He aha ka hanu ʻana o ka nitric oxide: Nā hoʻohana, ka nui o ka lāʻau, nā hopena ʻaoʻao a me nā mea hou aku

ʻO ka hanu ʻana o ka nitric oxide he lāʻau lapaʻau kinoea kūikawā e kōkua ana i nā pēpē hānau hou e hanu maikaʻi aʻe ke paʻakikī ko lākou māmā e loaʻa ka oxygen lawa. Hana kēia lapaʻau ma ka hoʻomaha ʻana i nā kīʻaha koko i loko o nā māmā, e ʻae ana i ka oxygen e kahe maʻalahi i loko o ke kino. Hoʻohana maʻamau ʻia i loko o nā keʻena mālama koʻikoʻi o ka haukapila ma lalo o ka mālama ʻana i ka lāʻau lapaʻau, kahi e hiki ai i nā hui mālama ola ke nānā pono i ka holomua o kāu pēpē.

He aha ka hanu ʻana o ka nitric oxide?

ʻO ka hanu ʻana o ka nitric oxide he kinoea ʻaʻole kala, ʻaʻala ʻole e hāʻawi pololei nā kauka i loko o nā māmā o kāu pēpē ma o ka paipu hanu a i ʻole ka pale maka. E noʻonoʻo iā ia he mea kōkua mālie e wehe ana i nā kīʻaha koko liʻiliʻi i loko o nā māmā, e maʻalahi ai ka oxygen e hiki i nā ʻāpana a pau o ke kino o kāu pēpē. ʻAʻole kēia he mea hiki iā ʻoe ke loaʻa ma ka hale kūʻai lāʻau lapaʻau - he kinoea lāʻau lapaʻau i kauoha ʻia e pono ai nā lako kūikawā a me nā poʻe loea mālama ola i hoʻomaʻamaʻa ʻia e lawelawe palekana.

ʻO ke kinoea ponoʻī he molekala kūlohelohe e hana maoli ai kou kino i nā mea liʻiliʻi. Ke hoʻohana ʻia ma ke ʻano he lāʻau lapaʻau, mālama pono ʻia a hui pū ʻia me ka ea e hanu ai kāu pēpē. He manawa pōkole ka lapaʻau a hoʻohana maʻamau ʻia no nā manawa pōkole ʻoiai e hoʻōla a hoʻoikaika nā māmā o kāu pēpē.

No ke aha i hoʻohana ʻia ai ka hanu ʻana o ka nitric oxide?

Hoʻohana nui ʻia ka hanu ʻana o ka nitric oxide e mālama i nā pēpē hānau hou me ka hypertension pulmonary mau, kahi maʻi koʻikoʻi kahi e noho ai ke koko i loko o nā ʻaʻa māmā i ke kiʻekiʻe weliweli. Hana kēia ke ʻole ka holo ʻana o ke koko o ka pēpē mai ka hilinaʻi ʻana i ka lako oxygen o ka makuahine i ka hanu ʻana ma hope o ka hānau ʻana.

I ka wā e loaʻa ai i nā pēpē kēia maʻi, ʻaʻole hiki i ko lākou mau māmā ke hāʻawi i ka oxygen lawa i ko lākou kino, he mea weliweli paha ia i ke ola. Kōkua ka lapaʻau ma ka hoʻomaha ʻana i nā paia ʻiʻo o nā kīʻaha koko i loko o nā māmā, e hōʻemi ana i ke kaomi a hoʻomaikaʻi i ke kahe koko. Hiki i kēia i ka oxygen ke neʻe ʻoi aku ka maikaʻi mai nā māmā i ke koena o ke kino.

I kekahi mau hihia, hiki i nā kauka ke hoʻohana i ka nitric oxide no nā pilikia hanu ʻē aʻe i nā pēpē hānau hou, ʻoiai ʻaʻole maʻamau kēia. E loiloi pono kāu hui lapaʻau inā kūpono kēia lapaʻau no ke kūlana kikoʻī o kāu pēpē.

Pehea e hana ai ka hanu ʻana i ka Nitric Oxide?

Hana ka nitric oxide ma ka ʻimi ʻana i nā cell kikoʻī i nā paia kīʻaha koko o nā māmā o kāu pēpē. Ke hiki ke kinoea i kēia mau cell, hoʻomaka ia i kahi pane hoʻomaha maoli e hoʻonui ai i nā kīʻaha koko. Ua like kēia me ke ʻano o ka wehe ʻana o ka paipu māla paʻa ke hoʻokuʻu ʻoe i ke kaomi - hiki i ke koko ke kahe manuahi, e lawe ana i ka oxygen waiwai i loko o ke kino o kāu pēpē.

Ua manaʻo ʻia ka lapaʻau he lāʻau lapaʻau ikaika waena e hana wikiwiki ana, e hōʻike pinepine ana i nā hopena i loko o nā minuke a i ʻole nā hola. ʻAʻole ia he lāʻau lapaʻau, akā he lāʻau lapaʻau kākoʻo e hāʻawi ana i nā māmā o kāu pēpē i ka manawa e hoʻōla a hoʻomohala pono. Hoʻopilikia wale ke kinoea i nā māmā, ʻo ia hoʻi, ʻoi aku ka liʻiliʻi o nā hopena ma nā ʻāpana ʻē aʻe o ke kino i hoʻohālikelike ʻia me nā lāʻau lapaʻau i hāʻawi ʻia ma o IV a i ʻole ka injection.

ʻO ka mea e hana ai i kēia lapaʻau he mea kūikawā, ʻo ia ka hana pololei ʻana i kahi e pono ai - i loko o ka ʻiʻo māmā ponoʻī. Ke hana ka nitric oxide i kāna hana i loko o nā māmā, ua wāwahi koke ʻia a hoʻopau ʻia mai ke kino, e kōkua ana i ka hōʻemi ʻana i nā hopena ʻaoʻao.

Pehea e hāʻawi ʻia ai ka hanu ʻana i ka Nitric Oxide?

Hoʻokomo ʻia ka nitric oxide e nā poʻe loea mālama ola i aʻo ʻia ma kahi haukapila, maʻamau i ka neonatal intensive care unit (NICU). ʻAʻole pono ʻoe e hopohopo e hāʻawi iā ʻoe iho i kēia lāʻau - mālama ka hui lapaʻau i nā mea āpau. Hāʻawi ʻia ke kinoea ma o ka ʻōnaehana kākoʻo hanu o kāu pēpē, inā he ventilator, paipu hanu, a i ʻole mask kūikawā.

Pono ka lapaʻau i nā lako kūikawā e hoʻomalu pono i ka nui o ka nitric oxide e loaʻa ai i kāu pēpē. Mālama mau nā mea mālama ola i nā pae e hōʻoia i ka loaʻa ʻana o kāu pēpē i ka nui kūpono. Hoʻohui ʻia ke kinoea me ka oxygen maʻamau a me ka ea e hanu ai kāu pēpē, e hana ana i kahi hui kaulike.

E nānā pono ʻia kāu pēpē i ka wā o ka lapaʻau, me nā loiloi pinepine o nā pae oxygen, ke koko, a me ke kūlana holoʻokoʻa. E hoʻoponopono ka hui lapaʻau i ka mahele ma muli o ka pane ʻana o kāu pēpē, e manaʻo mau ana i ka nui liʻiliʻi loa e hōʻemi i nā pilikia.

Pehea ka lōʻihi e hoʻohana ʻia ai ka Nitric Oxide Inhalation?

He ʻokoʻa loa ka lōʻihi o ka lapaʻau nitric oxide ma muli o ke kūlana o kāu pēpē a me ka wikiwiki o ko lākou hoʻomaikaʻi ʻana. Loaʻa ka lapaʻau i ka hapa nui o nā pēpē no kekahi mau hola a i kekahi mau lā, akā pono paha kekahi no hoʻokahi pule a ʻoi aku paha. E loiloi mau kāu hui lapaʻau inā pono kāu pēpē i ka lapaʻau a i ʻole inā ikaika lākou e hanu maikaʻi me ka ʻole.

Pono ka hoʻolālā pono a me ka hoʻemi ʻana ma mua o ka hoʻōki ʻana i ka lapaʻau. ʻO kēia no ka mea pono ke kino o kāu pēpē i ka manawa e hoʻoponopono ai i ka hanu ʻana me ka ʻole o ke kākoʻo hou. E hoʻemi mālie nā mea mālama ola i ka nui o ka nitric oxide i ka manawa e nānā pono ana i ka pane a kāu pēpē.

ʻO ka pahuhopu, ʻo ia ka hoʻohana ʻana i ka lāʻau lapaʻau no ka manawa pōkole loa e kōkua i ka hoʻōla ʻana o nā māmā o kāu pēpē a me ka hana pono. E kūkākūkā kāu hui lapaʻau i ka manawa i manaʻo ʻia me ʻoe, akā e hoʻoponopono lākou i ka hoʻolālā e pili ana i ka holomua o kāu pēpē.

He aha nā hopena ʻaoʻao o ka hanu ʻana i ka nitric oxide?

ʻOiai ua ʻae maikaʻi ʻia ka hanu ʻana i ka nitric oxide, aia kekahi mau hopena ʻaoʻao e nānā pono ai nā mea mālama ola. ʻO nā hopena ʻaoʻao maʻamau ka mea maʻamau a maʻalahi hoʻi me ka mālama olakino kūpono.

Eia nā hopena ʻaoʻao maʻamau e nānā ai nā hui lapaʻau i ka wā o ka lāʻau lapaʻau:

• He emi iki o ke koko, he maʻalahi a maʻalahi hoʻi
• Nā loli liʻiliʻi i nā pae oxygen e koi ai i nā hoʻoponopono ʻana i ka mahele
• He huhū iki o ka ea, ʻoiai ʻaʻole maʻamau kēia me ka lawelawe pono
• Nā loli manawa i ke kemika koko e nānā ai nā kauka ma o nā hoʻokolohua koko maʻamau

He manawa pōkole kēia mau hopena a hoʻoponopono ʻia ke hoʻoponopono ʻia a i ʻole ke pau ka lāʻau lapaʻau. Ua aʻo ʻia kāu hui lapaʻau e ʻike a mālama i kēia mau loli me ka wikiwiki.

He mea maʻamau nā hopena ʻaoʻao koʻikoʻi, akā hiki ke komo i nā pilikia hanu inā hoʻōki koke ʻia ka lāʻau lapaʻau, a i ʻole i nā hihia maʻamau loa, ka hana ʻana o kahi mea i kapa ʻia ʻo methemoglobin i ke koko. Hoʻāʻo mau nā mea mālama ola i kēia e hōʻoia i ka palekana o kāu pēpē. ʻO ka nānā mau ʻana i ka NICU e kōkua i ka hopu ʻana i nā loli e pili ana i ka wā mua, e ʻae ana i ka hana wikiwiki inā pono.

ʻO wai ka mea ʻaʻole pono e loaʻa i ka hanu ʻana i ka nitric oxide?

ʻAʻole kūpono ka hanu ʻana i ka nitric oxide no nā pēpē a pau, a aia kekahi mau kūlana kikoʻī e pale ai nā kauka i kēia lāʻau lapaʻau. Aia mau ka hoʻoholo i ke kūlana olakino holoʻokoʻa o kāu pēpē a me ke kumu kumu o ko lākou pilikia hanu.

ʻO nā pēpē i pono ʻole ke loaʻa i ka hanu ʻana i ka nitric oxide, ʻo ia nā pēpē me kekahi mau maʻi puʻuwai kahi e hiki ai i ka lāʻau lapaʻau ke hoʻonui i ko lākou maʻi. Inā he pilikia puʻuwai congenital kāu pēpē kahi e hilinaʻi ai ke kahe koko i nā kaomi kikoʻī, hiki i ka nitric oxide ke keakea i ko lākou kahe. Eia kekahi, ʻaʻole paha he moho maikaʻi nā pēpē me nā maʻi koko nui no ka mea hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka hoʻopaʻa ʻana o ke koko.

E loiloi pono kāu hui lapaʻau i ke kūlana o kāu pēpē ma mua o ka ʻōlelo ʻana i ka nitric oxide. E noʻonoʻo lākou i nā mea e like me ka makahiki o kāu pēpē, ke kaumaha, nā maʻi ʻē aʻe, a me ke ʻano kikoʻī o ka pilikia hanu e loaʻa nei iā lākou. Inā ʻaʻole kūpono ka nitric oxide no kāu pēpē, aia nā koho lapaʻau ʻē aʻe.

Nā inoa inoa o ka hanu ʻana i ka Nitric Oxide

ʻO ka inoa inoa nui no ka hanu ʻana i ka nitric oxide ma ʻAmelika Hui Pū ʻIa ʻo INOmax, i hana ʻia e Mallinckrodt Pharmaceuticals. ʻO kēia ka mea i hoʻohana nui ʻia i nā haukapila ma ka ʻāina. Hiki i kekahi mau keʻena lapaʻau ke hoʻohana i nā mana generic o ke kinoea nitric oxide, ʻoiai e mau ana nā mea hana a me nā ʻōnaehana hāʻawi i ka loea nui me ka nānā ʻole i ka brand.

Hiki iā ʻoe ke lohe i nā mea mālama ola e kuhikuhi ana i ka lāʻau lapaʻau ma ke ʻano he

ʻO kekahi koho ʻē aʻe he lapaʻau i kapa ʻia ʻo ECMO (extracorporeal membrane oxygenation), e lawe manawa ana i ka hana o ka puʻuwai a me nā māmā o kāu pēpē. Hoʻopaʻa ʻia kēia no nā hihia koʻikoʻi loa kahi i kū ʻole ai nā lapaʻau ʻē aʻe. ʻO kekahi koho ʻē aʻe he ventilation kiʻekiʻe-frequency, e hoʻohana ana i nā hanu wikiwiki a liʻiliʻi e kōkua i ka hāʻawi ʻana i ka oxygen me ka maikaʻi.

Hiki i kekahi mau pēpē ke pōmaikaʻi mai nā lāʻau lapaʻau i kapa ʻia he vasodilators i hāʻawi ʻia ma o IV, akā naʻe, pili kēia mau mea i ke kino holoʻokoʻa ma mua o nā māmā wale nō. Hiki i kāu hui lapaʻau ke hoʻohana i nā ʻenehana hoʻonohonoho kūikawā, ka hoʻomaha mālie, a i ʻole nā hana mālama kākoʻo ʻē aʻe e pili ana i nā pono kikoʻī o kāu pēpē.

Ua ʻoi aku ka maikaʻi o ka hanu ʻana i ka Nitric Oxide ma mua o nā lapaʻau ʻē aʻe?

Hāʻawi ka hanu ʻana i ka nitric oxide i nā pono kūikawā ma luna o nā lapaʻau ʻē aʻe no nā pilikia hanu hānau hou no ka mea e hana pololei ana i nā māmā kahi e hana ʻia ai ka pilikia. ʻAʻole like me nā lāʻau lapaʻau i hāʻawi ʻia ma o IV e pili ana i ke kino holoʻokoʻa, ua manaʻo ʻia ka nitric oxide i nā kīʻaha koko kikoʻī i nā māmā e pono ai ke kōkua, e hōʻemi ana i nā hopena ʻaoʻao ma nā ʻōkana ʻē aʻe.

I ka hoʻohālikelike ʻana i nā lapaʻau invasive hou e like me ECMO, ʻaʻole paʻakikī ka nitric oxide a lawe i nā pilikia liʻiliʻi. ʻAʻole pono ia i ke ʻoki a i ʻole nā kaʻina hana nui, a hiki i nā pēpē ke hoʻomau pinepine me kā lākou hana hānai a me ka mālama maʻamau. Hoʻomaʻamaʻa pū ka lapaʻau e hana wikiwiki, e hōʻike pinepine ana i nā hopena i loko o nā hola ma mua o nā lā.

Eia naʻe, ʻaʻole ʻo nitric oxide ka koho maikaʻi loa no kēlā me kēia pēpē. Pane maikaʻi kekahi mau kūlana i nā lapaʻau ʻē aʻe, a ʻo ka koho

ʻAe, hiki ke hoʻohana palekana ʻia ka hanu ʻana i ka nitric oxide i nā pēpē hānau mua ke pono i ka lāʻau lapaʻau, akā e mālama ʻia nā hana mālama hou. He palupalu nā pēpē hānau mua a hiki ke pane ʻokoʻa i nā lāʻau lapaʻau, no laila e nānā pono nā mea mālama ola iā lākou i ka wā o ka lāʻau nitric oxide. Hiki ke hoʻoponopono ʻia ka dosage e pili ana i ka nui o ka pēpē a me ke kahua hoʻomohala.

Ma keʻano maʻamau, maikaʻi ka palekana i nā pēpē hānau mua, akā e ana pono ka hui lapaʻau i nā pōmaikaʻi e kūʻē i nā pilikia. E noʻonoʻo lākou i nā mea e like me ka wā i hānau ʻia ai ka pēpē, ko lākou kaumaha i kēia manawa, a me nā pilikia olakino ʻē aʻe e kū nei.

He aha kaʻu e hana ai inā ʻike ʻia ka pēpē e ʻino aʻe i ka wā o ka lāʻau nitric oxide?

Inā ʻike ʻoe i nā loli i ke kūlana o kāu pēpē i ka wā o ka lāʻau nitric oxide, e makaʻala koke i ka hui mālama ola o kāu pēpē. Ua aʻo ʻia nā limahana NICU e ʻike i ka wā e pane ʻole ai nā pēpē i ka lāʻau lapaʻau a hiki ke hoʻoponopono wikiwiki i ka lāʻau lapaʻau a i ʻole e hoʻololi i nā ala ʻē aʻe. Mai kali a i ʻole e hoʻāʻo e loiloi iā ʻoe iho - aia kēia mau poʻe loea e kōkua.

I kekahi manawa, ʻike ʻia nā pēpē e ʻino aʻe ma mua o ka maikaʻi ʻana, a i ʻole pono lākou i nā lāʻau lapaʻau hou me ka nitric oxide. Ua mākaukau kāu hui lapaʻau no kēia mau kūlana a loaʻa nā hoʻolālā hoʻihoʻi. E mālama lākou iā ʻoe i ka ʻike e pili ana i nā loli a giải thích i nā hana a lākou e hana nei e kōkua i kāu pēpē.

He aha ka mea e hana ai inā hoʻōki koke ʻia ka lāʻau nitric oxide?

ʻO ka hoʻōki koke ʻana i ka lāʻau nitric oxide hiki ke hana i kahi hopena rebound kahi e hoʻi koke ai nā pilikia hanu o kāu pēpē a hiki ke ʻino iki. ʻO ia ke kumu e hoʻemi mau ai nā mea mālama ola i ka lāʻau lapaʻau, e hoʻemi mālie ana i ka nui o ka nitric oxide i ka manawa e nānā pono ana i ka pane a kāu pēpē.

Inā pono e hoʻōki koke ʻia ka lapaʻau ma muli o kahi pilikia, ua mākaukau kāu hui lapaʻau e hāʻawi koke i ka mālama kākoʻo a me nā lapaʻau ʻē aʻe. Loaʻa iā lākou nā protocols e mālama pono ai i kēia mau kūlana, ʻoiai makemake mau ʻia ka hoʻōki ʻana i ka hoʻolālā ʻia, me ka mālie ke hiki.

I ka manawa hea e hiki ai i kaʻu pēpē ke hele i ka home ma hope o ka lapaʻau nitric oxide?

Hiki i kāu pēpē ke hele i ka home ke pono hou ʻole lākou i ka nitric oxide a hiki ke mālama i nā pae oxygen maikaʻi e hanu ana i ka ea lumi ma kā lākou iho. Hana maʻamau kēia ke hoʻomaikaʻi maikaʻi ʻia ko lākou maʻi kumu i hiki i ko lākou mau māmā ke hana pono me ke kōkua ʻole. ʻOkoʻa loa ka manawa ma muli o ke kūlana kikoʻī o kāu pēpē a me ka wikiwiki o ko lākou hoʻōla.

Ma mua o ka hoʻokuʻu ʻana, e hōʻoia kāu hui lapaʻau e paʻa ana kāu pēpē, e hānai maikaʻi ana, a e mālama mau ana i nā pae oxygen olakino. E hōʻoia nō hoʻi lākou e ʻoluʻolu ana ʻoe i ka mālama ʻana i kāu pēpē a ʻike i nā hōʻailona e nānā ai ma ka home. Pono paha kekahi mau pēpē i nā manawa mālama e nānā i ka hana o ko lākou māmā i ko lākou ulu ʻana a me ka hoʻomohala ʻana.

Aia kekahi hopena lōʻihi o ka inhalation nitric oxide?

ʻAʻole ʻike ka hapa nui o nā pēpē e loaʻa ana i ka inhalation nitric oxide i nā hopena lōʻihi mai ka lapaʻau ponoʻī. Hoʻopau koke ʻia ke kinoea mai ke kino ke pau ka lapaʻau, a ua hōʻike nā haʻawina i ka ulu maʻamau o ka hapa nui o nā keiki ma hope o ka loaʻa ʻana o kēia therapy ma ke ʻano he pēpē hānau hou. Eia naʻe, loaʻa paha i kekahi mau pēpē nā manaʻo olakino e pili ana i ko lākou kūlana kumu ma mua o ka lapaʻau nitric oxide.

E kūkākūkā ke kime mālama ola o kāu pēpē i nā manaʻo lōʻihi e pili ana i ko lākou kūlana. Hiki iā lākou ke paipai i ka mālama ʻana me nā loea e nānā i ka hoʻomohala ʻana o ka māmā a me ke olakino holoʻokoʻa i ka wā e ulu ana kāu pēpē. E kōkua nā loiloi pediatric maʻamau e hōʻoia i ka hoʻomau ʻana o kāu keiki ma hope o kā lākou mau pilikia lapaʻau mua.