Death by Neurologic Criteria
Kana munhu akafa, ivo vanowanzofa pane izvo zvinonzi "kufa kwemoyo." Rudzi urwu rworufu runoitika apo moyo hausisina hanya kupa ropa kumuviri neuropi, izvo zvinoguma nekufa. Nhamba zhinji yevakafa, inenge 99%, inouraya mwoyo. Zvisinei, pane imwe rudzi rwekufa, iyo inonzi uropi rufu. Pasina 1 muzana yevanhu vose inogara ichitaura kuti uropi yafa.
Ubongo hwehupombwe hutachiona uye kuwanikwa kwepamutemo kwekufa. Iko pfungwa yeuropi rufu inogona kuva yakavhiringidza nokuti mwoyo wemunhu ichiri kurova uye chifuva chavo chicharamba chichimuka uye chichiwa nemhepo yose kubva mumhepo. Ganda racho rinodziya uye munhu wacho angaita seanozorora akanyaradzwa, pane kurwara zvakanyanya uye asina ubongo hunoita. Ichi ndechokuti chakaipisisa chekuvhiringidza kwepanyama chaicho chakavanzwa muuropi, pane kuonekwa pamuviri.
Masero eubongo haana kuchinjazve. Izvi zvinoita kuti zvive zvakaoma kuti uropi hudzoke kubva mukukuvara. Kana uropi uchinzwa nzara ye okisijeni kwenguva yakareba zvakakwana kuti masero europi afe, haazobatsiri. Kana kukanganisa kwakakwana kunoitika kudzivirira huropi kuti irege kugamuchira ropa uye oksijeni, uye uropi hunova pasina okisijeni kwenguva yakakwana, uropi hunogona kuitika.
Kuzivisa Ubongo Rufu
Uropi hunoita kuti chiremba anokwanisa, kazhinji aine maitiro emagetsi, akaongorora zvakanyanya murwere uye akawana kuti murwere anokwana mitemo yekufa kweuropi.
Pamberi peuropi kufa rufu rwuri kutaurwa, zvitatu zvinokonzerwa nekliniki zvinofanira kusangana:
- Kusateerera
- Kutadza kwemafungiro
- Apnea (kusakwanisa kufema pasina ventilator)
Uropi Rufu Kuedzwa
Kuongorora rufu rwehupombwe kunowira mumapoka matatu makuru:
- Kuongorora kwepanyama
- Apnea test
- Mimwe miedzo, inozivikanwa sechiedza chekuedza
Kuongorora Kwepanyama
Kunyatsoongorora kunoitwa kuti uone kana murwere ari kuteerera. Kana ivo vasati vari, kuongorora kwemuviri kunogona kutarisa kugadzirisa. Murwere ane uropi akafa haazovi nehupi hwehutano hwekufunga. Semuenzaniso, mumwe munhu anorwara anokwanisa kuchenesa kana kutamisa misoro yavo kana mumwe munhu akabata ziso nekande yekotoni. Iropi chirwere chakafa hachizonyunyuti kana chiremba achibata ziso ravo nechidimbu chekotoni. Nokudaro, kana pasina kubwinya, izvo zvinoreva kuti brainstystem haina kushanda zvakanaka.
Imwe nzira yekuedzwa mumuviri ndiyo inotonhorera caloric. Uyu muedzo unoitwa kuburikidza uchishandisa sironji yemvura inotonhorera yechando uye inorovera iyo munzeve. Murwere ane uropi akafa haazovi nemhinduro kune rudzi urwu rwekukurudzira, munhu ane ubongo huchaita achava nemhinduro, iyo inogona kubva kubva pakuona kwemaziso kusvika mukurutsa. Hora caloric test haifaniri kumboitwa kune mumwe munhu anozivikanwa kuti ane hutano hwepfungwa dzakasimba sekumushongedza kwepisipilisi inowanzova mugumisiro.
Apnea Testing
Murwere ane chirwere chakakwana pakuongororwa kweuropi kufa achave pavheti . Murwere anonyatsofa muuropi haagoni kufema pasina ventilator. Kuti uongorore kuona kana kufema kufema kwakanyatsoshanda kana kusipo, murwere wacho anobviswa kubva muvharidziro mune imwe nzira inonzi test apnea.
Kazhinji, an ABG inoswededzwa pakarepo isati yatanga kuongorora kwepnea, apo murwere anotorwa kubva muvharidzi. Oxygen inogona kupiwa murwere panguva yekuedzwa kwepnea, asi ventilator haigone kubatsira murwere kufema.
Murwere ane uropi-akafa haafaniri kupora munguva yekuongorora kwepnea. Mumwe munhu anorwara achaedza kubudisa kufema apo uropi hunoudza muviri kuti zvakakodzera. Kune varwere vehopi-vakafa, uropi haikwanise kutumira chiratidzo chekufema nekufema hazviitiki kunze kwekutsigirwa kwevheti.
Chimwe Chirwere Chekufa Kuedzwa
Pashure pokupedzisa kuongorora kwepanyama, chiremba angasarudza kuronga kuongororwa kwakawedzerwa.
Kunyange zvazvo iyo inofanirwa kuongorora kwepanyama uye kuongorora kwepnea kuti iitwe, mune dzimwe nguva murwere haagoni kubvumira apnea kuedza. Kazhinji, mumatambudziko iwayo, kuongorora kunoitwa kuchaitwa. Izvi zvidzidzo zvinoitwa kuti zvione kana ropa riri kuenda kuuropi kuburikidza neropa. Kana chidzidzo ichi chinoratidza kuti hapana ropa rinosvika kuuropi, muedzo unoenderana neuropi kufa.
Vamwe vanachiremba vachashandisa EEG, kana electroencephalogram, iyo ndiyo muedzo unoenzanisa mafunde europi. Murwere ane uropi akafa achava ne "gorofa" EEG, sezvo mafungu europi achange asipo.
Uropi Rufu Kurondedzera
Apo murwere anonzi anonzi uropi afa, ivo vakafa zviri pamutemo. Chirwere chavo chekufa chicharatidza zuva apo uropi hwafa hwakataurwa, kwete apo mwoyo yavo inomira pane imwe nguva. MuUnited States, kana murwere anonzi chirofu akafa uye murwere anosangana nedzimwe nzira dzokurapa, chipo chemuviri chinogona kuva chakanaka. Muzviitiko zvizhinji, munhu wacho atoita chisarudzo chekupa uye akaratidza chisarudzo chavo pamutemo wavo wekutyaira kana mukuda kwavo.
Sources:
Dzidzira Parameters: Kusarudza Brain Rufu MuVakuru. American Academy of Neurology. http://www.aan.com/professionals/practice/guidelines/pda/Brain_death_adults.pdf