Ukuthi yini i-ARDS? Izimpawu, Izimbangela, kanye Nokwelashwa

I-ARDS imelela i-Acute Respiratory Distress Syndrome, okuyisimo esinzima sephunga elenza ukuphefumula kube nzima kakhulu. Kwenzeka lapho amaphaphu akho eba namafutha kakhulu futhi agcwele amanzi, okwenza ukuba i-oksijini ingafinyeleli egazini lakho kahle.

Lesi simo sithuthuka ngokushesha, ngokuvamile ngamahora noma izinsuku zemicimbi ebangela njengopnemonia noma ukulimala okukhulu. Nakuba i-ARDS iyinkulu ngempela, ukuqonda ukuthi iyini nokuthi iphelelwa kanjani kungakusiza uzizwe ulungile futhi ungakhathazeki ngalolu bhubhane lwezokwelapha.

Iyini i-ARDS?

I-ARDS yisimo esiyingozi lokuphila lapho amaphaphu akho eba namafutha kakhulu futhi aphuza amanzi ezingxenyeni ezincane zomoya ebizwa ngokuthi yi-alveoli. Cabanga ngamaphaphu akho njengesiponji esivame ukusiza i-oksijini ukudlula egazini lakho, kodwa nge-ARDS, lesi siponji siyakha futhi singakwazi ukwenza umsebenzi wawo kahle.

Lesi simo sithinta isikhungo esincane phakathi kwezingxenye zakho zomoya nemithambo yegazi. Uma lesi sikhungo silimale, amanzi avela lapho kungafanele kube khona, okwenza kube nzima kakhulu i-oksijini ukufinyelela egazini lakho. Lokhu kudala isimo esiyingozi lapho izitho zomzimba wakho zingafinyeleli i-oksijini eyanele ukusebenza kahle.

I-ARDS ngokuvamile ithuthuka njengobunzima besifo esinzima noma ukulimala. Akuyona into oyibamba komunye umuntu, kodwa kunokuba impendulo enkulu yomzimba wakho ekuhluphekeni okukhulu noma ukulimala.

Ziyini izimpawu ze-ARDS?

Izimpawu ze-ARDS zithuthuka ngokushesha futhi zinzima kakhulu, ngokuvamile zivele phakathi kwamahora angu-24 kuya kwangu-48 emcimbi obangela. Izibonakaliso eziyinhloko zibonisa ukuthi amaphaphu akho alwa ukuthola i-oksijini eyanele emzimbeni wakho.

Nazi izimpawu eziyinhloko ongaziqaphela:

• Ukuphefumula okunzima kakhulu okuya kubi ngokushesha
• Ukuphefumula okusheshayo, okuncane ngisho nasekuphumuleni
• Ukukhathala okukhulu nobuthakathaka
• Umbala oluhlaza okwesibhakabhaka oqhele ngezindebe, iinzipho, noma isikhumba
• Ukudideka noma ukuzizwa ungacabangi kahle
• Uxinzelelo lwegazi oluphansi
• Ukuhlanza okwomile okungase kukhiqize i-sputum ephuziwe

Lezi zimpawu zingaba yizinto ezimangazayo, kodwa ukuzazi ngokushesha kubalulekile ukuthola ukunakekelwa kwezokwelapha okufanele. Uma wena noma othile owaziyo enezibonakaliso, ikakhulukazi ngemuva kwesifo esinzima noma ukulimala, funa usizo lwezokwelapha oluphuthumayo ngokushesha.

Ubunzima bezimpawu bungase buhluke komunye umuntu kuya komunye, kodwa i-ARDS idinga ukwelashwa okukhulu kwezokwelapha. Ungalindi ukubona uma izimpawu ziphulukana zodwa, njengoba lesi simo singaba sibi kakhulu ngokushesha ngaphandle kokunakekelwa okufanele.

Ziyini izimbangela ze-ARDS?

I-ARDS ithuthuka lapho kukhona okuthile okubangela ukuvuvukala okukhulu emaphaphwini akho, noma ngenxa yokulimala okuqondile emaphaphwini noma kwenye indawo emzimbeni wakho. Ukuvuvukala kulimaza ukugqoka okubuthakathaka kwezingxenye zomoya emaphaphwini akho, okubenza baphuze amanzi.

Ukulimala okuvamile kwamaphaphu okuqondile okungabangela i-ARDS kuhlanganisa:

• I-pneumonia enzima evela kubhaktheriya, ama-virus, noma ama-fungi
• Ukuphefumula izinto eziyingozi njengomusi, amakhemikhali, noma ukugabha
• Izehlakalo zokuncintisana
• Ukulimala kwesifuba ezingozi noma ekulimaleni
• Ukuvezwa phezulu emazingeni aphezulu ezimweni ezingavamile

I-ARDS ingathuthuka futhi ezimweni ezingathinti amaphaphu akho ngokuqondile kodwa zibangela ukuvuvukala emzimbeni wonke:

• Ukutheleleka okukhulu egazini lakho (i-sepsis)
• Ukulimala okukhulu noma ukushisa
• I-pancreatitis (ukuvuvukala kwe-pancreas)
• Ukuphikisana okukhulu
• Ukudlula ngokweqile kokwelashwa, ikakhulukazi kusuka kuma-opioids noma i-cocaine
• Ukudluliselwa kwegazi okuningi

Ngokungavamile, ezinye izidakamizwa noma izinqubo zezokwelapha zingabangela i-ARDS. Lokhu kuhlanganisa ezinye izidakamizwa ze-chemotherapy, ukuphefumula okuningi ngomshini, noma izinkinga ngesikhathi sokuhlinzwa.

Kubalulekile ukuqonda ukuthi ukuba nesinye salezi zimo akusho ukuthi uzokuthola i-ARDS. Abantu abaningi bahlangabezana nalezi zinto ezingabangela ngaphandle kokuthola i-syndrome, kodwa ukwazi ingozi kungakusiza wena neqembu lakho lokunakekelwa kwezokwelapha ukubuka izibonakaliso zokuqala.

Nini kufanele ubona udokotela nge-ARDS?

I-ARDS yingozi yezokwelapha edinga ukwelashwa ngokushesha esibhedlela. Kufanele ubizela u-911 noma uye endlini yokwelapha ngokushesha uma uhlangabezana nobunzima obukhulu bokuphumula, ikakhulukazi uma zithuthuka ngokushesha ngemuva kwesifo noma ukulimala.

Funani ukunakekelwa okuphuthumayo ngokushesha uma uqaphela:

• Ukuphefumula okunzima ngokushesha okungaphuli ngokuphumula
• Umbala oluhlaza okwesibhakabhaka oqhele ngezindebe, ubuso, noma iinzipho
• Ukuphefumula okusheshayo okwenza uzizwe sengathi awukwazi ukuthatha umoya
• Ukudideka noma ubunzima bokucabanga ngokucacile
• Ubuhlungu besifuba kanye nezingqinamba zokuphefumula

Ungazami ukuphatha lezi zimpawu ekhaya noma ulinde ukubona uma ziphulukana. I-ARDS ingaba sibi kakhulu ngokushesha, futhi ukwelashwa okuqala kwindawo yokunakekelwa okukhulu kuthuthukisa imiphumela.

Uma usuvele uvalelwe esibhedlela ngenxa yesimo esinye futhi uqaphela ubunzima obusha bokuphumula, xhumana neqembu lakho lokunakekelwa kwezokwelapha ngokushesha. Ngezinye izikhathi i-ARDS ithuthuka njengobunzima bezinkinga zezokwelapha ezikhona, futhi ukuqaphela okusheshayo kuyisihluthulelo sokwelashwa okuphumelelayo.

Ziyini izinto ezingabangela i-ARDS?

Ezinye izinto zingandisa amathuba akho okuthola i-ARDS uma ubhekene nesimo esibangela. Ukuqonda lezi zinto ezingabangela kungakusiza wena neqembu lakho lokunakekelwa kwezokwelapha ukuba niqaphele izibonakaliso zokuqala.

Izinto eziyinhloko ezingabangela zihlanganisa:

• Iminyaka engaphezu kuka-65, njengoba abadala abakhulu banamandla amancane emaphaphwini
• Ukusetshenziswa kokutshwala njalo, okungonakalisa ukuvikela kwamaphaphu
• Umbhalo wokubhema, owonakalisa ithishu lamaphaphu ngokuhamba kwesikhathi
• Izifo zamaphaphu ezikhona njenge-COPD noma i-pulmonary fibrosis
• I-immune system ebuthakathaka evela esifweni noma emithi
• Izimo zezokwelapha ezinzima ezikhona

Ezinye izinto ezingavamile kodwa eziyisihluthulelo zihlanganisa:

• Izinto zofuzo ezihlukanisa indlela umzimba wakho ophatha ngayo ukuvuvukala
• Ukondleka okungalungile, okungonakalisa ikhono lomzimba wakho lokuphulukisa
• Ukuhlinzwa okukhulu kwamuva noma ukuphumula kwesikhathi eside embhedeni
• Ukukhuluphala, okungenza ukuphefumula kube nzima

Ukuba nalezi zinto ezingabangela akusho ukuthi uzothola i-ARDS, kodwa kusho ukuthi kufanele uqaphele ngokwengeziwe ngokuvikela ukutheleleka nokufuna ukunakekelwa kwezokwelapha ngokushesha nganoma yisiphi isifo esinzima noma ukulimala.

Ziyini izinkinga ezingaba khona ze-ARDS?

I-ARDS ingabangela izinkinga eziningi ezinkulu, kokubili ngesikhathi sesigaba esibuhlungu nasekuphulukeni. Lezi zinkinga zenzeka ngoba izitho zomzimba wakho azitholi i-oksijeni eyanele, futhi ukwelashwa okudingekayo ngezinye izikhathi kubangela izinselele zabo.

Izinkinga eziqondile kakhulu ngesikhathi se-ARDS ephakathi zihlanganisa:

• Ukwehluleka kwezitho eziningi, ikakhulukazi ekuthinta izinkalankala, isibindi, nenhliziyo
• Ama-blood clots ezinyaweni noma emaphaphwini ngenxa yokuphumula kwesikhathi eside embhedeni
• Iphaphu eliwa (pneumothorax) evela ekuphefumuleni ngomshini
• Ukutheleleka okukhulu, kuhlanganise i-pneumonia ehlotshaniswa nomshini wokuphefumula
• Ukugcinwa kwamanzi nokuvuvukala emzimbeni wonke

Izinkinga zesikhathi eside zingathinta abaphila ngisho nasekuphulukeni:

• Ukulimala kwamaphaphu okungapheli okunciphisa amandla okuphumula
• Ubuthakathaka bemisipha nokukhathala ngenxa yokuphumula kwesikhathi eside embhedeni
• I-Post-traumatic stress disorder evela ekuhlangenwe nakho kokunakekelwa okukhulu
• Izinkinga zokuqonda ngekhono lokukhumbula nokugxila
• Usizi nokukhathazeka okuhlobene nenqubo yokuphulukisa

Nakuba lezi zinkinga zizwakala zesabekisa, abantu abaningi bayaphulile kahle e-ARDS ngokwelashwa okufanele nokubuyiselwa. Iqembu lakho lokunakekelwa kwezokwelapha lizozama kanzima ukuvimbela izinkinga futhi liqonde noma yiziphi ezivela.

I-ARDS ihlonishwa kanjani?

Ukuhlola i-ARDS kuhilela ukubuka izimpawu zakho, umlando wezokwelapha, nokulingwa okuthile okubonisa ukuthi amaphaphu akho asebenza kahle kangakanani. Ayikho i-test eyodwa eqinisekisa i-ARDS, ngakho odokotela basebenzisa ukuxuba kolwazi ukwenza ukuxilongwa.

Udokotela wakho uzoqala ngokukuhlola nokubuza ngezifo zakamuva, ukulimala, noma ukuvezwa okungase kube yimbangela yezinkinga zamaphaphu. Bazolalela amaphaphu akho futhi bahlole amazinga akho e-oksijini besebenzisa idivayisi encane eminweni yakho.

Izivivinyo eziyinhloko ezisetshenziswa ukuhlola i-ARDS zihlanganisa:

• I-X-ray yesifuba noma i-CT scan ukubona amanzi emaphaphwini akho
• Izivivinyo zegazi ukuhlola amazinga e-oksijini ne-carbon dioxide
• Izivivinyo zegazi ukufuna ukutheleleka
• Izivivinyo zenhliziyo ukuqeda izinkinga zenhliziyo
• I-Bronchoscopy ukuhlola imizila yakho yomoya uma kudingeka

Odokotela basebenzisa izindinganiso ezithile ukuhlola i-ARDS, kuhlanganise ukuthi izimpawu zithuthuke ngokushesha kangakanani, ukuthi i-X-ray yesifuba yakho ibonisa ini, nokuthi izinkinga zakho zokuphefumula zinzima kangakanani. Lokhu kubasiza ukuhlukanisa i-ARDS kwezinye izimo zamaphaphu ezingase zibonakale zifana.

Inqubo yokuxilongwa ngokuvamile yenzeka ngokushesha endlini yokwelapha ephuthumayo noma endaweni yokunakekelwa okukhulu, njengoba i-ARDS idinga ukwelashwa ngokushesha. Iqembu lakho lezokwelapha lizoqala ukunakekelwa okusekela ngenkathi lisebenza ukuqinisekisa ukuxilongwa.

Ukwelashwa kwe-ARDS kuyini?

Ukwelashwa kwe-ARDS kugxila ekusekeleni ukuphefumula kwakho ngenkathi amaphaphu akho ephulukana nokubhekana nesimo esibangela i-syndrome. Abantu abaningi abane-ARDS badinga ukunakekelwa okukhulu endaweni yesibhedlela ngemishini ekhethekile nokulandelela.

Ukwelashwa okuyinhloko ukuphefumula ngomshini, lapho umshini ukusiza ukuphefumula ngokuletha i-oksijini ngaphansi kokucindezela. Lokhu akuyona nje ukwelashwa okuvamile kwe-oksijini kodwa uhlelo oluhle olutholakala ngezilinganiso ezithile ze-oksijini nokucindezela ukuze kusize amaphaphu akho ukusebenza kangcono.

Uhlelo lwakho lokwelashwa luzohlanganisa cishe:

• Ukuphefumula ngomshini ngokucindezela nokulinganisela kwe-oksijeni okulawulwa ngokucophelela
• Imithi yokwelapha imbangela ephakathi njenge-antibiotics yokutheleleka
• Ukuphathwa kwamanzi ukuvimbela ukuvuvukala kwamaphaphu okwengeziwe
• Ukwelashwa kokubeka, ngezinye izikhathi kuhlanganisa ukuwela ubuso phansi
• Ukusekelwa kokudla ukuze kusize umzimba wakho uphulukise
• I-blood thinners ukuvimbela ama-clots

Ezimweni ezinzima, odokotela bangase basebenzise ukwelashwa okuphambili:

• I-ECMO (i-extracorporeal membrane oxygenation) ukuthatha indawo yomsebenzi wamaphaphu okwesikhashana
• Imithi ekhethekile yokuqeda ukuvuvukala
• Ukwelashwa okuvivinywayo ngokusebenzisa izivivinyo zezokwelapha

Inhloso iwukunikela amaphaphu akho isikhathi sokuphulukisa ngenkathi ugcina umzimba wakho wonke uphilile. Ukwelashwa kuyinkulu futhi kungathatha amasonto noma izinyanga, kodwa abantu abaningi bayaphulile ngokunakekelwa okufanele.

Ungayisekela kanjani impumelelo ngesikhathi sokwelashwa kwe-ARDS?

Ukuphulukana ne-ARDS kuyinqubo ehamba kancane edinga isineke nokunakekelwa okubanzi. Ngenkathi iqembu lezokwelapha liphatha ukwelashwa okuqondile, kukhona izici ezibalulekile zokunakekelwa okusekela ezisiza umzimba wakho ukuba uphulukise ngokuphumelelayo.

Ngesikhathi sesigaba esibuhlungu kwi-ICU, iqembu lakho lokunakekelwa lizogxila ku:

• Ukuvimbela ukutheleleka ngokuhlanzeka okucophelelayo nezinqubo ezingcolile
• Ukugcina ukudla ngemizila yokudla noma ukudla kwe-IV
• Ukwelashwa komzimba ukuvimbela ubuthakathaka bemisipha ngisho nalapho ulele embhedeni
• Ukusekelwa ngokwengqondo kuwe nendlu yakho ngalesi sikhathi esicindezelayo
• Ukulandelela ngokucophelela ukubamba nokwelapha izinkinga zokuqala

Njengoba uqala ukuphulukana, ukubuyiselwa kubaluleke kakhulu:

• Ukuqeda kancane umshini wokuphefumula njengoba amaphaphu akho ephulukana
• Ukuzivocavoca komzimba okuqhubekayo ukwakha amandla
• Ukuzivocavoca kokuphefumula ukuthuthukisa umsebenzi wamaphaphu
• Ukwelashwa komsebenzi ukuze kusize nemisebenzi yansuku zonke
• Ukwelulekwa ukubhekana nezici zokuzizwa zokuphulukisa

Ukusekelwa komndeni kudlala indima ebalulekile ekuphulukiseni. Ukuba nabathandekayo abahilelekile ekunakekelweni kwakho, bemelela izidingo zakho, nokuletha ukusekelwa ngokwengqondo kungathinta kakhulu inqubo yakho yokuphulukisa.

Kufanele ulungiselele kanjani izikhathi zokubona udokotela mayelana ne-ARDS?

Uma uphulukana ne-ARDS noma usekela othile ophila, ukulungiselela izikhathi zokubona udokotela kungakusiza uthole okuningi eqenjini lakho lokunakekelwa kwezokwelapha. Lezi zingxoxo ziyisihluthulelo sokulandelela intuthuko nokuguqula izinhlelo zokwelapha.

Ngaphambi kokubona udokotela, buza ulwazi olukhulu:

• Bala zonke izimpawu ezikhona nokuthi zishintshe kanjani
• Bhala yonke imithi kanye nezingxenye zayo
• Qaphela noma yiziphi izinkathazo ezintsha noma imibuzo onayo
• Letha amakhophi emiphumela yokuvivinya yakamuva uma evela ezibhedlela ezahlukene
• Yiba nolwazi loxhumana nabo oluphuthumayo olutholakalayo

Imibuzo ongafuna ukuyibuza udokotela wakho ihlanganisa:

• Amaphaphu ami aphulukana kanjani, futhi kufanele ngilindele ini okulandelayo?
• Ziyini izimpawu engizibona ezibonisa izinkinga?
• Iyiphi imisebenzi ephephile kimi manje?
• Yini engingayenza ukuze ngisekele ukuphulukana kwami ekhaya?
• Nini kufanele ngilandele, futhi ngobani ochwepheshe?

Ungangabazi ukuletha ilungu lomndeni noma umngani ukukusiza ukukhumbula ulwazi nokubuza imibuzo. Ukuphulukana ne-ARDS kungaba nzima, futhi ukuba nokusekelwa ngesikhathi sokubona udokotela kubalulekile.

Iyini into ebalulekile mayelana ne-ARDS?

I-ARDS yisimo esinzima kodwa esiphatheka esidinga ukunakekelwa kwezokwelapha ngokushesha nokunakekelwa okukhulu. Nakuba kungaba yinto ebangela ukwesaba ukubhekana nalolu xilongo, ukuqonda ukuthi abantu abaningi bayaphulile ngokwelashwa okufanele kungaletha ithemba ngesikhathi esinzima.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi i-ARDS yingozi yezokwelapha. Uma uhlangabezana nobunzima obukhulu bokuphumula, ikakhulukazi ngemuva kwesifo noma ukulimala, ungalindi ukusiza. Ukuqaphela nokwelashwa okuqala kuthuthukisa imiphumela.

Ukuphulukana ne-ARDS kuthatha isikhathi nesineke, kodwa ngokuthuthuka ekunakekelweni kwezokwelapha nokubuyiselwa okubanzi, abantu abaningi baqhubeka bephila impilo egcwele, esebenzayo. Iqembu lakho lokunakekelwa kwezokwelapha likhona ukukusekela kuzo zonke izinyathelo zenqubo.

Gxilisa ukulandela uhlelo lwakho lokwelashwa, uhlale uxhumene nesisekelo sakho sokusekela, futhi uthathe ukuphulukana usuku ngosuku. Ngokunakekelwa okufanele nesikhathi, amaphaphu akho angaphulile, futhi ungasebenza ekubuyeleni emisebenzini ebalulekile kuwe.

Imibuzo evamile ebuzwa mayelana ne-ARDS

Ungaphulile ngokuphelele e-ARDS?

Abantu abaningi bayaphulile kahle e-ARDS, nakuba inqubo yokuphulukisa ihluke komunye umuntu kuya komunye. Abanye abantu babuyela ezingeni labo langaphambili lomsebenzi, kanti abanye bangase babe nemiphumela ethile emsebenzini wamaphaphu noma impilo yonke. Izici eziyinhloko ezihlukanisa ukuphulukisa zihlanganisa ukuthi i-ARDS yayinzima kangakanani, ukuthi ukwelashwa kwaqala ngokushesha kangakanani, impilo yakho yonke ngaphambi kokugula, nokuthi uphendula kanjani ekwelapheni nasekubuyiselweni.

Kuthatha isikhathi esingakanani ukuphulukana ne-ARDS?

Ukuphulukana ne-ARDS ngokuvamile kuyinqubo ehamba kancane engathatha izinyanga kuya eminyakeni. Isigaba esibuhlungu kwi-ICU singathatha amasonto ambalwa, okulandelelwa izinyanga zokubuyiselwa ukubuyisela amandla nomsebenzi wamaphaphu. Ukuthuthuka okuningi kwenzeka ngonyaka wokuqala, kodwa abanye abantu baqhubeka bebona ukuthuthuka kancane kuze kube eminyakeni emibili. Iqembu lakho lezokwelapha lizosisebenza nawe ukusetha amathemba angokoqobo ngokuya ngesimo sakho esithile.

Ingabe i-ARDS iyadluliseka?

I-ARDS ngokwayo ayidluliseki futhi ayikwazi ukudluliselwa komunye umuntu kuya komunye. Kodwa-ke, ezinye zezimo ezingabangela i-ARDS, njengohlobo oluthile lwe-pneumonia noma i-flu, zingadluliseka. Uma othile owaziyo enesifo se-ARDS, awudingi ukukhathazeka ngokuyibamba kuye, kodwa kufanele ulandele noma yiziphi izinyathelo zokulawula ukutheleleka ezinconywa yiqembu lakhe lokunakekelwa kwezokwelapha.

Iyini izinga lokuphila le-ARDS?

Izinga lokuphila le-ARDS liye lasebenza kakhulu eminyakeni eminingi ngenxa yokwelashwa okungcono nokunakekelwa okukhulu. Njengamanje, cishe amaphesenti angu-60-70 abantu abane-ARDS bayaphila, nakuba lokhu kuhluke ngokuya ngezici njengobudala, impilo yonke, nokuthi yini ebangela i-ARDS. Nakuba lezi zibalo zingase zizwakale zicindezela, khumbula ukuthi isimo somuntu ngamunye sihlukile, futhi iqembu lakho lokunakekelwa kwezokwelapha lizozama kanzima ukukunika umphumela omuhle kakhulu.

Ingabe i-ARDS ingaba khona ngaphezu kwesikhathi esisodwa?

Nakuba kungenzeka ukuthi i-ARDS iphinde ibe khona, akuvamile kubantu abaningi. Ingozi yakho yokuthola i-ARDS futhi ihluke ngokuya ngezimo zakho zezokwelapha ezikhona nokuthi uveziwe yini ezintweni ezifanayo ezazibangela ekuqaleni. Abanye abantu bangase babe nengozi encane uma benenkinga yamaphaphu noma izimo ezenza babe lula ekuthelelekeni, kodwa abantu abaningi abaphila e-ARDS abayitholi futhi.