“Phakathi kwemithi yokunakekelwa okubucayi, i-hypoxemia ethule iqhubeka njengento engaqondakali yomtholampilo enemiphumela emibi kakhulu. Ebonakala ngokuphelelwa umoya komoyampilo ngaphandle kwe-proportional dyspnea (okuthiwa 'i-hypoxia ethule'), lokhu kubonakaliswa okuyindida kusebenza njengenkomba ebalulekile yokwehluleka ukuphefumula okuzayo. Ukufa kwabantu kuyo yonke i-pneumonia, i-COVID-19, kanye nezimo zamaphaphu ezingamahlalakhona I-New England Journal of Medicine isanda kugqamisa 'indida yomtholampilo' - lapho umzamo ojwayelekile wokuphefumula ufihla inhlekelele yokuntula umoya-mpilo, efuna ukuqapha okuvuselelwe emtholampilo kanye nezinguquko zokuqapha.
Iyini i-hypoxemia?.
“I-Hypoxemia, echazwa njengokushoda kwe-pathological kokugcwala komoyampilo egazini le-arterial (PaO2 <80 mmHg ezingeni lolwandle kubantu abadala), iphakama lapho umfutho wengxenye uwela ngaphansi kwemikhawulo eguquguqukayo yeminyaka yobudala (AARC Clinical Practice Guideline 2021) Amaqembu asengozini enkulu akhombisa iphrofayili ehlukile ye-pathophysiological:
- Ukungena komoya/Ukungezwani kahle: Iziguli ezinenyumoniya ezinzima ezine-alveolar zingena ziphazamisa amandla okusabalalisa
- Izindlela ze-Cardiogenic: Amaqembu okwehluleka kwenhliziyo kwesokunxele/kwesokudla abonisa i-pulmonary edema ebangelwa ukucindezela (PCWP>18 mmHg)
- I-Neuromuscular compromise: Izibalo zezingane ezine-intercostal musculature ezingathuthukisiwe kanye nabantu abadala abanokukhubazeka kwe-diaphragmatic
- Ukuchayeka okungamahlalakhona: Abasebenzisi bakagwayi babonisa izinguquko zesakhiwo samaphaphu (emphysema, COPD-GOLD isigaba ≥2)
- I-Iatrogenic triggers: Iziguli zangemva kokuhlinzwa ezibhekene nokucindezeleka kokuphefumula okubangelwa i-opioid (RR <12/min) kanye ne-atelectasis
Ngokuphawulekayo, u-38% weziguli ezihlinza isifuba ziba ne-hypoxemia phakathi namahora angu-24 ngemva kokukhishwa (i-ASA Closed Claims Data 2022), okugcizelela isidingo sokuqapha okuqhubekayo kwe-pulse oximetry kulezi zibalo.”
Yiziphi izingozi ze-hypoxemia?
Ngokwezibalo zomtholampilo, izinga lokufa kweziguli ezine-hypoxemia enzima lingafinyelela ku-27%, futhi ezimweni ezimbi kakhulu, izinga lokufa lingafinyelela ngisho nangaphezu kwama-50%. Uma ukungenelela okufika ngesikhathi kungenziwanga ezigabeni zokuqala zesifo, imiphumela emibi ingase yenzeke.
- Umthelela ebuchosheni: Lapho amazinga komoyampilo wegazi ehla (hypoxemia), ubuchopho buba ntula umoya-mpilo. Lokhu kungase kubangele izimpawu ezisheshayo ezifana nekhanda elibuhlungu elingapheli, isiyezi esizumayo, nokuphelelwa amandla kwenkumbulo. Uma kuyekwa kungelashwa, ukulamba komoyampilo isikhathi eside kungalimaza amangqamuzana obuchopho, okungase kuholele ekushayweni okubangelwa ukugeleza kwegazi okuvalekile (i-cerebral infarction) noma imithambo yegazi ephukile (ukopha kobuchopho). Ukuqashelwa kusenesikhathi kwalezi zimpawu eziyisixwayiso kubalulekile ukuze kuvinjwe ukulimala okungapheli kwemizwa.
- Umthelela enhliziyweni: Lapho inhliziyo ingawutholi umoya-mpilo owanele, idonsa kanzima ukupompa ngempumelelo. Lokhu kucindezeleka kungabangela izimpawu eziyisixwayiso njengokushaya kwenhliziyo okusheshayo noma okungajwayelekile, ukuqina kwesifuba (i-angina), nokukhathala okungajwayelekile. Ngokuhamba kwesikhathi, ukuntula umoya-mpilo okungalashiwe kungase kwenze imisipha yenhliziyo ibe buthaka, okungase kuholele ezinkingeni ezisongela ukuphila njengokuhluleka kwenhliziyo, lapho inhliziyo ingakwazi ukuhambisana nezidingo zomzimba.
- Umthelela emaphashini: Amazinga aphansi komoyampilo aphoqa amaphaphu ukuthi asebenze kanzima ukuze nje aqhubeke. Ngokuhamba kwesikhathi, lolu bunzima lungalimaza imigudu yomoya kanye nezicubu zamaphaphu, okwandisa ingozi yokuthuthukisa ukuphazamiseka kokuphefumula njengeCOPD (isifo esingamahlalakhona sokuvimbela amaphaphu). Ezimweni ezimbi kakhulu, ukuncishwa komoyampilo isikhathi eside kungase kwenze buthakathaka uhlangothi olungakwesokudla lwenhliziyo njengoba izabalaza ukumpompa igazi ngamaphaphu aqinile, isimo esaziwa ngokuthi i-cor pulmonale.
- Imiphumela yomzimba wonke: Ukushoda komoyampilo okungapheli kucindezela zonke izitho njengemoto esebenzisa uphethiloli omncane. Izinso nesibindi kancane kancane kuncipha ukusebenza kahle ekuhlungeni ubuthi, kuyilapho amasosha omzimba eba buthaka, okwenza izifo ezivamile zibe nzima ukulwa nazo. Ngokuhamba kwesikhathi, lesi sikweletu se-oksijini esingasho lutho sandisa izingozi zokulimala kwezitho futhi sishiya umzimba usengozini yezinkinga zempilo ezikhulayo - kusukela ekuguleni okuvamile kuya ezibazini zomzimba ezihlala njalo. Lokhu kwenza ukuqapha kwangaphambi kwesikhathi komoyampilo kubaluleke kakhulu ekuvimbeleni izinkinga zezitho eziningi.
Unganquma kanjani ukuthi une-hypoxemia?
Izinga le-oxygen egazini liyisilinganiso esibalulekile sokuthola ukuntuleka komoya-mpilo. Kubantu abanempilo, ukufundwa okuvamile kusuka ku-95% kuya ku-100%. Amazinga aphakathi kuka-90-94% abonisa ukushoda komoyampilo okuncane, okungenzeka kungabonisi izimpawu ezisobala. Ukwehla ukuya ku-80-89% kubonisa ukuntula umoya-mpilo okumaphakathi, ngokuvamile okubangela ukuphefumula kanzima noma ukudideka. Ukufundwa okungaphansi kuka-80% kubonisa isimo esiphuthumayo esinzima, lapho izitho ezibalulekile zisengozini yokulimala ngenxa yendlala yomoya-mpilo eyeqile futhi zidinga ukunakekelwa kwezokwelapha ngokushesha.
Ungakugcina kanjani ukugcwala kwe-oxygen okwejwayelekile kwegazi?
- Vula amafasitela ukuze kungene umoya
Vuselela umoya wakho wasendlini ngokuvula amafasitela nsuku zonke ukuze ujikeleze umoya-mpilo omusha. Ukuze uthole imiphumela engcono, vakashela amapaki ngezikhathi ezithile noma izindawo ezinothile ngemvelo ngaphandle kwezindawo zamadolobha ukuze uthathe umoya ojulile, ohlanzekile osiza ukushajwa kabusha amazinga komoyampilo womzimba wakho.
- I-Aerobics
Imisebenzi ye-aerobic evamile njengokuhamba ngokushesha, ukubhukuda, noma ukugibela ibhayisikili kungathuthukisa ukugeleza kwegazi nokujikeleza komoyampilo. Khetha izinketho ezinezinga eliphansi njenge-water aerobics noma ukugijima kancane uma usanda kuzivocavoca - lokhu kuvivinya umzimba okuthambile kuthuthukisa ngokuphephile ukulethwa komoyampilo ngenkathi kwakha amandla ngokuhamba kwesikhathi.
- Ukwelashwa kwe-oxygen ekhaya
Kubantu abanezimo zokuphefumula okungamahlalakhona abazabalaza namazinga aphansi e-oxygen, ukusebenzisa idivayisi ye-oxygen yasekhaya kungasiza ukugcina umoya-mpilo ngendlela efanele. Odokotela bavame ukutusa ukuthi kuqalwe ngezigxilisa komoyampilo eziphathwayo ngesikhathi sokulala noma imisebenzi yansuku zonke - uma isetshenziswa njengoba kuyaliwe, lokhu kwelashwa kungathuthukisa amazinga wamandla, kunciphise ukuphefumula, futhi kusekele ikhwalithi yokulala engcono.
Isikhathi sokuthumela: Apr-25-2025