakanya ukushintshana phakathi komoya-mpilo ne-carbon dioxide.

Uzodinga ukuthi kukalwe amazinga e-oksijeni necarbon dioxide egazi lakho njalo uma ukwelashwa komoya-mpilo noma uhlinzwa okuthile.

Isampuli yegazi ithathwa kanjani

Amasampula egazi ohlolo lwegazi lwe-CO2 angathathwa emthanjeni noma emthanjeni.

Isampula yegazi le-Venipuncture

I-Venipuncture yigama elisetshenziselwa ukuchaza isampula yegazi eyisisekelo ethathwe emthanjeni. Udokotela wakho uzoku-oda isampula yegazi elula yokuphindisela uma efuna ukukala i-HCO3 kuphela.

Ukuthola isampula yegazi lokuphindisela, umhlinzeki wezokunakekelwa kwempilo:

• ihlanza isiza (imvamisa ingaphakathi lendololwane) ngesinqanda magciwane esibulala amagciwane
• isonga ibhande lokunwebeka elizungeze ingalo yakho engenhla ukwenza umthambo uvuvukale ngegazi
• ngobumnene ufaka inaliti emthanjeni bese uqoqa igazi kushubhu enamathiselwe lize ligcwale
• isusa ibhande lokunwebeka nenaliti
• imboza isilonda sokubhoboza nge-gauze oyinyumba ukumisa noma yikuphi ukopha

Isampula yegazi

Ukuhlaziywa kwegesi yegazi kuvame ukuba yingxenye yokuhlolwa kwe-CO2. Ukuhlaziywa kwegesi yegazi kudinga igazi lokushintshana ngoba amagesi namazinga e-pH emithanjeni ahlukile egazini le-venous (igazi elivela emthanjeni).

Imithambo yegazi ithwala umoya-mpilo emzimbeni wonke. Imithambo ithwala imfucumfucu ye-metabolism kanye negazi elingenawo amandla emaphashini ukuze likhishwe njenge-carbon dioxide nasezinsweni ezizodluliselwa emchameni.

Le nqubo eyinkimbinkimbi ngokwengeziwe yenziwa ngudokotela oqeqeshelwe ukufinyelela ngokuphepha emithanjeni yegazi. Igazi le-arterial livame ukuthathwa emthanjeni esihlakaleni okuthiwa i-radial artery. Lona ngumthambo omkhulu ngokuhambisana nesithupha, lapho ungazizwa khona ukushaya kwenhliziyo yakho.

Noma, igazi lingaqoqwa emthanjeni we-brachial endololwaneni noma emthanjeni wabesifazane emgodini. Ukuze uthole isampula yegazi elisezingeni eliphansi, udokotela:

• ihlanza isiza ngesibulali magciwane esibulala amagciwane
• ngobumnene ufaka inaliti emthanjeni bese udonsela igazi kushubhu enamathiselwe lize ligcwale
• kususa inaliti
• ifaka ingcindezi ngokuqinile esilondeni okungenani imizuzu emihlanu ukuqinisekisa ukuphuma kwegazi. (Imithambo yegazi ithwala igazi ngokucindezela okuphezulu kunemithambo, ngakho-ke kuthatha isikhathi esithe xaxa ukuthi igazi lakhe ihlule.)
• ibeka ukugoqwa okuqinile eduze kwesiza sokubhoboza esizodinga ukuhlala endaweni okungenani ihora

Ukulungiselela kanjani ukuhlolwa kwegazi lakho

Udokotela wakho angakucela ukuthi uzile ukudla, noma uyeke ukudla nokuphuza, ngaphambi kokuhlolwa kwegazi.Udokotela wakho futhi angakucela ukuthi uyeke ukuthatha imishanguzo ethile ngaphambi kokuhlolwa okufana ne-corticosteroids noma ama-antacids. Le mithi yandisa ukuhlushwa kwe-bicarbonate emzimbeni.

Izingozi zokuhlolwa kwegazi le-CO2

Kunobungozi obuncane obuhambisana nokuhlolwa kwe-venipuncture kanye ne-arterial blood. Lokhu kufaka phakathi:

• ukopha ngokweqile
• ukuquleka
• ubumhlophe
• i-hematoma, okuyisigaxa segazi ngaphansi kwesikhumba
• ukutheleleka endaweni yokubhoboza

Ngemuva kokudonswa kwegazi, udokotela wakho uzoqinisekisa ukuthi uzizwa kahle futhi uzokutshela ukuthi unganakekela kanjani indawo yokubhoboza ukuze unciphise amathuba okutheleleka.

Imiphumela yokuhlola

Ububanzi obujwayelekile be-CO2 bungu-23 kuya ku-29 mEq / L (amayunithi we-milliequivalent ngelitha ngalinye legazi).

Ukuhlolwa kwegazi kuvame ukukala i-pH yegazi kanye namazinga e-CO2 ukuze kutholakale imbangela yezimpawu zakho. I-pH yegazi isilinganiso se-asidi noma i-alkalinity. I-Alkalosis kulapho uketshezi lomzimba wakho lune-alkaline kakhulu. I-Acidosis, ngakolunye uhlangothi, kulapho uketshezi lomzimba wakho lune-asidi kakhulu.

Imvamisa, igazi liyisisekelo esincane ngesilinganiso se-pH esiseduze no-7.4 esigcinwe ngumzimba. Ububanzi obujwayelekile busuka ku-7.35 kuye ku-7.45 buthathwa njengongathathi hlangothi. Isilinganiso se-pH segazi esingaphansi kuka-7.35 sithathwa njenge-asidi. Into ine-alkaline engaphezulu lapho isilinganiso sayo se-pH yegazi singaphezu kuka-7.45.

I-bicarbonate ephansi (HCO3)

Umphumela wokuhlolwa kwe-bicarbonate ephansi ne-pH ephansi (engaphansi kuka-7.35) yisimo esibizwa nge-metabolic acidosis. Izimbangela ezivamile yilezi:

• ukwehluleka kwezinso
• isifo sohudo esibi
• i-lactic acidosis
• isithuthwane
• umdlavuza
• ukungabi khona komoya-mpilo isikhathi eside ngenxa yokushoda kwegazi, ukwehluleka kwenhliziyo, noma ukwethuka
• ketoacidosis sikashukela (sikashukela acidosis)

Umphumela wokuhlolwa kwe-bicarbonate ephansi kanye ne-pH ephezulu (ngaphezu kuka-7.45) yisimo esibizwa ngokuthi i-alkalosis yokuphefumula. Izimbangela ezivamile yilezi:

• i-hyperventilation
• imfiva
• ubuhlungu
• ukukhathazeka

I-bicarbonate ephezulu (HCO3)

Umphumela wokuhlolwa kwe-bicarbonate ephezulu ne-pH ephansi (engaphansi kuka-7.35) yisimo esibizwa nge-respiratory acidosis. Izimbangela ezivamile yilezi:

• inyumoniya
• isifo esingapheliyo sokuvimbela kwamaphaphu (COPD)
• isifuba somoya
• i-fibrosis yamaphaphu
• ukuchayeka kumakhemikhali anobuthi
• izidakamizwa ezicindezela ukuphefumula, ikakhulukazi uma zihlangene notshwala
• isifo sofuba
• umdlavuza wamaphaphu
• umfutho wegazi ophakeme wamaphaphu
• ukukhuluphala okukhulu

Umphumela wokuhlolwa kwe-bicarbonate ephezulu ne-pH ephezulu (ngaphezu kuka-7.45) yisimo esibizwa nge-metabolic alkalosis. Izimbangela ezivamile yilezi:

• ukuhlanza okungapheli
• amazinga aphansi e-potassium
• i-hypoventilation, ebandakanya ukuphefumula okunciphise futhi yehlise ukuqedwa kwe-CO2

Umbono wesikhathi eside

Uma udokotela wakho ethola ukungalingani kwe-CO2 okuphakamisa i-acidosis noma i-alkalosis, bazobheka imbangela yalokhu kungalingani futhi bakuphathe ngokufanele. Ngoba izimbangela ziyahlukahluka, ukwelashwa kungabandakanya inhlanganisela yezinguquko zendlela yokuphila, imishanguzo nokuhlinzwa.