"Mukati memishonga yekurapa kwakanyanya, silent hypoxemia inoramba ichionekwa sechiitiko chekiriniki chisingazivikanwe chine zvinokonzeresa." Inoratidzwa neoxygen desaturation pasina proportional dyspnea (inonzi 'silent hypoxia'), kuratidzwa kunoshamisa uku kunoshanda sechiratidzo chakakosha chekutadza kufema. kufa kwemumabayo, COVID-19, uye chirwere chisingaperi chemapapu The New England Journal of Medicine nguva pfupi yadarika yakasimbisa iyi 'kangaidzo yemukiriniki' - uko kuedza kufema kwakajairwa kunovhara kushaikwa kweokisijeni, ichida kusvinurira kukiriniki uye kuongorora shanduko yeprotocol.
Chii chinonzi hypoxemia?.
"Hypoxemia, inotsanangurwa sechirwere chekushayikwa kwekuzara kweokisijeni muropa re arterial (PaO2 <80 mmHg pamwero wegungwa muvanhu vakuru), inomuka apo kumanikidzwa kwechikamu kunowira pasi pemakore-akagadziridzwa Normative thresholds (AARC Clinical Practice Guideline 2021) .
- Ventilation / Perfusion mismatch: Yakanyanya pneumonia varwere vane alveolar inopinda inokanganisa kupararira kugona
- Cardiogenic nzira: Kuruboshwe / kurudyi mwoyo kukundikana cohorts kuratidza kumanikidzwa-induced pulmonary edema (PCWP> 18 mmHg)
- Neuromuscular compromise: Vana vevana vane underdeveloped intercostal musculature uye vakuru vane diaphragmatic dysfunction.
- ◄ ZVIRI MUKATI ZVIRI MUKATI 20 Kuratidzwa kwenguva refu: Vashandisi vefodya vachiratidzira shanduko yemapapu (emphysema, COPD-GOLD nhanho ≥2)
- Iatrogenic zvinokonzeresa: Varwere vepashure vane opioid-induced kufema kushushikana (RR <12/min) uye atelectasis.
Zvikuru, 38% yevarwere vekuvhiya kwechipfuva vanogadzira hypoxemia mukati me24h post-extubation (ASA Yakavharwa Claims Data 2022), ichisimbisa kukosha kwekuenderera mberi kwepulse oximetry yekutarisa muhuwandu uhu.
Ndedzipi njodzi dze hypoxemia?
Zvinoenderana nenhamba dzekiriniki, huwandu hwekufa kwevarwere vane hypoxemia yakanyanya inogona kusvika 27%, uye mumatambudziko akakomba, huwandu hwekufa hunogona kusvika kupfuura 50%. Kana kupindira panguva yakakodzera kusati kwaitwa mumatanho ekutanga echirwere, migumisiro yakakomba inogona kuitika.
- Mhedzisiro pahuropi: Kana mwero weokisijeni weropa uchidonha (hypoxemia), uropi hunoshaikwa okisijeni. Izvi zvinogona kukonzeresa zviratidzo senge kuenderera mberi kwemusoro, dzungu, uye kupera kwendangariro. Kana ikasiyiwa isina kurapwa, nzara yeokisijeni yenguva refu inogona kukanganisa masero europi, zvinogona kutungamirira kune sitiroko inokonzerwa nekuvharika kweropa (cerebral infarction) kana kuputika kwetsinga dzeropa (cerebral hemorrhage). Kukurumidza kuzivikanwa kwezviratidzo zveyambiro izvi kwakakosha kudzivirira kukanganisa zvachose kwetsinga.
- Kukanganisa pamwoyo: Kana mwoyo ukasawana oxygen yakakwana, unonetseka kupomba zvinobudirira. Iyi dhizaini inogona kukonzeresa zviratidzo zveyambiro sekukurumidza kana kusajairika kurova kwemoyo, kusimba kwechipfuva (angina), uye kuneta kusingawanzo. Nekufamba kwenguva, kushaikwa kweokisijeni kusingatariswe kunogona kunetesa tsandanyama yemwoyo, izvo zvinogona kutungamirira kumatambudziko anotyisa akadai sekukundikana kwemoyo, uko mwoyo usingakwanisi kuenderana nezvinodiwa nemuviri.
- Kukanganisa pamapapu: Mwero weokisijeni wakaderera unomanikidza mapapu kuti ashande nesimba kuti arambe aripo. Nokufamba kwenguva, dambudziko iri rinogona kukuvadza mhepo nemapapu emapapu, zvichiwedzera njodzi yekuvandudza zvirwere zvekufema zvakadai seCOPD (chronic obstructive pulmonary disease). Muzviitiko zvakakomba, kushaikwa kweokisijeni kwenguva refu kunogona kutonetesa rutivi rworudyi rwemwoyo sezvo ichinetseka kupomba ropa kuburikidza nemapapu akaomarara, mamiriro anozivikanwa secor pulmonale.
- Migumisiro yemuviri wese: Kushaikwa kweokisijeni kusingaperi kunokanganisa nhengo yese semota iri kumhanya nemafuta mashoma. Itsvo nechiropa zvishoma nezvishoma zvinotanga kusashanda zvakanaka pakusefa chepfu, ukuwo immune system ichipera simba, zvichiita kuti utachiona hunozivikanwa huve hwakaoma kurwisa. Nekufamba kwenguva, ichi chikwereti cheokisijeni chinyararire chinowedzera njodzi dzekukuvadzwa kwenhengo uye chinosiya muviri uri panjodzi yedambudziko rehutano rinowedzera - kubva kuhurwere hunogara huchienda kune mavanga asingaperi. Izvi zvinoita kuti kutarisisa kweokisijeni kwekutanga kuve kwakakosha kudzivirira matambudziko mazhinji enhengo.
Nzira yekuziva sei kana uine hypoxemia?
Mwero weokisijeni yeropa ndiyo chiyero chakakosha chekuona kushomeka kweokisijeni. Muvanhu vane hutano, kuverenga kwakajairwa kunobva pa95% kusvika ku100%. Mazinga ari pakati pe90-94% anoratidza kushomeka kweokisijeni yakapfava, iyo inogona kusaratidza zviratidzo zviri pachena. Kudonha kusvika pa80-89% kunoratidza kushaikwa kweokisijeni iri pakati nepakati, kazhinji ichikonzera kufema kana kuvhiringika. Kuverenga kuri pasi pe80% kunomiririra dambudziko rakanyanya, apo nhengo dzinokosha panjodzi yekukuvadzwa nekuda kwekunyanya nzara yeokisijeni uye inoda kurapwa nekukurumidza.
Nzira yekuchengetedza sei yakajairika ropa oxygen saturation?
- Vhura mahwindo ekupinza mhepo
Zorora mweya wako wemukati nekuvhura mahwindo mazuva ese kuti utenderedze mweya mutsva. Kuti uwane mibairo iri nani, nguva nenguva shanyira mapaki kana nzvimbo dzakapfuma kwazvo dziri kunze kwemaguta kuti utore kufema kwakadzika, kwakachena kunobatsira kuwedzera mwero weokisijeni womuviri wako.
- Aerobics
Zviitwa zvenguva nenguva zvakaita sekufamba nekukurumidza, kushambira, kana kuchovha bhasikoro zvinogona kuwedzera kuyerera kweropa uye kutenderera kweokisijeni. Sarudza zvakaderera-kusimba sarudzo semvura aerobics kana kumhanyisa kumhanya kana iwe uri mutsva kurovedza muviri - izvi zvinyoro kurovedza muviri zvinonatsiridza zvakachengetedzeka kuendeswa kweokisijeni uchivaka simba nekufamba kwenguva.
- Kurapa kweokisijeni kumba
Kune vanhu vane chirwere chisingaperi chekufema vanonetseka nekuderera kweokisijeni, kushandisa mudziyo weokisijeni wepamba kunogona kubatsira kuchengetedza oxygenation yakakodzera. Vanachiremba vanowanzokurudzira kutanga neanotakurika okisijeni concentrators panguva yekurara kana mabasa ezuva nezuva - kana akashandiswa sekurairwa, kurapa uku kunogona kuvandudza mazinga esimba, kuderedza kufema, uye kutsigira zvirinani kurara.
Nguva yekutumira: Kubvumbi-25-2025