Iko CPAP uye BiPAP inogona kubata sei COPD
Zvinorevei kana chiremba wako achikurudzira "kusvibiswa kwemazuva ano?" Izvi zvinopesana sei nemhepo inopinda mumhepo? Ndeipi nzira dzakadai seCPAP neBiPAP dzakaratidza uye ndezvipi zvinobatsira uye ngozi dzekurapa?
Chii Chisingatauri Kuputira Mhepo?
Noninvasive ventilation ndiyo imwe nzira inoparadzanisa mhepo inokonzera mhepo (kuiswa kune ventilalor) kune vanhu vane chirwere chisingaperi chokushaya kufema kana kupererwa nekupora uye havagoni kufema zvakakwana ivo pachavo.
Iyo inozivikanwawo seNininvasive Positive Pressure Ventilation (NIPPV,) isina vhudziro yemhepo inobatsira inobatsira munhu mukufema zvakakwana uye inobatsira kuchengetedza oksijeni yakakwana kune muviri.
NIPPV inopa rubatsiro rwemhepo kune munhu kuburikidza nepamusoro pemhepo. Inogadzirisa nzira yekufema kuburikidza nekupa musanganiswa wemhepo uye oksijeni kubva mumhepo inoyerera kuburikidza nesimba rakanyatsogadzikana kana masalic. Sezvo mapapu aripo, nenzira, akazarurirwa nemhepo yakasimba, zviri nyore kuwana oxygen pasi mudiki duku realveoli uko kushandiswa kweokisijeni uye carbon dioxide kuitika.
Mune zvisiri pamakiriniki iwe unogona kufungidzira mazairo ako sevana maduku. Uchishandisa chitsigiro chemukoko, "mabhaloni" anoramba asinganzwisisiki mushure mekunge ufuridzira kunze kuitira kuti zvive nyore kukura pamwe chete nekufema kwako kunotevera. Mune mamwe mazwi, zvakafanana nokuzadza ibhoti uye kuchenjerera kusatendera mhepo yose kubva pakati pemhepo yekufema kuitira kuti zvive nyore kuzadza.
Nzira yekuti Ininvasive Ventilation Inoshandiswa muCOPD
Vanhu vane chirwere chisingaperi cheplmmmm (COPD) dzimwe nguva vanorondedzerwa kuti vhepo isingasviki, yakadai seCPAP (inoramba ichienderera mberi mumhepo) kana BiPAP (bilevel positive airway pressure,) panguva yakaoma kuvabatsira kufema.
Inowanzobatanidzwa nehutano hwekurara , zvose CPAP neBiPAP zvinopa oksijeni yakamanikidzwa kuburikidza nechinangwa chechimiro kumhepo yomunhu.
Mhirizhonga inodzivirira mitsipa yemitsipa kuti irege kuwira uye ichidzivirira kubuda kwemhepo. Makomera eCAPAP anosungirwa kune imwechete yekumanikidzwa inoramba ichingoramba iripo usiku hwose, asi BiPAP ine miviri miviri yakamanikidzwa, imwe yekugadzirisa uye imwe yekudhonza.
Kubudirira kweNyika isingawaniki muCOPD
A 2014 nyanzvi yekutsvakurudza yakabudiswa muLancet yakawana NIPPV yakasimudzika kuwedzera kwehuwandu kune vanhu vane COPD. Gore negore rakaparidzirwa maitiro akawanda, kuongorora nyika dzakawanda kwakawana kuti vanhu vane COPD avo vakagamuchira vhudziro risingaverengeki vaine 36 muzana panjodzi yakaderera yekufa.
Zvimwe zvidzidzo zvinoratidza kuti NIPPV yakashandiswa panguva yakaoma yeCOPD yakaipa inoderedza kudiwa kwe endotracheal intubation (invasive mechanical ventilation,) uye inosanganiswa nehuwandu hwehutachiona husakundikana uye nguva shomanana yekugara muchipatara.
Mukuwedzera, chidzidzo che 2016 chakawana kuti nguva refu yeNIPPV inogona kukonzera kuvandudzika kwehutachiona hwehutachiona (ABGs,) mapapu emabasa, uye hutano hwakabatana hupenyu. Nenzira yakawanda, huri nani huri nani huri nani uye hukuru hwemhepo husingaverengeki (usingashandise zvakanyanyisa kukurudzira kushandiswa) kunze kwekudzika kweNIPPV.
Apo Kusina Kuputika Kwemhepo Kunokurudzirwa
Mune vanhu vane COPD avo vane hutano hwekuporesa hweruzhinji nekuda kwekukurira kweCOPD yakaoma, noninvasive chinosimudzira kuputika kwemhepo inogona kushandiswa panzvimbo ye endotracheal intubation mukusarudza varwere.
Chiremba wako anogona kukurudzira NIPPV kwauri kana iwe unenge uchienzanisa kusvika kune zvakanyanya dyspnea (kunzwa kwekupfupika kwemhepo,) tachypnea (kukurumidza kufema kupemha,) uye hypercarbia (yakakwirira carbon dioxide muropa,) ine pH iri pakati pe7.25 uye 7.35.
Vanhu havafanirwi kurapwa neNIPPV panzvimbo yemagetsi yekudzivirira kana vasingashandisi mishonga nekuda kwe hypotension ( kuderera kweropa ,) sepsis (chirwere chakaremara chinokonzera zvinogona kukonzera kushamiswa,) hypoxia (kushayikwa kwe okisijeni mumatumbu emuviri wako ,) kana humwe hutano hwehupenyu hunotyisa, hunova nehuwandu hwakaipa hwepfungwa, kana kuti huri kutarisana nemavhiringiro akawandisa anovaisa pangozi yakawanda yekuda.
Kusiyana nemhepo inoputika, iyo inoda kutarisa muimba huru yekuchengetedza, iyo isina vhudziro yemhepo inogona kuwanzoitwa muhurumende yakawanda yedare, kupa vashandi zvakanyatsodzidziswa mukushandisa kwayo.
CPAP vs. BiPAP
Zvose CPAP neBiPAP zvinopa oksijeni yakamanikidzwa kuburikidza nemasikisi, kunyange zvazvo CPAP yakagadzirirwa pane imwe nguva nguva iyo BiPAP ine mamiriro maviri, imwe yekufuridzirwa uye imwe yekupera.
BiPAP inoshandiswa kakawanda kune vanhu vane COPD sezvo zviri nyore kubudisa zvinopesana nekudzvinyirirwa kwakaderera. BiPAP inobvumirawo kugadzirisa munguva.
The Bottom Line
Noninvasive ventilation haikodzeri munhu wese uye haisi kubudirira nguva dzose. Ndiwe chiremba wako chete anogona kugona kana iwe uri mukana wekupinda mhepo isina simba.
Izvozvo zvakati, zvidzidzo zvinoratidza zvose zvakaderedzwa zvido zvekupedzisira kwekugadziriswa uye kugadziriswa kwehupenyu hwevanhu vane COPD avo vanobvumirwa neNIPPV vanokurudzira zvikuru. Uyezve, patinotarisa kushandiswa kwenguva refu kwemhepo isina kuvharana neCOPD, kushanduka kwakafanana nekuvandudzika kweropa rinopisa uye mapapu, uyewo huri nani hwehupenyu huchangobva kutaurwa, kunyanya nekuderera kukuru kweNIPPV.
Ichokwadi kuti, kusvibiswa kwemhepo inenge isiri iyo imwechete mukunatsiridza hutano hwako hwehupenyu nekupona neCOPD yakasimba. Iva nechokwadi chekuzvidzidza pachako pane dzimwe mazano ekuchengetedza mapapu emabasa nechitatu III COPD .
> Sources
Altintas, N. Kuvandudza: Kwete-Inogadzirisa Chinhu Chinosimudzira Kuvhara Kwemhepo Mukupererwa Kwisina Kufuridzira Kuporesa Nokuda kweCOPD. COPD . 2016. 13 (1): 1110-21.
> Kasper, Dennis, Anthony Fauci, Stephen Hauser, Dan Longo, naJames Jameson. Harrison's Principles of Internal Medicine. New York: McGraw-Hill Dzidzo, 2015. Print.
> Kohnlein, T., Windisch, W., Kohler, D. et al. Kwete-Inopindira Chinhu Chinoita Kuti Mhepo Ive Nemafuro Okurapa Kwakaoma Kwakasimba Dambudziko Rekudzivirira Kurapa Kwepulmonary: A Tarisiro, Multicentre, Randomized, Controlled Clinical Trial. The Lancet. Respiratory Medicine . 2014. 2 (9): 698-705.
> Windisch, W., Storre, J., naT. Kohnlein. Nocturnal Isingaiti Inokuvadza Zvakanaka Kuvhara Kwemafuro kweCOPD. Nyanzvi Ongororo dzeHupemikirwo Mishonga . 2015. 9 (3): 295-308.