Ngabe ufuna ukuqonda ukuthi ingabe ukwelashwa kwe-overgen ye-overgen ephezulu kakhulu kuguqulwa kangakanani ukuguqula ukwesekwa kokuphefumula? Le ndatshana isho ukujula ezinzuzweni, izinhlelo zokusebenza, kanye nezinzuzo zale ndlela yokulethwa komoya-mpilo. Sizohlola ukuthi kungani iba ngumguquki womdlalo ekunakekelweni kwezempilo, enikeza indlela ekhululekile futhi ephumelelayo yokuletha umoya-mpilo owengeziwe. Qhubeka ufunda ukuthola ukuthi umuthi we-cannal we-cannal we-high-flow ephezulu ungathuthukisa kanjani imiphumela yeziguli futhi unakekele ukunakekelwa kokuphefumula.
1
I-Oxygen Cannapy ephezulu ye-NASAL CANCLAL (HFNC) I-OXygen Therapy iyindlela ethuthukisiwe yokuhlinzeka ngokusekelwa kokuphefumula ezigulini ezidinga i-oksijini esengeziwe. Ngokungafani nezinhlelo zendabuko zokulethwa komoya-mpilo, i-HFNC ingaletha umoya-mpilo ngamanani aphezulu okugeleza okuphezulu, okuvame ukusukela ezikhathini ezi-3 kuye kwezingama-50 ukugeleza kwe-cannula ejwayelekile ye-cannula. Lokhu amandla okuletha umoya-mpilo wokugeleza okuphezulu yilokho okubeka eceleni futhi kwenze kube uhlelo oluphakeme lokulethwa komoya-mpilo ezimweni eziningi zomtholampilo.
Izindlela zendabuko, ezinjenge-cannulal elula yama-nasal noma imaski yobuso, kubhekwa njenge-oksigen yokwelashwa okuphansi. Lezi zinhlelo ngokujwayelekile ziletha umoya-mpilo kumanani wokugeleza kuze kufike kumalitha ayi-6 ngomzuzu (LPM). Ngokuphambene nalokho, ukwelashwa kwe-cannal ye-high-flow cannal kungaletha amanani okugeleza afinyelela kuma-60 amalitha ngomzuzu, futhi kwesinye isikhathi aphakeme kakhulu. Lesi Silinganiso Sokugeleza Okuphezulu sinikeza izinzuzo eziningana. Okokuqala, kungahlangabezana ngempumelelo nezidingo zesiguli ezikhuthazayo, ikakhulukazi ezimweni zokukhuphuka kwezinga lokuphefumula noma usizi. Okwesibili, umoya-mpilo ovuthayo nowomswakama owethulwe ngokugeleza kwamaNasal High Flow usiza ukuthuthukisa induduzo yesiguli futhi anciphise ukomisa i-mucosa yamakhala, udaba olujwayelekile nokwelashwa kwendabuko kwendabuko. Ngenxa yekhono layo lokuletha ukulethwa okunembile futhi okunethezekile komoya ontantayo, i-HFNC iyanda kakhulu ezilungiselelweni ezahlukahlukene zezempilo.
2. I-High-Flow Clow Cannal Cannapa Therapy ihlukile kanjani ekwelashweni kwendabuko okuphansi kwe-oksigen?
Umehluko oyisisekelo phakathi kokwelashwa kwe-cannal ye-high-flow ephezulu kanye nokwelashwa okuphansi kwe-oksigen kulele esilinganisweni sokugeleza komoya-mpilo owethulwe esigulini. Izinhlelo ezi-Low-Flow, njenge-Cannulal ejwayelekile ye-Nasal, zenzelwe ukuletha umoya-mpilo ngamanani okugeleza afinyelela ku-6 lpm. Lokhu kufanelekile ezigulini ezidinga inani elincane le-oksijini elengeziwe. Kodwa-ke, ukugcwala komoya-mpilo okulethwa yizinhlelo eziphansi zokugeleza kungahlukahluka futhi kuncike emazingeni okuphefumula ngesiguli kanye nevolumu ye-tidal. I-cannal ye-nasal elula ingahlinzekela ngempumelelo ngempumelelo ingxenyenamba elilinganiselwe le-oxygen ephefumulelwe (i-fio2), futhi lokhu kuvame ukungalawulwa ngokunembile.
Ukwelashwa kwe-cannap okuphezulu kwe-cannal cannal, ngakolunye uhlangothi, kusebenzisa idivaysi ekhethekile yokuletha umoya-mpilo ofudumele futhi onomswakama ngamanani okugeleza asukela ku-15 kuye ku-60 lpm, futhi kwesinye isikhathi ephakeme kakhulu. Lokhu kugeleza okuphezulu kakhulu kuhlinzeka ngokuhlushwa okuguquguqukayo okuguquguqukayo nokunengqondo kwesiguli. Ngaphezu kwalokho, isici esifudumele nesinomswakama sokuhamba nge-overgen thenchen ephezulu kakhulu kubalulekile. I-oksigen ephansi yendabuko ephansi, ikakhulukazi lapho ilethwa ekugxileni okuphezulu, ingabe isomile futhi icasule izindinyana zamakhala nasezindleleni zomoya. I-oxygen efudumele futhi enomswakama isiza ukuvikela ukomiswa kwe-mucosa yamakhala, yehlisa ukumelana nomoya, futhi kuthuthukisa imvume yokuhlehlisa - inqubo yemvelo yokusula ama-mucus avela emigwaqweni yomoya. Lokhu kwenza ukwelashwa kwe-cannula ephakeme kakhulu kwe-cannal ye-cannal kungcono kakhulu nokwelashwa komoya-mpilo, ikakhulukazi iziguli ezidinga amazinga adlule noma aphezulu okusekelwa komoya-mpilo.
3. Yiziphi izinzuzo ezisemqoka ze-High-Flow Nasal Cnula Therapy yokwelashwa kweziguli ezidinga ukwelashwa komoya-mpilo?
Ukwelashwa kwe-cannal ye-high-flow cannal kunikeza ubuningi bezinzuzo zeziguli ezidinga ukwelashwa i-oxygen. Enye yezinzuzo eziyinhloko i-oxygenation ethuthukisiwe. Ngokuletha umoya-mpilo ngamanani aphezulu okugeleza, i-HFNC ingahlangana noma idlule izidingo zokugeleza ezikhuthazayo zesiguli, iqinisekisa ingxenyana eqinile futhi ephakeme yomoya-mpilo ophefumulelwe. Lokhu kuzuzisa ikakhulukazi iziguli ezinokucindezelwa okuphefumula noma labo abasebenza kanzima ukuze baphefumule. Isibonelo, isiguli esine-pneumonia noma i-acute respiratory design syndrome (Ards) singaba nesilinganiso esiphakeme kakhulu sokuphefumula futhi sidinga inani elikhulu le-oksijini. Ukwelashwa kwe-cannap kwe-cannal ephezulu kakhulu kungaletha umoya-mpilo ongeziwe okudingekayo kulezi zimo.
Enye inzuzo ebalulekile iyathuthukiswa induduzo yesiguli. I-oklygen evuthayo nenomswakama i-gener eningi emaphasini amakhala ngokuqhathaniswa ne-oksijini eyomile, ebandayo kusuka ezinhlelweni zendabuko. Lokhu kunciphisa ukoma kwamakhala, ukucasuka, nokungaphatheki kahle, ukwenza ngcono ukubekezelelana kweziguli kanye nokuhambisana nomoya we-oksijini. Iziguli ziyakwazi nokudla, zikhulume, futhi zikhwehlela kalula nge-cannal ye-nasal uma kuqhathaniswa nemaski yobuso obufanelekile, ethuthukisa ukunethezeka kwabo.
Ngaphezu kwalokho, ukwelashwa kwe-cannapy ephezulu kwe-cannal cannal kunganciphisa umsebenzi wokuphefumula. Ukugeleza kwegesi okuphezulu kungadala inani elincane lengcindezi yendiza enhle, esiza ukugcina imigwaqo emincane yomoya emaphashini ivulekile futhi inciphisa umzamo odingekayo ukuze uphefumule. Lokhu kusiza ikakhulukazi iziguli ezinezimo ezinjengesifo esingama-pulmonary esingama-pulmonary (COPD) noma ukwehluleka kwenhliziyo, lapho ukuphefumula kungasebenza khona. Izifundo zemitholampilo ziphinde zibonise ukuthi ukwelashwa kwe-cannapy ye-high-flow cannal kunganciphisa isidingo sokuthambisa kanye nomoya omncane weziguli kwezinye izindawo zeziguli, okuholela emiphumeleni engcono kanye nokuhlala esibhedlela okufushane. Sekukonke, inhlanganisela yokulethwa komoya-mpilo okwenziwe ngcono, induduzo ethuthukisiwe, futhi umsebenzi oncishisiwe wokuphefumula wenza ukwelashwa okuphezulu kwe-cannal cannal kuyithuluzi elinamandla ekunakekelweni kokuphefumula.
4. Kukuziphi izimo zezokwelapha ezihamba nge-high-flow cannal cannula Therapy indlela ethandwa yi-oxygen yokulethwa komoya?
Ukwelashwa kwe-cannal ye-high-flow cannal sekuyindlela ekhethwayo yokulethwa komoya-oxygen ngezimo eziningi zezokwelapha, ikakhulukazi ezimweni lapho iziguli zidinga ukwesekwa okubalulekile kokuphefumula kepha azidingi ukwesekwa okubalulekile kokuphefumula kepha kungadingeli ukuthi kudingeke noma ukulungele umoya omncane. Isicelo esisodwa esijwayelekile sekwelashwa ukwehluleka kokuphefumula okukhulu. Iziguli ezinezimo ezinjenge-pneumonia, i-bronchiolitis (ikakhulukazi ezinganeni), kanye nokukhulisa okukhulu kwe-COPD kuvame ukuzuza ekwelashweni kwe-cannal ephakeme kakhulu. Kulezi zimo, kungasiza ukuthuthukisa i-oksigenation, kuncishiswe usizi lokuphefumula, futhi kungahle kugweme isidingo sokungenelela okuhlaselayo okufana nokufunga.
Ukuxhaswa kwe-Post-Extubation kungenye indawo ebalulekile lapho kusetshenziswa khona i-high-flow nasal cannula. Ngemuva kokuthi isiguli besisemakhemini amakhekhe futhi sikhuphuke (kukhishwe ishubhu le-tube), basengozini yokuhlupheka noma ukwehluleka okuphefumulelwe. Izifundo eziningana, kufaka phakathi ucwaningo ngomphumela we-post-high-flow cannula ye-nasal cannula, ukhombisile ukuthi ukusebenzisa i-post-flow flow cannal cannula post-extubane kunganciphisa ubungozi bokuvuselelwa kwendabuko okuqhathaniswa ne-oksigen ephansi yendabuko noma i-oksijini elula ye-nasal. Lokhu kubaluleke kakhulu ezigulini ezithathwa njengengozi enkulu ezinkingeni zokuphefumula ngemuva kokukhushulwa.
EMnyangweni Wezimo eziphuthumayo, i-High-Flow Cannal Cannula ingaba yigugu ukuze i-oxygen esheshayo yeziguli ezigulini ezethulwa ekucindezelekeni okunzima kokuphefumula. Ivumela ukungenelela okusheshayo nokusebenza okusebenzayo komoya-mpilo ngaphandle kwesidingo samaski afanelekile, angabekezelelwa kabi. Ngaphezu kwalokho, kuzilungiselelo zokunakekelwa kwePalliative, i-cannula ephezulu yokugeleza kwamakhala inganikeza ukwelashwa okunempilo futhi okusebenzayo kweziguli ezinezifo zokuphefumula zesigaba se-End-Stage, kuthuthukisa ikhwalithi yempilo yabo ngokudambisa ukuphefumula. Ukuguquguquka okuhlukahlukene kanye nokusebenza kahle kwe-High-Flow Nasal Cannal kungenza kube yithuluzi elibalulekile kuzo zonke izinhlobo zezokwelapha ezahlukahlukene kanye neziguli zidinga ukwesekwa okuphambili kokuphefumula.
I-5
Induduzo yesiguli nokubekezelelana kuthuthukiswa kakhulu nge-High-Flow Clow Cannal Therapy Therapy uma kuqhathaniswa namanye amadivaysi amaningi okulethwa komoya-mpilo, ikakhulukazi imaski yobuso bendabuko. Enye yezizathu eziyinhloko zale nkokhelo ethuthukisiwe ngumswakama nokushisa komoya-mpilo. Ukwelashwa kwendabuko kwendabuko, ikakhulukazi ngamanani aphezulu okugeleza, kuhambisa igesi eyomile, engenamkhawulo ngqo ezindimeni zamakhala. Lokhu kungaholela ekomisweni okukhulu kwe-mucosa yamakhala, okubangela ukungakhululeki, ama-nosebleeds, kanye nokukhiqizwa kwe-mucus. I-oxygen efudumele e-High-Flow Clow Cannal Therapy yokwelashwa nge-cannal cannapy aphula lo mphumela wokomisa, ukugcina i-mucosal hydration nenduduzo.
Imaski yobuso, ngenkathi ikwazi ukuletha ukugxila okuphezulu kwe-oksijini, imvamisa izizwa i-claustrophobic futhi ikhawulele ezigulini. Bangakwenza futhi kube nzima ukudla, ukuphuza, noma ukuxhumana ngempumelelo. Ngokuphambene nalokho, i-cannula yamakhala, ngisho ne-prong ebanzi yamakhala esetshenziselwe ukugeleza okuphezulu, ayinakuphikwa. Iziguli zingadla kalula, zikhulume, futhi zikhwehleke ngaphandle kokuphazamisa ukwelashwa kwazo komoya-mpilo lapho usebenzisa i-cannula ye-high-flow cannula. Lokhu kuzuzisa ikakhulukazi iziguli ezidinga ukwesekwa kwe-oxygen ende noma labo abaphaphamele futhi abaxhumana nabo.
Ngaphezu kwalokho, i-cannal ye-nasal ivumela imvume engcono yokuthola amabhulukwe. Ngama-masks ubuso, ama-seections angangena ngaphansi kwe-mask, engakhuphula ingozi yokufisa noma ukungaphatheki kahle. Isimo esivulekile se-cannula ye-nasal sivumela ukulindelwa okulula kokuthola amabhulukwe, ukukhuthaza inhlanzeko ye-airway. Inhlanganisela ye-oksijini enomswakama futhi efudumele, isikhombimsebenzisi esinqunyelwe, kanye nekhono elithuthukisiwe lokudla nokuxhumana kwenza inkesi ye-high-flow inckebula inketho enobungani obukhulu ngokuqhathaniswa namadivayisi amaningi okulethwa kwendabuko okuqhathaniswa. Le nduduzo ethuthukisiwe ingaholela ekulandeleni iziguli ezingcono, isikhathi eside sokwelashwa lapho kudingeka, futhi jikelele okuhlangenwe nakho okuhle ngokwelashwa komoya-mpilo.
6. Yikuphi ukugeleza kwezinga lokugeleza okuvame ukusetshenziswa ekwelashweni okuphezulu kwe-cannol cnulal cannal
Izinga lokugeleza elisetshenzisiwe ku-Oflygen Therapy ephezulu kakhulu ye-Anygen Cannuta therapy lihluka kakhulu futhi lincike ezidingweni zesiguli ngazinye kanye nesimo somtholampilo. Ngokungafani ne-cannal ye-nasal ephansi, lapho amanani okugeleza ngokuvamile afakwe khona ku-6 LPM, izinhlelo eziphakeme kakhulu zingaletha amanani okugeleza afinyelela kwa-60 LPM, futhi kwezinye izikhathi eziphakeme kakhulu. Izinga lokugeleza kokuqala livame ukusetha ngokususelwa kumazinga wokuphefumula wesiguli kanye nomoya-mpilo. Iphuzu elijwayelekile lokuqala lingaba cishe ngo-20-30 lpm, kepha lokhu kuyisiqondiso nje esijwayelekile futhi kufanele senziwe umuntu ngamunye.
Izinga lokugeleza lithathwe ngokucophelela, noma lilungiswe, ngokususelwa ekubhekeni okuqhubekayo kokuphendula komtholampilo kwesiguli. Amapharamitha asemqoka abhekwe kufaka phakathi i-Oxygen Saturation (SPO2), isilinganiso sokuphefumula, ukushaya kwenhliziyo kanye nomsebenzi wokuphefumula. Umgomo ukufezekisa nokugcina ukugcwala komoya-mpilo okwanele (ngokuvamile ngenhla kwe-92-94%, kepha okuhlosiwe kungahluka ngokuya ngesimo sesiguli) ngenkathi kunciphisa izimpawu zokuhlupheka okuphefumula. Uma ukugcwala komoya-mpilo wesiguli kuphansi noma kusakhombisa izimpawu zokukhulisa umzamo wokuphefumula, izinga lokugeleza kungenzeka likhuphuke kancane. Ngakolunye uhlangothi, uma ukugcwala komoya-mpilo kuphakeme ngokungaguquki futhi isiguli sehle, izinga lokugeleza lingancishiswa libe sezingeni eliphansi kakhulu.
Ukulungiswa kwezinga lokugeleza kuyinqubo eshukumisayo edinga ukubonwa okusondelene nesahlulelo somtholampilo. Akukona nje ukufeza inombolo eqondiwe komoya-mpilo, kepha futhi mayelana nokuhlola isithombe sesiguli sonke somtholampilo. Izici ezifana nembangela eyisisekelo yokucindezelwa okuphefumula, iminyaka yesiguli, futhi noma yikuphi ukukhululeka futhi kuthonya izinguquko zokugeleza kwezinga. Ukuhlola njalo kanye nokutholwa kwabasebenzi bezokunakekelwa kwempilo kubalulekile ukuze kwandise ukwelashwa kwe-cannula ye-cannal ephezulu futhi kuqinisekise ukuthi ihlangabezana nezidingo zokuphefumula kweziguli.
I-7. Ingabe i-cannal ye-cannal ephezulu kakhulu isebenza ngokuphathwa okuphuthumayo komoya-mpilo kanye nosizi lokuphefumula?
Yebo, i-cannal ye-high-flow ye-high isebenza ngempumelelo ekuphathweni kwe-oksijini eziphuthumayo nasekuphatheni iziguli ekucindezelekeni okuphefumulayo. Ukuqala kwayo okusheshayo kwesenzo kanye nekhono lokuletha ukugxila okuphezulu kwe-oksijini ngokushesha kwenze ithuluzi elibalulekile ezimweni eziphuthumayo. Ezimweni ze-acute hypoxemia (amazinga aphansi omoya-mpilo) noma ukucindezelwa okukhulu kokuphefumula, ukulethwa okusebenzayo okufika ngesikhathi futhi okusebenzayo kubalulekile. I-High-Flow Cannal Cannula inganikeza lokhu kusekelwa okusheshayo, imvamisa ngempumelelo kunezinhlelo zendabuko eziphansi zendabuko noma amaskandi ajwayelekile wobuso.
Ezilungiselelweni eziphuthumayo njengoMnyango Wezezimo Eziphuthumayo noma i-Intensive Care Unit, iziguli zingaletha ngezimo ezahlukahlukene ezibangela usizi lokuphefumula, njengokuxoshwa okukhulu kwesifuba somoya, noma ukwehluleka kwenhliziyo okunamandla. Kulezi zimo, ukusebenzisa i-cannal ye-nasal ephezulu kuvumela ukwesekwa okungeziwe komoya-mpilo. Amanani aphezulu okugeleza angenza ngcono amazinga we-wagrampula ye-oksijini futhi adambise eminye imisebenzi yokuphefumula, enikeza ukwesekwa okubalulekile ngenkathi kusetshenziswa ezinye izindlela zokuxilonga nezokwelashwa.
Uma kuqhathaniswa namanye amadivaysi aphuthumayo we-oksijini afana nama-masks angewona kabusha, i-High-Flow Nasal Cannala inikeza izinzuzo eziningana ngesilungiselelo esibuhlungu. Ngokuvamile kubekezelelwa kangcono, okuvumela isikhathi eside sohlelo lokusebenza ngaphandle kokungaphatheki kahle. Iphinde ivumela ukuxhumana okulula nokufinyelela kokudla ngomlomo, okubalulekile esimweni esiphuthumayo esishukumisayo. Ngaphezu kwalokho, umoya-mpilo ovuthayo futhi onomswakama ungazuzisa kusukela ekuqaleni, ukunciphisa ukucasuka kwezindiza kanye nokwenza ngcono amakhekhesi okuphefumula jikelele. Ngenkathi i-cannal ye-high-flow cannal ingahle ingalungeli sonke isimo sokuphefumula esiphuthumayo (isb.
8. Yiziphi izingozi nokucatshangelwa okungaba khona lapho usebenzisa i-High-Flow Nasal Cannal Cannal Therapy Therapy?
Ngenkathi ukwelashwa kwe-cannapy ephezulu kwe-cannal kuphephile futhi kubekezelelwa kahle, kunezingozi ezingaba khona kanye nokucatshangelwa ukuthi abahlinzeki bezokunakekelwa kwempilo okufanele bazi. Ukucatshangelwa okukodwa okubalulekile yithuba le-barotrauma, noma ukulimala kwamaphaphu kusuka ekucindezelweni ngokweqile. Yize i-High-Flow Nasal Cannula enikezela ngengcindezi ephansi ye-Airway Pressure eqhathaniswa nomoya omncane, amanani aphezulu aphezulu, ikakhulukazi ezigulini ezinezimo ezithile zamaphaphu noma ukulimala. Ngakho-ke, ukuqapha ngokucophelela kwama-mechanics okuphefumula kanye nokuthathwa kwamanani okuhamba afanelekile kubalulekile.
Okunye ukucatshangelwa kuyingozi yobuthi be-oksijini. Ngenkathi kuvame kakhulu nge-cannal cannal oxygen yokuqhathanisa nezindlela eziphakeme ze-Fio2 ezinjengemaski, ukuvezwa isikhathi eside kokugxila okuphezulu kwe-oksijini kungaholela ekuphuzeni ubuthi be-oxygen pulmonary. Lokhu kungukukhathazeka okungaphezulu lapho usebenzisa i-cannula ye-high-flow cannula yezikhathi ezengeziwe kuzilungiselelo eziphakeme kakhulu ze-fio2. Ingxenyana yomoya-mpilo ophefumulelwe kufanele ibekwe phansi ngokushesha nje lapho ingenzeka emtholampilo ukuze inciphise le ngozi.
Ukucasuka kwe-Nasal kanye nokoma, yize kuncibilikiswa okuncane kunomoya o-oksijini wendabuko, kusenokwenzeka kwezinye iziguli, ikakhulukazi ukusetshenziswa isikhathi eside. Ngenkathi uhlelo lomswakama lwenzelwe ukunciphisa lokhu, ukuhlolwa okujwayelekile kwe-mucosa yamaNasal kanye nezinguquko ezifanele kumazinga omswakama kubalulekile. Ezimweni ezingavamile, iziguli zingakha ukucasuka kwamakhala nasala noma amakhala amancane.
Ekugcineni, kubalulekile ukuqaphela ukuthi i-High-Flow Nasal Cannula akuyona indawo yokufaka umoya omncane kuzo zonke izimo. Ezigulini ezinokwehluleka okukhulu kokuphefumula ezingaphenduli ku-HFNC noma ezinokuphambana nokusetshenziswa kwazo, ukukhuphuka okufika ngesikhathi ku-Mechanleation veration kuyadingeka. Ukubambezela ukuqonda lapho kudingeka ngempela imiphumela emibi. Ngakho-ke, ukukhethwa kwesiguli ngokucophelela, ukuqapha okuqhubekayo, nokuqonda okucacile kwezinkomba kanye nemikhawulo yokwelashwa kwe-cannal ye-high-flowell ephezulu kubalulekile ngohlelo lokusebenza lwayo oluphephile nolusebenzayo.
9. I-high-flow cannal canntala ithonya kanjani i-acygen sactivation kanye nomsebenzi wokuphefumula ophelele?
Ukwelashwa kwe-cannal ye-high-flow cannal kunethonya elikhulu elihle ekugcwalisweni komoya-mpilo kanye nokusebenza kokuphefumula okuphelele ezigulini ezidinga i-oksijini esengezekile. Enye yezindlela eziphambili lapho ithuthukisa i-okygenation iletha ngempumelelo umoya-mpilo owengeziwe emaphashini. I-cannulas yendabuko ye-nasal, ikakhulukazi ngamanani aphezulu okugeleza, ingahle isebenze kahle ekuletheni umoya-mpilo ngenxa ye-dilution ngephethini yokuphefumula yesiguli. I-High-Flow Nasal Cannula, enekhono layo lokuhlinzeka ngamanani okugeleza afinyelela ku-60 LPM, angahlangabezana kangcono nokuhamba kweziguli ezikhuthazayo futhi anciphise inani le-oxygen ephefumulelwe futhi eliphakeme kakhulu le-oksijini eliphefumulelwe, elihumusha ngokuqondile.
Ngaphandle kwe-oksigenation, i-cannula ephezulu yokugeleza kwamakhala nayo ingathuthukisa ezinye izici zomsebenzi wokuphefumula. Igesi evuthayo nenomswakama inganciphisa ukumelana nomoya futhi ithuthukise imvume yokusiza. Ngokunciphisa ukumelana nomoya, kuba lula ezigulini ukuphefumula, kunciphise umsebenzi wokuphefumula. Ukuvunyelwa Okuthuthukisiwe kwe-mucociliary kusiza ukusula ukucacisa ama-becreions kusuka emigwaqweni yomoya, okuzuzisa kakhulu ezigulini ezinezifo zokuphefumula noma izimo ezihambisana nokwakhiwa kwe-mucus.
Ngaphezu kwalokho, ukugeleza komoya-mpilo okulethwa ngama-prongs ama-nasal kungadala ingcindezi emnene emnandi emigwaqweni yomoya. Lokhu kucindezela okuhle, yize kuncane, kungasiza ukugcina i-alveoli (ama-sacs anomoya amancane emaphashini) avulelekile, ethuthukisa ukushintshana kwegesi nokunciphisa i-atelectasis (ukuwa kwamaphaphu). Lo mphumela ufana, kepha uma kushiwo kancane kunokucindezela okuqhubekayo kwe-airway airway (CPAP) noma umoya omncane.
Ucwaningo lweMitholampilo lukhombise njalo ukuthi ukwelashwa kwe-cannap kwe-cannal ephezulu kungathuthukisa ukugcwala komoya-mpilo, kunciphise isilinganiso sokuphefumula, bese wehlisa umsebenzi wokuphefumula ezigulini ezinezimo ezahlukahlukene zokuphefumula. Lokhu kuthuthuka emsebenzini wokuphefumula kufaka isandla kwimiphumela yeziguli engcono, isidingo esincishisiwe sokukhuphuka kokusekelwa kokuphefumula okuhlaselayo, kanye nenhlala-kahle inhlala-kahle yokuphefumula.
10. Liyini ikusasa le-High-Flow Nasal Cannula ekwelashweni komoya-mpilo kanye nokunakekelwa kokuphefumula?
Ikusasa le-High-Flow Nasal Cannula ekwelashweni komoya-mpilo kanye nokunakekelwa kokuphefumula kuthembisa kakhulu, ngocwaningo oluqhubekayo kanye nokuthuthuka kwezobuchwepheshe okwandisa izinhlelo zayo kanye nokwenza ngcono ukusebenza kwayo kanye nokwenza ngcono ukusebenza kwayo kanye nokwenza ngcono ukusebenza kwayo. Indawo eyodwa ebalulekile yentuthuko yesikhathi esizayo ekucobeni ubuchwepheshe namadivayisi uqobo. Abakhiqizi basebenza ngokuqhubekayo ekwenzeni amasistimu we-HFNC asebenziseka kalula, aphatheke futhi abize kakhulu. Intuthuko ku-Advid Diffication and Heating Technology ingaphinde ithuthukise induduzo yesiguli futhi yehlise izinkinga ezingaba khona.
Ucwaningo luqhubeka futhi ukuhlola izinhlelo ezintsha zemitholampilo ze-High-Flow Nasal Cannula. Ngenkathi ukusetshenziswa kwayo ukwehluleka kokuphefumula okukhulu kanye nokuxhaswa kwe-post-yokukhushulwa kusungulwe kahle, izifundo ziphenya amathuba azo kwezinye izindawo ezinjengezinto zangaphambi komoya-mpilo njenge-apnea yokulala, ngisho nasemibanweni ethile yenhliziyo. Ukusebenza kahle kwe-high-flow cannal cannula ezindaweni ezahlukahlukene zeziguli kanye nezilungiselelo zemitholampilo kuyahlolwa ngenkuthalo.
Esinye isiqondisi esijabulisayo ukuhlanganiswa kwe-high-flow cannula ye-cannula enamanye ama-modalities okusekelwa okuphefumula. Ukuhlanganisa i-HFNC enomoya omncane ongahlaseli (i-NIV) noma ukuyisebenzisa ngokubambisana nezindlela zokwelapha ezikhethekile ezikhemisi kungahle kube ngcono imiphumela yokuphefumula emaqenjini athile eziguli. Izindlela ezenzelwe wena zokugeleza kwe-cannal cannula ephezulu, amanani wokugeleza okuhambisana nokuhambisa kanye ne-fio2 ngokususelwa ezifweni zeziguli ngazinye kanye nokuqapha kwangempela komzimba, kungenzeka futhi kube khulu.
Njengokuqonda kwethu kwe-physiology yokuphefumula kanye nemishini yokwenza i-High-Flow Nasal Cannal Cannal iyajula, futhi njengoba ubuchwepheshe buyaqhubeka nokuqhubekisela phambili, i-HFNC ilungele ukudlala indima enkulu kakhulu ekwelashweni komoya-mpilo kanye nokunakekelwa kokuphefumula eminyakeni ezayo. Ukusebenza kwayo okuhlukahlukene, ukusebenza ngempumelelo, kanye nemvelo enobungane ukukwenza kube yitshe lezinga lokuphathwa kokuphefumula kwanamuhla, kanye nemishini yesikhathi esizayo izokwenzelwe isikhundla sayo njengohlelo oluholayo lwe-oxygen.
Ukuthathwa Key:
- I-High-Flow Nasal Cannula (HFNC) Therapy Ihambisa umoya-mpilo ovuthayo futhi onomswakama ngamanani wokugeleza aphakeme kakhulu kunama-cannulal endabuko wendabuko, ngokuvamile aphindwe ka-3-50 abe ngaphezulu.
- I-HFNC inikeza ukulethwa okuphezulu komoya-mpilo Ngokuhlangana nezidingo ezikhuthazayo, ukuhlinzeka ngengxenye engaguquki ye-oksijini ephefumulelwe, kanye nokwenza ngcono ukugcwala komoya-mpilo.
- Induduzo Yesiguli ithuthukiswa kakhulu Nge-HFNC ngenxa ye-oksijini efudumele nenomswakama, ukunciphisa ukoma kwamakhala nokucasuka uma kuqhathaniswa nokwelashwa okuphansi kwe-oxygen.
- I-HFNC iyasebenza ezimweni ezahlukahlukene zezokwelapha, kufaka phakathi ukwehluleka kokuphefumula okuphezulu, ukwesekwa kwe-post-acucution, kanye nokuphathwa komoya-mpilo eziphuthumayo.
- Izinga lokugeleza ku-HFNC liyazinye futhi libekiwe Ngokusekelwe ekuqapheleni okuqhubekayo kokugcwaliswa komoya-mpilo, isilinganiso sokuphefumula, nomsebenzi wokuphefumula.
- Izingozi ezingaba khona ze-HFNC ziphansi Kepha faka ubuthi be-barotrauma ne-oxygen, kudinga ukuqapha ngokucophelela nokulungiswa kwezilinganiso zokugeleza okufanele.
- I-HFNC inomthelela omuhle umsebenzi wokuphefumula Ngokwenza ngcono umoya-mpilo, ukunciphisa umsebenzi wokuphefumula, kanye nokwenza ngcono imvume yokusizakala.
- Ikusasa le-HFNC likhanya, ngokucwaninga okuqhubekayo kanye nokuthuthuka kwezobuchwepheshe okwandisa izinhlelo zayo kanye nokwenza ngcono ukusebenza kwayo ekunakekelweni kokuphefumula.
Le ndatshana yenzelwe izinjongo zolwazi kuphela futhi ayisenzi izeluleko zezokwelapha. Hlala uthintana nochwepheshe wezempilo ofanelekile wokuxilongwa nokwelashwa.
Izixhumanisi Zangaphakathi:
Ngeminye imininingwane ngokudla okuhlobene nezokwelapha, hlola ububanzi bethu bekhwalithi ephezulu I-Medical Gauze Bandage Roll na- Imaski yobuso bezokwelapha. Siphinde sinikeze okuhlukahlukene Amashidi ombhede wezokwelapha alahlwayo Ilungele izibhedlela nemitholampilo. Cabanga ngethu Suture oyinyumba ngenaliti ngezidingo zakho zokuhlinzwa. Ukunakekelwa kokuphefumula, kwethu Ukulahlwa kwe-PVC NASAL OXYGEN Cnula Tube ihlinzeka ngokulethwa komoya-mpilo othembekile.
Isikhathi sePosi: Feb-05-2025