Zvakaitwa navanachiremba navanachiremba
Varwere vane zvirwere zvepurojeni vakasiyana nemamwe marudzi evarwere. Nokuti dambudziko ravo rinosanganisira hurongwa hwavo hwemagetsi, ivo vanowanzogadzirisa kutanga mamwe marudzi ematambudziko. Kubatsira kweropa reCU ndechokuti vanachiremba uye vanamukoti vane ruzivo rwakanaka runovabvumira kuti vaone zviri nani nekugadzirisa matambudziko akadaro pavanomuka.
Hyponatremia
Neurological zvirwere zvinogona kukonzera kusunungurwa kwehomoni inoshandisa kuwanda kwe sodium muropa, iyo inozivikanwa se hyponatremia . Izvi zvinonetsa kubva pakaderera ropa reyerodium zvinogona kukonzera kusvibiswa kunyura mukati mehutachi tissue uye kuwedzera kuodema nekuputika. Pane nzira mbiri dzakakonzerwa nekukuvara kweuropi kunotungamirira ku hyponatremia: chirwere chesafananidziro hormone hypersecretion (SIADH) uye cerebral salt kuparadza syndrome (CSWS).
SIADH inowirirana nehuwandu hwemvura yakadzika mumvura, uye CSWS inonyanya kukonzera kusinganzwisisiki pasi masimba emuviri sodium. Mune mamwe mazwi, nepo matambudziko maviri angakonzera kubhadhare yakadai saiyo, chaizvoizvo yakasiyana zvakasiyana uye inoda kurapa kwakasiyana.
Deep Vein Thrombosis
Kune zvitatu zvinokonzerwa nehutachiona hwekuvhara ropa: stasis, kuparadza kwemavhukira, uye hypercoagulability.
Stasis zvinongoreva kuti iwe hausi kufamba zvakanyanya.
Ndicho chikonzero ndege dziri kukurudzira vatasimuka kuti vasimuke nguva nenguva panguva dzenguva refu uye vachifamba-famba nekambani. Kuramba uchiri kure kwenguva refu kunogona kukonzera kuvhara ropa kuve mumakumbo emakumbo ako. Kana zvipfeko izvi zvichibvaruka pamakumbo, zvinogona kutenderera kusvika kumapapu uye zvinokonzera kuti mishonga inopisa upenyu iwedzere .
Kukuvadza kumadziro eropa mudziyo kunogona kukonzera kuti machudzi aumbe, sezvinoitika nehutachiona hutsva . Pakupedzisira, vamwe vanhu vane ropa iro rinonyanya kugadziriswa pakuumba zvipfeko uye, saka, pahuwandu hwehutachiwana hwehutachiona hwehutachiona uye hwemapulmoni embolism.
Varwere muuropiyumu ICUs inonyanya kutaridzika pakugadzira ropa. Nokuda kwehutano hwehutano hwavo, vanhu vakaoma rutivi rwomuviri kana kuti mu coma havafambi. Uyezve, vamwe vakaroorwa vane chirwere chavo vaiva nechirwere cheschemic nokuti vane ropa iro rinowanzogadzirisa zvipfeko. Vanoshungurudzwa nemusoro vanogona kunge vakatambura zvimwe zvinokanganisa kumadziro emadziro eropa.
Kuwedzera kunetsa nyaya iyi mubvunzo wezvinofanira kuitwa kana mumwe munhu achiwedzera ropa paanenge ari muI ICU kubuda ropa muuropi. Semuenzaniso, subarachnoid hemorrhage yakabatanidzwa nehuwandu hwepamusoro hwekudzika kwevheinstrombosis. Ropa rega rega rinowanzodzivirirwa nekupa ropa rakanyanya se heparin, asi mishonga iyi inogona kuwedzera kubuda ropa. Nzira yekugadzirisa dambudziko rekukwikwidza iyi inogona kuva chisarudzo chakaoma.
Aspiration
Paunotarisana nemamiriro ekukurumidzira, vanachiremba vanodzidziswa kuisa pfungwa paAABC -airway, kufema, uye kuparadzirwa. Chinonyanya kukosha pane zvinhu izvi nderegeti.
Kunze kwekuti magwaro anotitendera kufema akazaruka, hapana chimwe chinhu chinokosha. Kunyange kubatwa kwemwoyo kunowanzokosha zvakanyanya. Kufambisa chimwe chinhu mumapapu asina kuitirwa kuti avepo anozivikanwa sechishuvo , uye chinogona kugadzirisa mumwe munhu nokuda kwezvirwere zvakakomba.
Vakawanda vedu tinoita zvinhu zviduku nguva imwechete kuti tione kuti mhepo dzedu dzomumhepo dzinogara dzakasununguka. Izvo zvisinganzwisisiki zvisinganzwisisiki zvokumedza samate, somuenzaniso, inoita kuti mabhakitiriya kubva pamiromo yedu arege kupinda mukati memaapapu edu otumbuka kuva pneumonia . Tinogomera pane imwe nguva kuti tichengetedze madunhu maduku emapapu edu kuti arege kuputsika. Kana tikanzwa kunyorera kumashure kwehuroti yedu, tinoshuva.
Vanhu vakakonzera mitsipa iyo inodzora rusvingo rwechifuva, chirwere, rurimi kana huro zvinogona kuva nezvinetso kuita izvi zvisiri nyore, zvisingazivikanwi. Mumwe munhu ari mu coma angasaita chero chezvinhu izvi kana. Mune chikwata chekuchengetedza zvakanyanya, zvinhu izvi zvinoitwa kwavari nevanyanzvi nevanamukoti vane mazano sekutsvaira, kuporesa, uye kuputika kwekugadzirisa.
Kurwara
Kunyatsotarisira zviyero zviyero ndiko kune avo vanorwara kupfuura vanhu vanorwara vanochengetwa. Izvo zvinorevawo kuti ICUs inowanzotarisa mabhakitiriya anorema uye ane ngozi anogona kuwanikwa. Nemhaka yekushandiswa kwenguva refu kwemishonga inorwisa mabhakitiriya muICUs, mamwe emabhakitiriya aya akashanduka kuti arwise mishonga inorwisa mabhakitiriya , kuita zvirwere zvakanyanya kuoma kubata.
Vashandi vanorayiridzirwa vanodzidzisa kushandisa masimba ose kuti vasapararira utachiona, kusanganisira kushambidza maoko uye dzimwe nguva nguo uye masikisi zvakare. Zvisinei, hapana kudzivirira kunoshanda zana zana kubva panguva, uye dzimwe nguva zvirwere zvinopararira pasinei nezvinochengetedzwa. Nokuda kwechikonzero ichi, vashandi vezvechiremba vanotarisa varwere vanoona zviratidzo zvehutachiona. Uyezve, kuedza kunoitwa kuendesa murwere kune imwe nzvimbo inenge isina kunaka, yakadai sedare rechipatara pasi, nokukurumidza sezvazvinogona.
Acute Confusional State
Mamiriro akaoma anonyadzisa, anozivikanwawo sekuti delirium kana encephalopathy, ndeimwe yezvinhu zvinonyanya kunetsa izvo varwere kana vadiwa vavo vanoona muchipatara. Zvinosuruvarisa, zvakare ndeimwe yezvakanyanya kufanana. Vose vanenge 80% vevashandi vanonzi intubated muCIU vanosangana nemamiriro aya. Munhu wacho anovhiringidzika pamusoro pokuti aripi, nguva ipi iyo, uye chii chiri kuitika. Vangave vasingazivi shamwari kana mhuri. Vanogona kukanganisa, kana kuti kuchinja. Dzimwe nguva izvi zvinotungamirira kuedza kupukunyuka kuchipatara kana kubvisa mabhuku uye IV zvinoda kuchengetwa murwere.
Kurapa kwemaitiro akaoma anonyadzisa kunogona kunge kunoshungurudza sezvinongoita dambudziko sezvo zvingave zvinosanganisira kupa mishonga yekugarisa kana kuvhara murwere. Zvisinei, kune matanho akawanda akaderera zvakanyanya anokwanisa kutorwa kuti agadzirise kupesana asati asununguka.
Subclinical Status Epilepticus
Apo vanhu vazhinji vanofunga nezvekubatwa, vanofananidzira mumwe munhu achizununguka. Kune dzimwe nzira dzisinganyengeri dzokutora, kunyange zvakadaro, mune mumwe munhu asingaoneki ari kuita zvakawanda zvechinhu chero chipi zvacho, kana kuti angangoita seanovhiringidzika.
Kunyange zvakadaro, vanhu ava vanogona kubatsirwa nemishonga yakakodzera. Zvimwe zvidzidzo zvakaratidza kuti vazhinji vanoita 10% yevanhu vari muCIU vanogona kunge vakagumburwa izvo zvinowanzoenda zvisingachaonekwi, uye chiyero ichi chinogona kunge chakanyanya kune varwere vane zvinetso zvepfungwa.
Dysautonomia
Izwi rinotyisa remagetsi hazvizivi uye rinowanzokoshesa. Iyi ndiyo chikamu chehurongwa hwemitsipa hunotarisa moyo wehutano, kufema, ropa, nezvimwewo. Kungofanana nezvirwere zvepfungwa zvinogona kuchinja mabasa atinofunga pamusoro payo, sekufambisa uye kutaura, zvimwe zvinetso zvingakanganisa hutachiona hwehutano hwakanaka pamwe chete.
Matambudziko ari pamusoro apa anowanzowanika mumhando dzakawanda dzezvirwere zvakasiyana siyana zvinoita kuti munhu ave neurological ICU . Kunyange zvazvo vangawanika kune dzimwe dzimba dzekuchengetedza zvakanyanya ,wo dzimwe nyanzvi dzingave dzisingazivi sekuziva nekugadzirisa matambudziko aya. Nokuda kwechikonzero ichi, neuro-ICUs dzakaratidza kuva dzinokosha mukurapa vanhu vane zvirwere zvakakomba zvepfungwa.
Sources:
Allan H. Ropper, Daryl R. Gress, Michael. Diringer, Deborah M. Green, Stephan A. Mayer, Thomas P. Bleck, Neurological uye Neurosurgical Care Intensive, Nhivi yechina, Lippincott Williams & Wilkins, 2004
Braunwald E, Fauci ES, et al. Harrison's Principles of Internal Medicine. 16th ed. 2005.