Hypovolemic kuvhunduka

Hypovolemic kuvhunduka mamiriro ekukurumidzira umo ropa rakakomba kana kumwe kurasikirwa kwemvura kunoita kuti moyo usakwanise kupomba ropa rakakwana kumuviri. Rudzi rwekuvhunduka urwu runogona kukonzera kuti nhengo zhinji dzimire kushanda.

Kurasikirwa nechikamu chimwe muzvishanu kana kudarika ehuwandu hweropa mumuviri wako kunokonzeresa kushamisika.

Ropa kurasikirwa kunogona kuve nekuda kwe:

• Kubuda ropa kubva pakachekwa
• Kubuda ropa kubva kune kumwe kukuvara
• Kubuda ropa mukati, senge mudumbu

Kuwanda kweropa rinotenderera mumuviri wako zvakare kunogona kudonha kana iwe uchinge warasikirwa neakawanda muviri muviri kubva kune zvimwe zvikonzero. Izvi zvinogona kukonzerwa ne:

• Kunopisa
• Manyoka
• Kudikitira kwakanyanya
• Kusvipa

Zviratidzo zvinogona kusanganisira:

• Kuzvidya mwoyo kana kushungurudzika
• Kutonhorera, clammy ganda
• Kuvhiringidzika
• Yakadzikira kana isina kubuda weti
• Kwose kushaya simba
• Ruvara rweganda rakachenuruka (pallor)
• Kukurumidza kufema
• Kudikitira, ganda nyoro
• Kusaziva (kushaya kwekuteerera)

Iyo yakakura uye nekukurumidza kurasika kweropa, zvakanyanya kukomba zviratidzo zvekuvhunduka.

Kuongorora kwemuviri kucharatidza zviratidzo zvekuvhunduka, kusanganisira:

• Kuderera kweropa
• Tembiricha yemuviri yakaderera
• Inokurumidza kupomba, kazhinji isina simba uye yatove

Miedzo inogona kuitwa inosanganisira:

• Ropa kemisitiri, kusanganisira itsvo basa rekuyedza uye iwo miedzo iri kutsvaga humbowo hwekukuvara kwemhasuru yemoyo
• Yakazara kuverenga ropa (CBC)
• CT scan, ultrasound, kana x-ray yenzvimbo dzinofungidzirwa
• Echocardiogram - ruzha wave bvunzo yemamiriro emoyo uye mashandiro
• Electrocardiogram
• Endoscopy - chubhu yakaiswa mumuromo kuenda mudumbu (yepamusoro endoscopy) kana colonoscopy (chubhu yakaiswa kuburikidza neanus kune iro hombe ura)
• Right moyo (Swan-Ganz) catheterization
• Urinary catheterization (chubhu yakaiswa mudundiro kuyera weti kuburitsa)

Mune zvimwe zviitiko, kumwe kuyedzwa kunogona kuitwa zvakare.

Wana rubatsiro rwechiremba ipapo. Panguva ino, tevera nhanho idzi:

• Chengeta munhu akasununguka uye achidziya (kudzivirira hypothermia).
• Ita kuti munhu avete akati sandara tsoka dzakasimudzwa kuita gumi nemaviri (30cm) kuwedzera kutenderera. Zvisinei, kana munhu wacho ane musoro, mutsipa, musana, kana kukuvara kwegumbo, usashandure nzvimbo yemunhu kunze kwekunge ari pangozi pakarepo.
• Usape zvinwiwa nemuromo.
• Kana munhu achinge achinge asisina chaanogona kuita, bata chirwere chisingaite, kana iwe uchiziva kuti sei.
• Kana munhu wacho achifanira kutakurwa, edza kuvachenesa, nemusoro pasi uye tsoka dzakasimudzwa. Dzikamisa musoro nemutsipa usati wafambisa munhu ane fungidziro yekukuvara kwemuzongoza.

Chinangwa chekurapwa muchipatara kutsiva ropa uye zvinwiwa. Mutsara (IV) mutsetse uchaiswa muruoko rwemunhu kubvumidza ropa kana zvigadzirwa zveropa kupihwa.

Mishonga yakadai sedopamine, dobutamine, epinephrine, uye norepinephrine inogona kudikanwa kuwedzera kuwedzera kweropa uye huwandu hweropa rakaputirwa kunze kwemoyo (kubuda kwemoyo).

Zviratidzo uye mhedzisiro zvinogona kusiyana, zvichienderana ne:

• Huwandu hweropa / fluid vhoriyamu yakarasika
• Chiyero cheropa / kurasikirwa kwemvura
• Kurwara kana kukuvara zvichikonzera kurasikirwa
• Pasi pehutano husingaperi, hwakadai seshuga uye moyo, mapapu, uye chirwere cheitsvo, kana zvine hukama nekukuvara

Kazhinji, vanhu vane madhigirii akasimba ekuvhunduka vanowanzoita zvirinani pane avo vane kuvhunduka kwakanyanya. Kuvhunduka kwakanyanya kunogona kutungamira kurufu, kunyangwe nekurapwa nekukasira. Vakwegura vakuru vanowanzo kuve nemhedzisiro yakaipa kubva mukuvhunduka.

Zvinetso zvinogona kusanganisira:

• Kukuvara kweitsvo (kungangoda kushandiswa kwenguva pfupi kana kusingagumi kweiyo itsvo dialysis muchina)
• Kukuvara kwehuropi
• Gangrene yemaoko kana makumbo, dzimwe nguva inotungamira mukugurwa
• Kumira kurova kwemoyo
• Zvimwe zvinokanganisa nhengo
• Rufu

Hypovolemic kuvhunduka ndeyekukurumidzira kwekurapa. Fonera iyo yemunharaunda emergency nhamba (senge 911) kana tora munhu wacho kuenda kuchimbichimbi kamuri.

Kudzivirira kuvhunduka kuri nyore pane kuyedza kurapa kana zvangoitika. Kurumidza kurapa chikonzero kuchaderedza njodzi yekukuvara zvakanyanya. Rubatsiro rwekutanga rwekutanga runogona kubatsira kudzora kuvhunduka.

Kuvhunduka - hypovolemic

Angus DC. Kusvika kumurwere nekuvhunduka. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 98.

Dries DJ. Hypovolemia uye zvinoshungurudza kuvhunduka: manejimendi manejimendi manejimendi. Mune: Parrillo JE, Dellinger RP, eds. Critical Kuchengetedza Mushonga: Nheyo dzeKuongorora uye Management muVakuru. 5 ed. Philadelphia, PA: Elsevier; 2019: chitsiko 26.

Maiden MJ, Peake SL. Kuongorora kwekuvhunduka. Mune: Bersten AD, Handy JM, eds. Chinyorwa Chekuchengetedza Kwakanyanya. 8th ed. Philadelphia, PA: Elsevier; 2019: chits. 15.

Puskarich MA, Jones AE. Shock. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits.