Kuyini Ukuphefumula kwe-Nitric Oxide: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

Ukuphefumula kwe-Nitric oxide kuyindlela yokwelapha ngamagesi ekhethekile asiza izingane ezisanda kuzalwa ukuba ziphefumule kangcono lapho amaphaphu azo elwa nokuthola umoya-mpilo owanele. Lokhu kwelapha kusebenza ngokukhulula imithambo yegazi emaphaphu, okuvumela umoya-mpilo ukuba ugeleze kalula emzimbeni. Ngokuvamile kusetshenziswa emayunithi okunakekela okukhulu esibhedlela ngaphansi kokuqashwa kwezokwelapha okuseduze, lapho amaqembu ezempilo engakwazi ukuqapha intuthuko yengane yakho ngokucophelela.

Kuyini Ukuphefumula kwe-Nitric Oxide?

Ukuphefumula kwe-Nitric oxide kuyigesi engenambala, engenaphunga odokotela abayisa ngqo emaphaphu engane yakho ngeshubhu lokuphefumula noma imaski. Cabanga ngayo njengomsizi omnene ovula imithambo yegazi emincane emaphapheni, okwenza kube lula ukuthi umoya-mpilo ufinyelele kuzo zonke izingxenye zomzimba wengane yakho. Lokhu akuyona into ongayithola ekhemisi - kuyigesi yezokwelapha kadokotela edinga imishini ekhethekile kanye nabasebenzi bezempilo abaqeqeshiwe ukuyiphatha ngokuphepha.

Igesi ngokwayo iyimolekyuli eyenzeka ngokwemvelo umzimba wakho owenza ngamanani amancane. Uma isetshenziswa njengomuthi, ilawulwa ngokucophelela futhi ixutshwe nomoya ingane yakho ewuphefumulayo. Ukwelashwa okwesikhashana futhi ngokuvamile kusetshenziswa izikhathi ezimfushane ngenkathi amaphaphu engane yakho elulama futhi eqina.

Kuyini Ukuphefumula kwe-Nitric Oxide Okusetshenziselwa?

Ukuphefumula kwe-Nitric oxide ikakhulukazi kusetshenziselwa ukwelapha izingane ezisanda kuzalwa ezinomfutho wegazi ophezulu wamaphaphu oqhubekayo, isimo esibi lapho umfutho wegazi emithanjeni yamaphaphu uhlala uphezulu ngendlela eyingozi. Lokhu kwenzeka lapho ukujikeleza kwegazi kwengane kungashintshi kahle ekuthembekeni ekunikezeni umoya-mpilo kanina ekuphefumuleni ngokwabo ngemva kokuzalwa.

Lapho izingane zinalolu hlobo lwesifo, amaphaphu azo awakwazi ukuletha umoya-mpilo owanele emzimbeni wazo, okungaba yingozi empilweni. Ukwelashwa kusiza ngokuphumuza izindonga zemisipha zemithambo yegazi emaphapheni, kunciphisa ingcindezi futhi kuthuthukisa ukugeleza kwegazi. Lokhu kuvumela umoya-mpilo ukuthi uhambe ngempumelelo emaphapheni uye kuyo yonke ingxenye yomzimba.

Kwezinye izimo, odokotela bangase futhi basebenzise i-nitric oxide kwezinye izinkinga zokuphefumula ezinganeni ezisanda kuzalwa, nakuba lokhu kungavamile. Ithimba lakho lezokwelapha lizohlola ngokucophelela ukuthi ngabe lokhu kwelashwa kulungile yini esimweni esithile somntwana wakho.

Isebenza Kanjani I-Nitric Oxide Inhalation?

I-Nitric oxide isebenza ngokugxila kumaseli athile ezindongeni zemithambo yegazi yamaphaphu omntwana wakho. Lapho igesi ifinyelela kula maseli, iqala impendulo yokuphumula yemvelo ekhulisa imithambo yegazi. Lokhu kufana nendlela ipayipi lengadi eliqinile livuleka ngayo uma ukhulula ingcindezi - igazi lingageleza ngokukhululeka, lithwala umoya-mpilo obalulekile kuwo wonke umzimba womntwana wakho.

Ukwelashwa kuthathwa njengomuthi onamandla aphakathi nendawo osebenza ngokushesha, ngokuvamile ubonisa imiphumela ngemizuzu noma ngamahora. Akuyona ikhambi, kodwa kunalokho ukwelashwa okusekelayo okunika amaphaphu omntwana wakho isikhathi sokuphola nokukhula kahle. Igesi ithinta ngqo amaphaphu kuphela, okusho ukuthi inemiphumela embalwa kwezinye izingxenye zomzimba uma iqhathaniswa nemithi enikezwa nge-IV noma ukujova.

Okuthatha lokhu kwelashwa njengokukhethekile ukuthi kusebenza ngqo lapho kudingeka khona kakhulu - ethisshu lamaphaphu ngokwalo. Lapho i-nitric oxide isenza umsebenzi wayo emaphapheni, iyanqanyulwa ngokushesha futhi ikhishwe emzimbeni, okusiza ukunciphisa imiphumela emibi.

Kufanele Kunjani Ukunikezwa I-Nitric Oxide Inhalation?

Ukuphefumula kwe-nitric oxide kuhlala kunikezwa ochwepheshe bezempilo abaqeqeshiwe endaweni yasesibhedlela, ngokuvamile kuyunithi lokunakekela izingane (NICU). Ngeke kudingeke ukhathazeke ngokuzinika lo muthi wena uqobo - ithimba lezokwelapha libhekana nakho konke. Leli gesi linikezwa ngohlelo lokusekela ukuphefumula lwengane yakho olukhona, kungakhathaliseki ukuthi i-ventilator, ipayipi lokuphefumula, noma imaski ekhethekile.

Ukwelashwa kudinga imishini ekhethekile elawula ngokuqondile ukuthi ingane yakho ithola kangakanani i-nitric oxide. Abahlinzeki bezempilo baqapha njalo amazinga ukuze baqinisekise ukuthi ingane yakho ithola inani eliqondile. Leli gesi lixutshwa nomoya-mpilo ovamile nomoya ingane yakho ewuphefumulayo, okudala ingxube elinganiselwe ngokucophelela.

Ingane yakho izobhekwa ngokucophelela kuyo yonke inkathi yokwelashwa, ngokuhlolwa njalo kwamazinga omoya-mpilo, umfutho wegazi, kanye nesimo esiphelele. Ithimba lezokwelapha lizolungisa umthamo ngokusekelwe endleleni ingane yakho esabela ngayo, ngaso sonke isikhathi lihlose inani eliphansi elisebenzayo ukuze kuncishiswe noma yiziphi izingozi.

Kufanele Kusetshenziswe Isikhathi Esingakanani Ukuphefumula Kwe-Nitric Oxide?

Ubude bokwelashwa nge-nitric oxide buhluka kakhulu kuye ngesimo sengane yakho nokuthi ithuthuka ngokushesha kangakanani. Iningi lezingane lithola ukwelashwa isikhathi esithile kusuka emahoreni ambalwa kuya ezinsukwini ezimbalwa, nakuba ezinye zingase zikudinga isonto noma ngaphezulu. Ithimba lakho lezokwelapha lizohlola njalo ukuthi ingane yakho isayidinga yini le nqubo yokwelapha noma ngabe iqinile ngokwanele ukuphefumula kahle ngaphandle kwayo.

Ukunqamula ukwelashwa kudinga ukuhlelwa ngokucophelela nokuncishiswa kancane kancane kunokuyeka kungazelelwe. Lokhu kungenxa yokuthi umzimba wengane yakho udinga isikhathi sokuzivumelanisa nokuphefumula ngaphandle kosizo olwengeziwe. Abahlinzeki bezempilo bazokwehlisa kancane kancane inani le-nitric oxide ngokuhamba kwesikhathi ngenkathi beqapha ngokusondela ukusabela kwengane yakho.

Injongo

Injongo ihlala ukusebenzisa ukwelashwa isikhathi esifushane esidingekayo ukusiza amaphaphu engane yakho ukuthi aphole futhi asebenze kahle. Ithimba lakho lezokwelapha lizoxoxa nawe ngesikhathi esilindelekile, nakuba lizolungisa uhlelo ngokusekelwe ekuqhubekeleni phambili kwengane yakho.

Yiziphi Imiphumela Eceleni Yokuphefumula I-Nitric Oxide?

Ngenkathi ukuphefumula i-nitric oxide kuvame ukubekezelelwa kahle, kunemiphumela ethile eceleni abahlinzeki bezempilo abayibhekisisa ngokucophelela. Imiphumela ejwayelekile eceleni ivame ukuba mnene futhi iphathwe ngaphansi kokuqondisa okufanele kwezokwelapha.

Nansi imiphumela ejwayelekile eceleni amaqembu ezokwelapha abheka ngesikhathi sokwelashwa:

• Ukwehla kwesikhashana kwengcindezi yegazi, okuvame ukuba mnene futhi kulawulwa kalula
• Ushintsho oluncane emazingeni omoya-mpilo adinga ukulungiswa komthamo
• Ukuqubuka okuncane komgudu womoya, nakuba lokhu kungavamile ngokuphatha okufanele
• Ushintsho lwesikhashana ekhemistri yegazi odokotela abayilandela ngezivivinyo zegazi ezivamile

Le miphumela ngokuvamile yesikhashana futhi iyaxazululwa uma ukwelashwa kulungiswa noma kuqedwa. Ithimba lakho lezokwelapha liqeqeshwe ukubona nokulawula lezi zinguquko ngokushesha.

Imiphumela emibi kakhulu ayivamile kodwa ingabandakanya ubunzima bokuphefumula uma ukwelashwa kumiswa ngokushesha kakhulu, noma ezimweni ezingavamile kakhulu, ukwakheka kwento ebizwa ngokuthi i-methemoglobin egazini. Abahlinzeki bezempilo bahlola njalo lokhu ukuze baqinisekise ukuphepha kwengane yakho. Ukuqapha okuqhubekayo ku-NICU kusiza ukubamba noma yiziphi izinguquko ezikhathazayo ekuqaleni, okuvumela ukungenelela okusheshayo uma kudingeka.

Ubani Ongafanele Athole Ukuphefumula I-Nitric Oxide?

Ukuphefumula i-nitric oxide akulungelanga zonke izingane, futhi zikhona izimo ezithile lapho odokotela bezogwema lokhu kwelashwa. Isinqumo sihlala sincike esimweni sempilo yengane yakho kanye nembangela eyisisekelo yobunzima bayo bokuphefumula.

Izinsana okungafanele zithole ukuhogela i-nitric oxide zihlanganisa lezo ezinezinkinga ezithile zenhliziyo lapho ukwelashwa kungase kube kubi kakhulu isimo sazo. Uma ingane yakho inenkinga yenhliziyo ezelwe ngayo lapho ukugeleza kwegazi kuncike ezingcindezi ezithile, i-nitric oxide ingase iphazamise ukujikeleza kwayo. Ngaphezu kwalokho, izinsana ezinokuphuma kwegazi okukhulu kungenzeka zingabi ngabakhethekile abahle ngoba ukwelashwa kungathinta ukujiya kwegazi.

Ithimba lakho lezokwelapha lizohlola ngokucophelela isimo sengane yakho ngaphambi kokuncoma i-nitric oxide. Bazocabangela izinto ezinjengobudala bengane yakho, isisindo, ezinye izimo zezokwelapha, kanye nohlobo oluthile lwenkinga yokuphefumula ababhekene nayo. Uma i-nitric oxide ingalungile enganeni yakho, zikhona ezinye izinketho zokwelapha ezitholakalayo.

Amagama Omkhiqizo Wokuhogela i-Nitric Oxide

Igama eliyinhloko lomkhiqizo wokuhogela i-nitric oxide e-United States yi-INOmax, ekhiqizwa yi-Mallinckrodt Pharmaceuticals. Le yindlela esetshenziswa kakhulu emitholampilo ezweni lonke. Ezinye izikhungo zezokwelapha zingase futhi zisebenzise izinguqulo ezivamile zegesi ye-nitric oxide, nakuba imishini nezinhlelo zokulethwa zihlala zikhethekile kakhulu kungakhathaliseki ukuthi umkhiqizo yini.

Ungase uzwe abahlinzeki bezempilo bekhuluma ngokwelashwa ngokuthi "i-nitric oxide" noma "i-NO ehogelwayo" kunokuthi ngegama lomkhiqizo. Okubalulekile akulona uhlobo oluthile, kodwa kunalokho ukuthi ingane yakho ithola ukwelashwa kochwepheshe abaqeqeshiwe besebenzisa imishini elungiswe kahle.

Ezinye Izindlela Zokuhogela i-Nitric Oxide

Uma ukuhogela i-nitric oxide kungafaneleki enganeni yakho noma kungahlinzeki ngokuthuthuka okwanele, zikhona izindlela eziningana zokwelapha ezitholakalayo. Lezi zinketho zisebenza ngezindlela ezihlukene kodwa zihlose ukufeza umgomo ofanayo wokuthuthukisa amazinga omoya-mpilo engane yakho nokuphefumula.

Enye indlela ukwelashwa okubizwa nge-ECMO (extracorporeal membrane oxygenation), okuthatha isikhashana umsebenzi wenhliziyo namaphaphu omntwana wakho. Lokhu kuvame ukugcinelwa amacala abucayi kakhulu lapho okunye ukwelashwa kungaphumelelanga. Enye inketho ukungenisa umoya ngemvamisa ephezulu, okusebenzisa ukuphefumula okusheshayo, okuncane kakhulu ukusiza ukuletha umoya-mpilo ngempumelelo.

Ezinye izingane zingazuza emithini ebizwa ngokuthi ama-vasodilators anikezwa nge-IV, nakuba lokhu kuthinta wonke umzimba kunokuba amaphaphu kuphela. Ithimba lakho lezokwelapha lingase futhi lisebenzise izindlela ezikhethekile zokubeka, ukuthulisa okumnene, noma ezinye izindlela zokunakekela ezisekelayo kuye ngezidingo zomntwana wakho.

Ingabe Ukuphefumula nge-Nitric Oxide Kungcono Kunezinye Izindlela Zokwelapha?

Ukuphefumula nge-nitric oxide kunikeza izinzuzo eziyingqayizivele ngaphezu kokunye ukwelashwa kobunzima bokuphefumula kwabantwana abasanda kuzalwa ngoba kusebenza ngqo emaphashini lapho inkinga yenzeka khona. Ngokungafani nemithi enikezwa nge-IV ethinta wonke umzimba, i-nitric oxide iqondisa imithambo yegazi ethile emaphashini edinga usizo, okungenzeka ukuthi inciphisa imiphumela emibi ezinye izitho.

Uma kuqhathaniswa nokwelashwa okuningi okuhlaselayo njenge-ECMO, i-nitric oxide ayinkimbinkimbi futhi inezingozi ezimbalwa. Akudingi ukuhlinzwa noma izinqubo ezinkulu, futhi izingane zivame ukuqhubeka nokudla kwazo okuvamile kanye nemikhuba yokunakekela. Ukwelashwa futhi kuvame ukusebenza ngokushesha, ngokuvamile kubonisa imiphumela emahoreni kunokuba izinsuku.

Nokho, i-nitric oxide ayihlali iyona engcono kakhulu kuyo yonke ingane. Ezinye izimo ziphendula kangcono kwezinye izindlela zokwelapha, futhi inketho

Yebo, ukuhogela i-nitric oxide kungasetshenziswa ngokuphepha ezinganeni ezingakazalwa lapho kudingeka ngokwezokwelapha, nakuba kuthathwa izinyathelo ezengeziwe zokuqapha. Izingane ezingakazalwa zibucayi kakhulu futhi zingase zisabele ngendlela ehlukile emithini, ngakho ochwepheshe bezempilo bazigada ngokuqaphela nakakhulu ngesikhathi sokwelashwa nge-nitric oxide. Umthamo ungase ulungiswe ngokusekelwe osayizini yengane nesigaba sokukhula.

Iphrofayili yokuphepha ezinganeni ezingakazalwa ngokuvamile ilungile, kodwa ithimba lezokwelapha lizohlola izinzuzo ngokumelene nanoma yiziphi izingozi ngokucophelela. Bazocabangela izinto ezinjengokuthi ingane yazalwa ngaphambi kwesikhathi esingakanani, isisindo sayo samanje, nanoma yiziphi ezinye izinselelo zempilo ebhekene nazo.

Kufanele ngenzeni uma ingane yami ibonakala iba ngcono ngesikhathi sokwelashwa nge-nitric oxide?

Uma uqaphela noma yiziphi izinguquko esimweni sengane yakho ngesikhathi sokwelashwa nge-nitric oxide, yazisa ngokushesha ithimba lezempilo lengane yakho. Abasebenzi be-NICU baqeqeshwe ukubona lapho izingane zingasabeli kahle emithini futhi bangakwazi ukulungisa ngokushesha ukwelashwa noma bashintshele ezindleleni ezingezinye. Ungalindi noma uzame ukuzihlola wena isimo - ochwepheshe laba bakhona ukusiza.

Ngezinye izikhathi izingane zingase zibonakale ziba ngcono ngaphambi kokuba zibe ngcono, noma zingase zidinge eminye imithi ngaphandle kwe-nitric oxide. Ithimba lakho lezokwelapha lilungiselelwe lezi zimo futhi linamaphrojekthi okusekela alungile. Bazokugcina unolwazi mayelana nanoma yiziphi izinguquko futhi bachaze ukuthi yiziphi izinyathelo abazithathayo ukusiza ingane yakho.

Kwenziwani uma ukwelashwa nge-nitric oxide kuyekiswa ngokuzumayo?

Ukuyeka ukwelashwa nge-nitric oxide kungazelelwe kungabangela umphumela wokubuyela emuva lapho ubunzima bokuphefumula bengane yakho bubuya ngokushesha futhi bungase buze bube kubi okwesikhashana. Yingakho ochwepheshe bezempilo behlale behlisa ukwelashwa kancane kancane, behlisa kancane inani le-nitric oxide ngokuhamba kwesikhathi ngenkathi beqapha ngokucophelela ukusabela kwengane yakho.

Uma ukwelashwa kumele kumiswe kungazelelwe ngenxa yesimo esiphuthumayo, ithimba lakho lezokwelapha lilungele ukuhlinzeka ngokushesha ngokuqeqeshwa nokwelashwa okuhlukile. Banamaphrothokholi endaweni yokuphatha lezi zimo ngokuphepha, nakuba ukuyeka okuhleliwe, kancane kancane kuhlala kukhethwa uma kungenzeka.

Ingabe umntwana wami angahamba nini ekhaya ngemva kokwelashwa nge-nitric oxide?

Umntwana wakho ngokuvamile angahamba ekhaya uma engasadingi i-nitric oxide futhi ekwazi ukugcina amazinga amahle omoya-mpilo ephefumula umoya wegumbi yedwa. Lokhu kuvame ukwenzeka lapho isimo sabo esiyisisekelo sithuthuke ngokwanele ukuthi amaphaphu abo angasebenza kahle ngaphandle kosizo. Isikhathi siyahlukahluka kakhulu kuye ngesimo somntwana wakho esithile nokuthi balulama ngokushesha kangakanani.

Ngaphambi kokukhishwa, ithimba lakho lezokwelapha lizoqinisekisa ukuthi umntwana wakho uzinzile, udla kahle, futhi ugcina amazinga amahle omoya-mpilo ngokuqhubekayo. Bazokwenza futhi isiqiniseko sokuthi uzizwa ukhululekile ngokunakekelwa komntwana wakho futhi wazi ukuthi yiziphi izimpawu okufanele uziqaphele ekhaya. Abanye abantwana bangase badinge ukuqokwa okulandelayo ukuze baqaphe ukusebenza kwamaphaphu abo njengoba beqhubeka nokukhula nokuthuthuka.

Ingabe zikhona imiphumela yesikhathi eside yokuphefumula i-nitric oxide?

Iningi labantwana abathola i-nitric oxide inhalation ababi nemiphumela yesikhathi eside evela ekwelashweni ngokwako. Igesi isuswa ngokushesha emzimbeni uma ukwelashwa kuyeka, futhi izifundo zikhombisile ukuthi iningi lezingane lithuthuka ngokujwayelekile ngemva kokuthola le therapy njengosana olusanda kuzalwa. Nokho, abanye abantwana bangase babe nezinto okufanele zicatshangelwe ngempilo eqhubekayo ezihlobene nesimo sabo sokuqala kunokwelashwa nge-nitric oxide.

Ithimba lezempilo lomntwana wakho lizoxoxa nganoma yiziphi izinto ezingase zicatshangelwe zesikhathi eside ezithile esimweni sabo. Bangase batusa ukunakekelwa okulandelayo nochwepheshe ukuze baqaphe ukuthuthukiswa kwamaphaphu nempilo yonke njengoba umntwana wakho ekhula. Ukuhlolwa kwabantwana njalo kuzosiza ekuqinisekiseni ukuthi ingane yakho iyaqhubeka nokuchuma ngemva kwezinselelo zabo zokuqala zezokwelapha.