Ni iki cyitwa guhumeka umwuka wa Nitric Oxide: Ibikoresho, Urutonde rw'imiti, Ingaruka ziterwa n'ibindi

Umuvumo wa Nitric oxide ni uburyo bwihariye bwo kuvura abantu bakoresheje gasi, bufasha abana bavutse vuba guhumeka neza iyo ibihaha byabo bigoranye kubona umwuka uhagije wa oxygen. Ubu buvuzi bukora binyuze mu kuruhura imitsi y'amaraso mu bihaha, bigatuma oxygen itembera byoroshye mu mubiri. Muri rusange bikoreshwa mu bitaro byita ku barwayi barembye, aho amatsinda y'abaganga ashobora gukurikiranira hafi uko umwana wawe akomeza kumererwa neza.

Ni iki cyitwa guhumeka umwuka wa Nitric Oxide?

Umuvumo wa Nitric oxide ni gasi idafite ibara kandi idafite impumuro, abaganga batanga mu bihaha by'umwana wawe binyuze mu tuyunguruzo two guhumeka cyangwa mu gapfukamunwa. Tekereza nk'umufasha w'umutima ufungura imitsi mito y'amaraso mu bihaha, bigatuma oxygen igera byoroshye mu bice byose by'umubiri w'umwana wawe. Ibi ntushobora kubibona muri farumasi - ni gasi y'imiti itangwa n'abaganga isaba ibikoresho byihariye n'abakozi b'ubuzima babihuguriwe kugira ngo bitange neza.

Gasi ubwayo ni molekile ibaho mu buryo bwa kamere umubiri wawe ukora mu bwinshi buto. Iyo ikoreshejwe nk'umuti, igenzurwa neza kandi ivangwa n'umwuka umwana wawe ahumeka. Ubu buvuzi ni ubw'igihe gito kandi busanzwe bukoreshwa mu gihe gito mu gihe ibihaha by'umwana wawe bikira kandi bikarushaho gukomera.

Nitric Oxide ikoreshwa mu kuvura iki?

Umuvumo wa Nitric oxide ikoreshwa cyane cyane mu kuvura abana bavutse vuba bafite umuvuduko ukabije w'amaraso mu bihaha, ubu ni uburwayi bukomeye aho umuvuduko w'amaraso mu miyoboro y'ibihaha ukomeza kuba mwinshi cyane. Ibi bibaho iyo imikorere y'umwana idahinduka neza kuva ku kwishingikiriza ku mwuka wa oxygen wa nyina kugera ku guhumeka ubwabo nyuma yo kuvuka.

Iyo abana bafite iyi ndwara, ibihaha byabo ntibishobora gutanga umwuka uhagije wa oxygen mu mubiri wabo, ibyo bishobora gushyira ubuzima mu kaga. Ubuvuzi bufasha mu kurekurura imitsi y'urukuta rw'imitsi y'amaraso mu bihaha, bigabanya umuvuduko kandi bigateza imbere imikorere y'amaraso. Ibi bituma oxygen yimuka neza cyane kuva mu bihaha ikajya mu bindi bice by'umubiri.

Mu bindi bihe, abaganga bashobora gukoresha na oxyde nitrique ku bindi bibazo byo guhumeka ku bana bavutse, nubwo ibi bidakunze kubaho. Itsinda ryawe ry'abaganga rizagenzura neza niba ubu buvuzi bukwiye umwana wawe.

Ni gute guhumeka oxyde nitrique bikora?

Oxyde nitrique ikora yibanda ku turemangingo twihariye mu rukuta rw'imitsi y'amaraso y'ibihaha by'umwana wawe. Iyo gazi igeze kuri utwo turemangingo, itera igisubizo cyo kurekurura gisanzwe gituma imitsi y'amaraso yaguka. Ibi bisa n'uko umuyoboro w'amazi ufunguka iyo urekuye umuvuduko - amaraso ashobora gutembera neza, atwara oxygen y'agaciro mu mubiri w'umwana wawe.

Ubu buvuzi bufatwa nk'umuti ufite imbaraga ziringaniye ukora vuba, akenshi ugaragaza ibisubizo mu minota cyangwa amasaha. Ntabwo ari umuti, ahubwo ni ubuvuzi bufasha buha ibihaha by'umwana wawe umwanya wo gukira no gukura neza. Gazi igira ingaruka ku bihaha gusa, bivuze ko ifite ingaruka nkeya ku bindi bice by'umubiri ugereranije n'imiti itangwa binyuze muri IV cyangwa inshinge.

Igituma ubu buvuzi bwihariye ni uko bukora neza cyane aho bukenewe cyane - mu gice cy'ibihaha ubwacyo. Iyo oxyde nitrique yakoze akazi kayo mu bihaha, ihita isenyuka kandi ikavanwa mu mubiri, ibyo bifasha kugabanya ingaruka ziterwa.

Ni gute guhumeka oxyde nitrique bigomba gutangwa?

Ukwanduzwa kwa ogiside ya nitirike buri gihe bitangwa n'abakozi b'ubuvuzi bafite imyitozo mu bitaro, akenshi mu ishami ryita ku bana bavutse (NICU). Ntabwo bizagusaba kwitaho gutanga uyu muti wenyine - itsinda ry'abaganga niryo ryita kuri byose. Gasi itangwa binyuze mu buryo umwana wawe asanzwe afashwamo guhumeka, haba kuri ventilateri, umuyoboro wo guhumeka, cyangwa maski yihariye.

Ubu buvuzi busaba ibikoresho byihariye bigenzura neza urugero rwa ogiside ya nitirike umwana wawe yakira. Abaganga bakurikirana buri gihe urugero kugirango barebe ko umwana wawe abona neza urugero rukwiye. Gasi ivangwa na ogisijeni isanzwe n'umwuka umwana wawe ahumeka, bigakora uruvange rugenzurwa neza.

Umwana wawe azagenzurwa neza mu gihe cy'ubuvuzi, hamwe no kugenzura kenshi urugero rwa ogisijeni, umuvuduko w'amaraso, n'ubuzima muri rusange. Itsinda ry'abaganga rizagena urugero rishingiye ku buryo umwana wawe yitwara, buri gihe hagamijwe urugero ruto rukora kugirango bagabanye ibyago byose.

Ukwanduzwa kwa ogiside ya nitirike bikwiye gukoreshwa igihe kingana iki?

Igihe cy'ubuvuzi bwa ogiside ya nitirike gitandukanye cyane bitewe n'ubuzima bw'umwana wawe n'uburyo yihuta. Abana benshi bakira ubu buvuzi kuva ku masaha make kugeza ku minsi myinshi, nubwo bamwe bashobora kubikenera icyumweru cyangwa kirenzeho. Itsinda ryawe ry'abaganga rizasuzuma buri gihe niba umwana wawe agikeneye ubu buvuzi cyangwa niba akomeye bihagije kugirango ahumeke neza atabifashijwemo.

Guhagarika ubu buvuzi bisaba gukora gahunda neza no kugabanya buhoro buhoro aho guhagarika ako kanya. Ibi ni uko umubiri w'umwana wawe ukeneye igihe cyo kumenyera guhumeka atabifashijwemo. Abaganga bazagabanya buhoro buhoro urugero rwa ogiside ya nitirike uko igihe kigenda gishira mugihe bakurikirana neza uko umwana wawe yitwara.

Intego ni ukoresha ubuvuzi mu gihe gito gishoboka kugira ngo bifashe ibihaha by'umwana wawe gukira no gukora neza. Itsinda ryawe ry'abaganga rizaganira nawe ku gihe giteganyijwe, nubwo bazahindura gahunda bitewe n'imikurire y'umwana wawe.

Ni izihe ngaruka ziterwa no guhumeka Nitric Oxide?

Nubwo guhumeka nitric oxide muri rusange byihanganirwa neza, hariho ingaruka zimwe na zimwe abaganga bakurikirana neza. Ingaruka zisanzwe zikunze kuba zoroshye kandi zishobora gucungwa neza n'ubuvuzi bukwiye.

Dore ingaruka zisanzwe amatsinda y'abaganga akurikirana mugihe cy'ubuvuzi:

• Igabanuka ry'igihe gito ry'umuvuduko w'amaraso, akenshi biba byoroshye kandi byoroshye gucunga
• Impinduka ntoya mu rwego rwa ogisijeni zisaba guhindura urugero
• Uburakari buke bw'inzira y'umwuka, nubwo ibi bidakunze kubaho mugihe gikwiye
• Impinduka z'igihe gito mu mikorere y'amaraso abaganga bakurikirana binyuze mu bizami by'amaraso bisanzwe

Izi ngaruka zikunze kuba z'igihe gito kandi zikemuka mugihe ubuvuzi buhinduwe cyangwa burangiye. Itsinda ryawe ry'abaganga ryatojwe kumenya no gucunga izi mpinduka vuba.

Ingaruka zikomeye ni gake ariko zirimo ingorane zo guhumeka niba ubuvuzi buhagaritswe vuba cyane, cyangwa mu bihe bidasanzwe cyane, ikorwa ry'ikintu cyitwa methemoglobin mu maraso. Abaganga basuzuma buri gihe ibi kugirango barebe umutekano w'umwana wawe. Gukurikirana buri gihe muri NICU bifasha gufata impinduka zose ziteye impungenge hakiri kare, bituma habaho ubufasha bwihuse niba bibaye ngombwa.

Ninde utagomba guhabwa guhumeka Nitric Oxide?

Guhumeka nitric oxide ntibikwiriye abana bose, kandi hariho ibihe byihariye aho abaganga bazirinda ubu buvuzi. Icyemezo gihora gishingiye ku buzima bw'umwana wawe muri rusange n'impamvu nyamukuru y'ingorane zo guhumeka.

Urugero rw'abana batagomba guhabwa umwuka wa nitric oxide harimo abafite ubumuga bw'umutima aho ubu buvuzi bushobora gukomeza kubangamira ubuzima bwabo. Niba umwana wawe afite ikibazo cy'umutima cyavukanye aho imikorere y'amaraso ishingiye ku gipimo runaka, nitric oxide ishobora kubangamira imikorere y'amaraso ye. Byongeye kandi, abana bafite indwara zikomeye zo kuva amaraso ntibashobora kuba abakandida beza kuko ubu buvuzi bushobora kugira ingaruka ku kuvura amaraso.

Itsinda ryawe ry'abaganga rizasuzuma neza ubuzima bw'umwana wawe mbere yo gutanga umwuka wa nitric oxide. Bazatekereza ku bintu nk'imyaka y'umwana wawe, uburemere, izindi ndwara, n'ubwoko bw'ikibazo cy'ubuhumekero barimo guhura nacyo. Niba nitric oxide itari nziza ku mwana wawe, hariho ubundi buryo bwo kuvura buriho.

Amazina y'ubwoko bwa Nitric Oxide Inhalation

Izina rikuru ry'ubwoko bwa nitric oxide inhalation muri Leta Zunze Ubumwe z'Amerika ni INOmax, ikorwa na Mallinckrodt Pharmaceuticals. Iyi ni yo formulation ikoreshwa cyane mu bitaro hirya no hino mu gihugu. Ibikorwa by'ubuvuzi bimwe na bimwe bishobora gukoresha ubwoko bwa generic bwa nitric oxide gas, nubwo ibikoresho na sisitemu yo gutanga bikomeza kuba byihariye cyane hatitawe ku bwoko.

Ushobora kumva abaganga bavuga ku buvuzi nk'uko

Uburyo bumwe ni ubuvuzi bwitwa ECMO (extracorporeal membrane oxygenation), bufata by'agateganyo akazi k'umutima n'ibihaha by'umwana wawe. Ibi bikoreshwa cyane cyane mu gihe kitoroshye cyane aho izindi nshingano zitagize icyo zigeraho. Ikindi gishoboka ni ivuriro ryo hejuru, rikoresha guhumeka vuba cyane, guto kugirango rifashe gutanga umwuka wa oxygen neza.

Abana bamwe bashobora kungukirwa n'imiti yitwa vasodilators itangwa binyuze muri IV, nubwo ibi bigira ingaruka ku mubiri wose aho kuba gusa ibihaha. Itsinda ryawe ry'abaganga rishobora kandi gukoresha uburyo bwihariye bwo gushyira, guhagarika neza, cyangwa izindi ngamba zo gufasha bitewe n'ibyo umwana wawe akeneye.

Ese guhumeka Nitric Oxide biruta izindi nshingano?

Guhumeka Nitric oxide bitanga inyungu zidasanzwe ugereranije n'izindi nshingano nyinshi z'ingorane zo guhumeka ku bana bavutse kuko bikora mu buryo butaziguye mu bihaha aho ikibazo kibera. Bitandukanye n'imiti itangwa binyuze muri IV igira ingaruka ku mubiri wose, nitric oxide igamije imitsi y'amaraso yihariye mu bihaha bakeneye ubufasha, bishobora kugabanya ingaruka ku zindi ngingo.

Ugereranije n'ubuvuzi bwinshi bwinshi nka ECMO, nitric oxide ntabwo igoye kandi ifite ibyago bike. Ntabwo bisaba kubagwa cyangwa ibikorwa bikomeye, kandi abana bakunze gukomeza kurya no kwitabwaho. Ubuvuzi kandi bukunda gukora vuba, akenshi bigaragaza ibisubizo mu masaha aho kuba iminsi.

Ariko, nitric oxide ntabwo buri gihe ari amahitamo meza kuri buri mwana. Ibihe bimwe na bimwe byitabira neza izindi nshingano, kandi amahitamo

Yego, guhumeka umwuka wa nitric oxide birashobora gukoreshwa mu buryo bwizewe ku bana bavukiye igihe kitaragera igihe bibaye ngombwa mu by'ubuvuzi, nubwo ingamba zidasanzwe zifatwa. Abana bavukiye igihe kitaragera baroroshye cyane kandi bashobora gusubiza mu buryo butandukanye ku miti, bityo abaganga babakurikirana cyane mu gihe cyo kuvurwa na nitric oxide. Urutonde rw'imiti rushobora guhindurwa hakurikijwe ubunini bw'umwana n'icyiciro cy'iterambere.

Uburyo bwo kwitwara neza ku bana bavukiye igihe kitaragera muri rusange buraryoshye, ariko itsinda ry'abaganga rizagereranya inyungu n'ibishobora guteza akaga neza. Bazatekereza ku bintu nk'igihe umwana yavutse, uburemere bwe ubu, n'izindi ngorane z'ubuzima bahura nazo.

Nkwiriye gukora iki niba umwana wanjye asa n'uwongera kuremba mu gihe cyo kuvurwa na nitric oxide?

Niba ubonye impinduka iyo ari yo yose mu miterere y'umwana wawe mu gihe cyo kuvurwa na nitric oxide, uhite umenyesha itsinda ry'abaganga rirera umwana wawe. Abakozi ba NICU bahawe imyitozo yo kumenya igihe abana batitabira neza imiti kandi bashobora guhindura vuba imiti cyangwa bakajya mu bundi buryo. Ntukegere cyangwa ngo ugerageze kwisuzuma wenyine - aba bahanga bahari kugira ngo bagufashe.

Rimwe na rimwe abana bashobora kugaragara nk'abarushaho kuremba mbere y'uko bakira, cyangwa bashobora gukenera imiti yiyongera ku ya nitric oxide. Itsinda ryawe ry'abaganga ryiteguye kuri ibi bihe kandi rifite gahunda ziteguye. Bazagutegereza ku mpinduka iyo ari yo yose kandi bakusobanurire intambwe bafata kugira ngo bafashe umwana wawe.

Bikunda gute niba imiti ya nitric oxide ihagaritswe mu buryo butunguranye?

Guhagarika imiti ya nitric oxide mu buryo butunguranye bishobora gutera ingaruka yo gusubira inyuma aho ingorane zo guhumeka z'umwana wawe zigaruka vuba kandi zishobora no kurushaho igihe gito. Ibi nibyo bituma abaganga bahora bagabanya imiti buhoro buhoro, bagabanya buhoro buhoro umubare wa nitric oxide uko igihe kigenda gihita mu gihe bakurikirana neza uko umwana wawe yitwara.

Niba imiti igomba guhagarikwa ako kanya kubera ibibazo byihutirwa, itsinda ry'abaganga bawe ryiteguye gutanga ubufasha bwihuse n'imiti isimbura. Bafite uburyo bwo gukemura ibi bibazo mu buryo bwizewe, nubwo guhagarika buhoro buhoro buri gihe byifuzwa igihe bishoboka.

Umwana wanjye ashobora gutaha ryari nyuma yo kuvurwa na nitric oxide?

Umwana wawe akenshi ashobora gutaha igihe atagikeneye nitric oxide kandi ashobora kugumana urwego rwiza rwa ogisijeni ahumeka umwuka wo mu cyumba wenyine. Ibi bikunda kuba iyo uburwayi bwabo bwateye imbere bihagije ku buryo ibihaha byabo bishobora gukora neza batagombye ubufasha. Igihe gitandukanye cyane bitewe n'uburwayi bwihariye bw'umwana wawe n'uko akira vuba.

Mbere yo gutaha, itsinda ry'abaganga bawe rizagufasha kumenya ko umwana wawe ameze neza, agaburirwa neza, kandi agumana urwego rwiza rwa ogisijeni buri gihe. Bazanafasha kumenya niba wumva umeze neza n'uburyo bwo kwita ku mwana wawe kandi uzi ibimenyetso byo kwitondera iyo uri mu rugo. Abana bamwe bashobora gukenera gahunda yo gukurikiranwa kugira ngo bagenzure imikorere y'ibihaha byabo uko bakomeza gukura no gutera imbere.

Ese hari ingaruka zirambye zo guhumeka nitric oxide?

Abana benshi bakoresha nitric oxide ntibagira ingaruka zirambye zituruka ku miti ubwayo. Gasi ivanwa mu mubiri vuba iyo imiti ihagaze, kandi ubushakashatsi bwagaragaje ko abana benshi bakura neza nyuma yo guhabwa iyi terapi nk'abana bavuka. Ariko, abana bamwe bashobora kugira ibibazo by'ubuzima bifitanye isano n'uburwayi bwabo bw'umwimerere aho kuba imiti ya nitric oxide.

Itsinda ry'abaganga b'umwana wawe rizaganira ku ngaruka zirambye zishobora kuba zihari zihariye ku miterere yabo. Bashobora gushishikariza ubufasha bwo gukurikiranwa n'inzobere kugira ngo bagenzure iterambere ry'ibihaha n'ubuzima muri rusange uko umwana wawe akura. Kugenzura buri gihe kwa muganga w'abana bizafasha kumenya ko umwana wawe akomeza gutera imbere nyuma y'ibibazo byabo by'ubuvuzi byo hambere.