Bi-Level Positive Airway Pressure Kusiya CPAP
Bhi-level positive airway pressure (BiPAP) rudzi rwemhepo isingaiti mhepo inobatsira iyo kuchengetedza mhepo yepamusoro yemapapu inotanga nekupa kutenderera kwemhepo kunowanikwa kuburikidza neshinda masikati. Mhepo inomanikidzirwa nemichina, iyo inoitora iyo kumeso masikati kuburikidza nerefu, plastiki hosing.
Kunzwisisa BiPAP
BiPAP inoshandiswa iyo inopa kuendeswa kwemhepo yakamanikidzwa kubva pane imwe pombi yedenga, kuburikidza nechiso chemasikati kuitira kutsigira kufema.
Mune dzimwe nzira, zvakafanana neCPAP, asi neBiPAP, chiremba anonyora zvinetso zvakasiyana-siyana izvo zvinoshandiswa: Mhepo yakakwirira inoshandiswa kufema mu (inonzi inokurudzirwa zvakanaka mumhepo, kana IPAP) uye kudzvinyirirwa kwakadzama kunoshandiswa apo kufema kunze ( inonzi kudzvinyirira mafungiro akanaka emhepo, kana EPAP).
Iyo BiPAP Inobatsira Sei neCOPD
Vanhu vane COPD vane dambudziko nekufema, izvo zvinowanzoipisisa usiku. Usiku, hutomu hutachiona hwehuro hwevanhu vane COPD hunogona kugumburwa, hunoipisisa kuvhara kwemhepo kunowanikwa nehosha. Kana izvi zvikaitika, zvinogona kuva zvakaoma kuvarwere kuchengetedza mhepo yavo yakazaruka zvakakwana kuti kuchengetedza mweya yavo yakasvikidzika mazinga , uye panguva imwechete inochengetedza carbon dioxide muropa ravo pasi (usarega hypercapnia .) BiPAP inogona kubatsira neikupa inogara ichinetseka mumhepo kuburikidza nemasikisi inoderedza basa iro rinofanira kuitwa nekuda kwekugovana kwegesi kugovera oksijeni uye carbon dioxide kuti zviitike mualveoli .
Inofungidzirwa kuti BiPAP inogona kubatsirawo nekubvumira ikozvino kutora simba kumapfupa ekufema kuti uzorore kwenguva yakati usiku.
BiPAP vs CPAP
Kune varwere veCOPD, BiPAP ndiyo nzira inoshandiswa yekurapa pamusoro peCAPAP (inoramba iine mafungiro akanaka emhepo) nokuti zviri nyore kuti varwere ava vashandise kurwisana nechezasi.
Zvinogona kuva zvakaoma kune ani zvake kuti aende kunopesana nemhirizhonga (ichi ndicho chikonzero nei BiPAP inoshandiswa dzimwe nguva pane CPAP yekurara kwepnea), asi izvi zvinogona kunyanya kuoma neCOPD, umo kubuda kwacho kunowanzova dambudziko pane kuputika. BiPAP inobvumirawo kugadzirisa munguva, iyo inobatsira zvikuru kune avo vane COPD iyo kubuda kwemazuva kunonoka.
Apo Inoshandiswa neCOPD
Kune huwandu hwekugadzirisa umo BiPAP inogona kushandiswa kune vanhu vane COPD. Izvi zvinosanganisira:
- Ne hypercapnic respiratory failure (breathing type type II umo chiratidzo chikuru chekuchengetedza carbon dioxide) sechimwe chinhu chinokonzera kuputika kwemhepo.
- Kune vanhu vane mwero wakakura kusvika kune zvakanyanya dyspnea (kunzwa kwekufema kwepfupi), tachypnea (nokukurumidza asi kufema kufema), yakawedzerwa carbon dioxide muropa (hypercapnia) uye ropa pH ye7.25 kusvika ku7 .
Kubatsirwa kweBiPAP
Kushandiswa kweBiPAP, kana kuchiratidzwa, kunogona kuderedza nhamba yeCOPD inowedzera kune mumwe munhu, uye inogona kuderedza kudiwa kwemajini (air support respirator). BiPAP inogonawo kuita mutsauko mune tarisiro yehupenyu uye yakawanikwa ichideredza zvakanyanya njodzi yekufa kubva pachirwere.
Kuchengetedza uye Matambudziko
Kushandiswa kwemhepo isina kuvhara mukati meCOPD kuchiri mumatanho ekutanga ekuongororwa nenzira dzakawanda, uye basa rayo chaiyo kune varwere vane COPD vachiri kutsanangurwa.
Kunyange zvazvo zvingave zvichibatsira zvikuru kune vamwe vanhu vane chirwere, hazvibatsiri kune wese. Panguva ino, haifaniri kushandiswa kune vanhu vane mishonga isina kugadzikana, yakadai sevaya vane ropa rekudzivirira pasi kana zvirwere zvakakomba. Varwere vane severe acidosis (aine ropa pasi PH) nevaya vane kasi yepamwoyo yemwoyo (tachycardia) kunyanya, vanoita sevasingaiti zvakanaka nekurapa uku.
> Sources:
> Ankaergaard, K., Tonnesen, P., Laursen, L. et al. Musha NonInvasive Ventilation (NIV) Kurapa kwevarwere veCOPD vane Nhoroondo yekutengesa kweNIV kuwedzerwa; aRalomized, Controled, Multi-central Study. BMC Pulmonary Medicine . 2016. 16 (1): 32.
> Duiverman, M., Windisch, W., Storre, J., naP. Wijkstra. Basa reNIV mu Chronic Hypercapnic COPD Kutevera Kuwedzera Kwazvo: kukosha Kwekushivirira Murefu. Kurapa Kwokurapa Muzvirwere Zvinoporesa . 2016. 10 (2): 149-57.
> Gay, P. Nocturnal Ventilatory Kutsigira muCOPD. Kusvika pari zvino.
> Ko, B., Ahn, S., Lim, K. et al. Kukundikana Kwokutanga kweNyika Isingaiti Mhepo Inopinda Mune Zvirwere Zvisingagadziriswi Pulmonary Disease NeHurper Hypicnic Respiratory Failure. Internal and Emergency Medicine . 2015. 10 (7): 855-60.