Chirwere chekuzvimba kwemapapu zvakanyanya

Acute respiratory shida syndrome (ARDS) hupenyu hunotyisidzira mapapu hunodzivirira oxygen yakakwana kuti isvike mumapapu uye muropa. Vacheche vanogona zvakare kuve nekufema kunetseka chirwere.

ARDS inogona kukonzerwa nekukuvara kukuru kwakananga kana kunanga kumapapu. Zvinowanzoitika zvinosanganisira:

• Kufema kurutsa mumapapu (kuda)
• Inhaling makemikari
• Kugadzira mapapu
• Chirwere chemabayo
• Septic kuvhunduka (hutachiona mumuviri wese)
• Kushungurudzika

Zvichienderana nehuwandu hweoksijeni muropa uye panguva yekufema, kuomarara kweARDS kunoiswa se:

• Nyoro
• Pakati nepakati
• Zvakanyanya

ARDS inotungamira kune inovakwa yemvura iri mumhepo masaga (alveoli). Urume uhwu hunodzivirira okisijeni yakakwana kuti isapinda muropa.

Iyo mvura inovaka inoitawo kuti mapapu areme uye aome. Izvi zvinoderedza kugona kwemapapu kuwedzera. Iyo mwero weoxygen muropa unogona kuramba wakadzika zvine njodzi, kunyangwe kana munhu wacho akagamuchira okisijeni kubva kumuchina wekufema (ventilator) kuburikidza nepombi yekufema (endotracheal tube).

ARDS inowanzoitika pamwe nekutadza kwemamwe masisitimu enhengo, senge chiropa kana itsvo. Kusvuta fodya uye kunwa doro zvakanyanya kungave zvinhu zvine njodzi mukukura kwayo.

Zviratidzo zvinowanzo kukura mukati memaawa makumi maviri nemana kusvika makumi mana ekukuvara kana kurwara. Kazhinji, vanhu vane ARDS vanorwara zvekuti havagone kunyunyuta nezvezviratidzo. Zviratidzo zvinogona kusanganisira chero zvinotevera:

• Kufema kwekufema
• Kurumidza kurova kwemoyo
• Kuderera kweropa uye nhengo kutadza
• Kukurumidza kufema

Kuteerera chipfuva ne stethoscope (auscultation) kunoratidza kusanzwisisika mweya wekufema, senge makatsemuka, anogona kunge ari zviratidzo zvemvura mumapapu. Kazhinji, kuwedzera kweropa kwakaderera. Cyanosis (ganda rebhuruu, miromo, uye zvipikiri zvinokonzerwa nekushaikwa kweokisijeni kumatukisi) inowanzoonekwa.

Miedzo inoshandiswa kuongorora ARDS inosanganisira:

• Arterial ropa gasi
• Kuongororwa kweropa, kusanganisira CBC (yakazara ropa kuverenga) uye makemikari eropa
• Ropa uye weti tsika
• Bronchoscopy mune vamwe vanhu
• Chest x-ray kana CT scan
• Sputum tsika uye ongororo
• Kuedzwa kwehutachiona hunogona kuitika

Echocardiogram inogona kudikanwa kutonga kunze kwekutadza kwemoyo, iyo inogona kutaridzika yakafanana neARDS pachifuva x-ray.

ARDS inowanzoda kurapwa mune yevanotarisirwa unit (ICU).

Chinangwa chekurapa ndechekupa rubatsiro rwekufema uye kubata chinokonzeresa cheARDS. Izvi zvinogona kusanganisira mishonga yekurapa hutachiona, kuderedza kuzvimba, uye kubvisa fluid kubva mumapapu.

Mhepo inofefetedza inoshandiswa kuendesa yakakwira madosi eokisijeni uye kumanikidza kwakanaka kumapapu akakuvara. Vanhu vanowanzo fanirwa kudzikiswa zvakanyanya nemishonga. Panguva yekurapwa, vatapi vezvehutano vanoita zvese zvavanogona kuchengetedza mapapu kubva mukumwe kukuvara. Kurapa kunonyanya kutsigira kusvikira mapapu apora.

Dzimwe nguva, kurapwa kunonzi extracorporeal membrane oxygenation (ECMO) kunoitwa. Munguva yeECMO, ropa rinosvinwa kuburikidza nemuchina kuti upe oxygen uye kubvisa carbon dioxide.

Nhengo zhinji dzemhuri dzevanhu vane ARDS vari pasi pekunetseka kwakanyanya. Vanogona kazhinji kubvisa kunetseka uku nekujoinha mapoka ekutsigira uko nhengo dzinogovana zvakajairika matambudziko nematambudziko.

Inenge chikamu chimwe muzvitatu chevanhu vane ARDS vanofa nechirwere ichi. Avo vanorarama vanowanzo dzoka mazhinji eakajairika mapapu mashandiro, asi vanhu vazhinji vane zvachose (kazhinji kanyoro) kukuvara kwemapapu.

Vanhu vazhinji vanopona ARDS vane ndangariro kurasikirwa kana zvimwe zvemhando-zve- hupenyu matambudziko mushure mekupora. Izvi zvinokonzerwa nekukuvara kwehuropi kwakaitika apo mapapu aisashanda nemazvo uye huropi hwainge husiri kuwana oxygen yakakwana. Vamwe vanhu vanogona zvakare kuva neshure kwekushungurudzika mushure mekupona ARDS.

Matambudziko anogona kukonzerwa neARDS kana kurapwa kwawo anosanganisira:

• Kukundikana kwemaitiro mazhinji enhengo
• Kukanganiswa kwemapapu, senge mapapu akadonha (anonziwo pneumothorax) nekuda kwekukuvara kubva kumuchina wekufema unoda kurapa chirwere
• Pulmonary fibrosis (kucheka kwemapapu)
• Pneumonia inosanganiswa nemhepo

ARDS inowanzoitika mukati meimwe chirwere, iyo iyo munhu atove muchipatara. Mune zvimwe zviitiko, munhu akagwinya ane mabayo akakomba anowedzera uye anova ARDS. Kana uchinetseka kufema, fonera yako yemuno emergency emergency (se911) kana enda kuimba yekukurumidzira.

Noncardiogenic pulmonary edema; Kuwedzera-kukwana kwemapapu edema; ARDS; Kukuvadza kwemapapu

• Hosha uye dzihwa - zvaunofanira kubvunza chiremba wako - mukuru
• Hosha uye furuwenza - chii chekubvunza chiremba wako - mwana
• Kana mwana wako kana mucheche aine fivha

• Mapapu
• Kufuridzira system

Lee WL, Slutsky AS. Acute hypoxemic kufema kutadza uye ARDS. Mune: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray naNadel Chinyorwa cheKufema Kwemishonga. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 100.

Matthay MA, Ware LB. Acute kufema kutadza. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsama 96.

Seigel TA. Mechanical kufefetedza uye isingasvike mweya mweya rutsigiro. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 2.