Chii chaunotarisira apo Ventilator inodiwa
Vhetiyumu, inozivikanwawo sepuresi kana mhepo inopfurikidza, inyanzvi yezvokurapa iyo inopa murwere ane oxygen kana vasingakwanisi kufema ivo pachavo. Iyo ventilator inonyorovesa mweya mumapapu uye inobvumira kuti idzoke zvakare, semapapu aiwanzoita kana vachikwanisa.
Paivhiya chero ipi zvayo inoda kuti aneshehesia yakawanda, ventilator inokosha.
Panewo dzimwe nguva apo gasi rinotarisirwa mushure mekuvhiyiwa, sezvo murwere angave asingakwanisi kufema oga pakarepo mushure mekuita.
Nei Chirwere Chinodiwa Mukuvhiya
Jenesi anesthesia inoshanda kuburikidza nekuora mwoyo mishonga yomuviri kwechinguva. Izvi zvinosanganisira mishonga inotitendera kuti tive nekunyora. Pasina ventimiti, kupemha panguva yakawanda anesthesia haizoitike. Vakawanda varwere vari paventilator apo chirwere ichi chiri kuitika, zvino mushonga unopiwa kumira anesthesia. Kamwe apo anesthesia inomira, murwere anokwanisa kufema ari oga uye anobviswa kubva kumoto.
Nei Chiitiko Chingave Chinodiwa Pashure Kokuvhiya
Vhiyoti inofanirwa apo murwere asingakwanisi kufema zvakakwana kuti ape oxygen kuuropi nemuviri.
Vamwe varwere, nekuda kwekukuvara kana kurwara, havagoni kufema zvakakwana mushure mekuvhiyiwa kubviswa kubva kumhepo.
Izvi zvinogona kuva nekuda kwevarombo mapapu mushure mekuvhiyiwa, izvo zvinogona kuitika kana varwere vane uipi pamapapu avo anokonzerwa neHIV Obstructive Pulmonary Disease (COPD) . Varwere vanosvuta vanoonawo mazinga akakwirira ekuda ventiriyamu kwenguva yakareba mushure mekuvhiyiwa kwapera.
Izvi zvinoitikawo kana murwere ari kurwara zvokuti haafaniri kuzvifemera.
Izvi zvinogona kuitika pamusana pekutambudzika (zvakadai sekukanganisa kwemotokari yemotokari), utachiona kana imwe dambudziko. Mumwe murwere ari paventilator vasati vavhiyiwa vangangoramba vari muvharidziro mushure mekuvhiyiwa kusvikira vapora zvakakwana kuti vafeme zvakanaka ivo pachavo.
Mamwe mapurisa anoda kuti murwere ave muvharidziri kwenguva pfupi mushure mekuvhiyiwa sechikamu cherongwa. Semuenzaniso, varwere vane chirwere chepfungwa chinosvinura vanowanzochengetwa pane vheti kusvikira vasimuka zvakakwana kuti vasimudze musoro wavo kubva pamutsipa uye vanogona kutevera mirairo iri nyore. Havana kupa mishonga kuti vadzivise anesthesia, pane iyo inobvumirwa kupfeka pachayo, uye murwere wacho abviswa kubva muvharidzi apo ivo vakagadzirira kufema pachavo.
Intubation
Kuti iiswe panzvimbo inotonhora, murwere anofanira kuvharwa. Izvi zvinoreva kuva nechigumo chemagetsi akaiswa mumuromo kana mumhino uye akaiswa pasi mumugwagwa. Iyi tube inobata zvishoma gorosi gasket iyo inofungidzirwa kubata tubhu munzvimbo. Iyo ventilator inowanikwa kune tube uye ventilator inopa "kufema" kumurwere.
Sedation Pave paVentilator
Kana murwere ari muvharidziro mushure mekuvhiyiwa, mishonga inowanzopiwa kuti inotora murwere.
Izvi zvinoitika nokuti zvinogona kugumbura uye kuvhiringidza murwere kuti ave ne-endotracheal tube munzvimbo uye anonzwa ventilator ichisimudzira mweya mumapapu. Chinangwa ndechokuti murwere arambe akadzikama uye akasununguka asi asina kuvanyengedza zvakanyanya zvokuti havagoni kufema pachavo uye kubviswa kubva kumhepo.
Ventilator Kuchengeta
Kusvimha ndiro izwi rinoshandiswa pakugadzirisa mumwe munhu kubva kumhepo. Vazhinji varwere vanovhiyiwa vanobviswa kubva kumhepo yakananga nokukurumidza uye nyore. Zvinogona kugoverwa huwandu hwemhepo yakasvibiswa kuitira kuti nzira yacho ive nyore, asi inowanzokwanisa kufema pasina dambudziko.
Varwere vasingakwanisi kubviswa muvharidziro pakarepo mushure mekuvhiyiwa zvingada kusvimha, iyo inogadziriswa iyo zvirongwa zvemhepo inoita kuti murwere aedze kuzvifema ari oga, kana kuti ventiliti ishande basa shoma uye kushivirira kuita zvakawanda. Izvi zvinogona kuitwa kwemazuva kana masvondo, zvishoma nezvishoma zvichibvumira murwere kuti awedzere kufema kwavo.
CPAP, kana kuti inoenderera mberi inofungidzirwa nemhepo, inodzivirira mhepo inoita kuti varwere vaite basa rokufema nemhepo inowanikwa kubatsira kubatsira kana murwere wacho asiri kuita zvakanaka. Chirongwa cheCPAP, zvinoreva murwere akaiswa paCPAP yekuisa nguva yakatarwa, inogona kushandiswa kugadzirisa kana murwere anokwanisa kubvumira kubviswa kubva kumhepo.
Vamwe varwere vari muvhariyamu kwenguva yakareba vangave vari paCPAP masikati, ichazadza ventilator kusimba usiku kuitira kuti vagone kuzorora zvakakwana uye vacharamba vachiporesa vasina kupedzwa nebasa rokufema.
Kunyunyuta Pashure pokunge uri muVentilator
Kunyunyisa ndiyo nzira yekugadzirisa endotracheal tube. Munguva iyi, mukoti anobvisa mhepo kubva kune inokonzera gasket muhubhu uye inobudisa zvisungo kana tape inobata tubhu munzvimbo. Iyo tube inobva yanyatsotorwa kubva pamuromo wemurwere kana mumhino. Panguva ino vanogona kufema ivo pachavo uye ventilator haichagoni kupa chero rubatsiro rwekupema. Vakawanda vanorwara vanopiwa oxygen kuti vabatsire nehurongwa uhwu, zvichida kuburikidza nemasikisi kana kumativi ose.
Vakawanda vanorwara vanokanganiswa panguva iyi, asi haisi inorwadza. Varwere vakawanda vanonyunyutika nehuro mushure mekunge vakuvadzwa , saka mapuropa emitsipa, mazamu kana mishonga inoshandiswa inogona kushandiswa, kana murwere achigona kuvashivirira uye anogona kushandiswa zvakanaka.
Kuchengeta Pave paVentilator
Kuchengetedza varwere kune mumwe munhu pane pfuti inowanzobatwa nekudzivirira utachiona uye kushungurudzwa kweganda. Ava varwere vanenge vari nguva dzose mune imwe nhengo yekuchengetedza zvakanyanya (ICU) uye vanogamuchira nguva dzose kuchenjerera nekucherechedza.
Tape kana bhanhire rinoshandiswa kuchengetedza endotracheal tube munzvimbo, izvi zvinoshandiswa kana tsvina uye bhuti inogara ichibva kune rumwe rutivi rwomuromo kune rumwe. Kufambisa tube kunogadziriswa kudzivirira ganda rinoshungurudza uye kuputsika kubva pamubhodhoro uchibvarura nemisumbu yomuromo.
Muromo kuchengetwa kunowanzoitwa kuitira kudzivirira utachiona. Muromo unowanzooma, saka muromo unonatswa uye wakanyoroveswa kuchengetedza mazino uye kuderedza mabhakitiriya ose anokuvadza angaita kuti apinde mumapapu uye anokonzera pneumonia.
Zvinyorwa zvemumuromo zvinobudiswa mumuromo kuti zvidzivirire kupinda mumapapu uye zvinokonzera pneumonia . Zvinyorwa kubva kumapapu zvinowedzerwa sezvo murwere achange asingakwanisi kukanganisa zvinyorwa izvi apo paine ventilator.
Varwere vanoda ventirator vanowanzorwara kana kuti vasina simba kuti vadzokezve, saka kuchinja kakawanda kune chikamu chekuchengeta nguva dzose.
Kuporesa kunowanzogoverwa nehutano hwemapfupa kana vanamukoti, kubatsira kubvisa mhepo inovhara, zvinyoro zvishoma zvinogona kuvapo uye kubata chero mapapu emamiriro ezvinhu ayo murwere angave nawo.
Yenguva Yakareba Ventilator Care
Kune varwere vasingakwanisi kurumurwa kubva kumhepo inotonhora, tracheostomy inogona kudiwa. Chigadziro chekupedzisira hachifaniri kusara panzvimbo panzvimbo kwemavhiki mashomanana sezvo zvingazopedzisira zvichikonzera kukuvadza kusingaperi kumaketani ezwi kana mhepo yemhepo uye zvinogona kuita kuti ventilisi yokugadzirisa yakaoma zvikuru.
Kune varwere vanotarisirwa kuti vave muvharidziro kwenguva yakareba, kuzarura kunogadzirwa kunoitwa mumutsipa uye ventilator inosanganiswa ipapo, panzvimbo yekushanda kuburikidza nehuputi yakaiswa mumuromo.
Varwere vanowanzoendeswa kune imwe nzvimbo ye Long Term Acute Care (LTAC) inopa ventilator kutarisira. Zvivako izvi zvinowanzova nezvikwata apo ventilator yekuchenesa ndeyekukosha kwavo, uye nzira yekubatsira murwere kuona kuti kufema zvakanaka sei chikamu chekutarisira zuva nezuva.
> Kwakabva:
> Ndezvipi njodzi dzekuve pane ventilator? National Heart, Lung uye Blood Institute. Yakasvika munaSeptember, 2015. http://www.nhlbi.nih.gov/health/health-topics/topics/vent/risks