Okufanele Ukwazi Ngezibonakaliso Ze-Vital
Uma unomntwana ku-NICU, uzobe ujwayele ukuvuma umsindo ohambisana nale ndawo. Kulukhuni ukungaxhomekeki futhi ucishe ucashunwe ne-monitor njengoba kungukuthi njalo ku-NICU. Kungenzeka ukuthi utshelwe ngosho lwe-neonatal , ukuthi yikuphi "i-Brady" nokuthi yikuphi "okuthandayo" futhi kungenzeka ukuthi waqala ukubhekisela kubo ngokuthi "iziqephu." Kodwa ukwazi nokuqonda ngempela ukuthi "yikuphi" nokuthi "kungani" zonke izintambo kanye nokuqapha kungasiza ukubeka ingqondo yakho kalula.
Yonke ingane ekhoneni lokunakekelwa kwe-neonatal enkulu izobe ilindelwe okuthile okuthiwa i-cardiopulmonary monitor. Ngokuyinhloko, lena yinkqubo equkethe izintambo ezine-electrode ezinamathela kumntwana; ezimbili ngaphesheya kwesifuba, nesinye esiswini esingaphansi noma emlenzeni. Lawa mafutha ahlanganiswe nezintambo futhi ahlonze yonke imisebenzi yenhliziyo futhi ayithumele esimweni lapho kubhalwe khona futhi kuboniswa njengendlela yokuguqula esibukweni.
Uhlelo lubuye lulinganise izinga lokuphefumula lomntwana, (ukuthi ukuphefumula okusheshayo kangakanani) kunamandla okurekhoda i-oxygen saturation (O2 ehlezi) ngaphakathi kwegazi, (kulinganiswa ngeprobhethi ehlanganiswe esandleni noma enyaweni) futhi futhi umfutho wegazi wengane; noma ngokufunda i-cuff noma ngesikhathi sangempela ufunda ngomshini ohlangothini lwe-umbilicus, (UAC), noma unyawo. Ukufundwa okuhlelekile kuhunyushwa ku-waveform engabonwa kumqapha.
Lokhu kufundwa njalo njalo kwengcindezi yegazi ngokuvamile kusetshenziswe ekuqaleni kwe-NICU ukuhlala futhi ezimweni ezibucayi.
Ukucindezelwa kwegazi
Ukucindezelwa kwegazi kubalwa ngamanani amabili, i-systolic ne-diastolic. I-Systolic ingcindezi lapho inhliziyo ivumelana futhi i-diastolic ingcindezi lapho inhliziyo ikhululekile.
Umfutho wegazi ovamile wengane engakafiki kushintshana kuye ngokuthi iminyaka yobudala. Ngokujwayelekile ku-NICU, sifuna ukucindezeleka kwegazi (inomboro ephakathi) elinganiselwe phakathi kwe-systolic ne-diastolic, ukuba ibe seminyaka yobudala bomntwana.
Inhloso yokuqapha kwengcindezi yegazi enganeni engaphambi kwesikhathi iwukuba uqiniseke ukuthi ingcindezi yengane yegazi ayiwi phansi kakhulu. Umfutho wegazi ophansi uvamile emntwaneni wokuqala ngaphambi kokuzalwa kodwa futhi ungabangelwa ukutheleleka, igazi noma ukulahlekelwa kwamanzi, kanye neminye imithi. Ukukhulisa umfutho wegazi wengane kungaba lula njengokunikeza uketshezi oluthe xaxa nge-IV okwandisa umthamo wegazi wengane, okuzokwenza ngcono ukusebenza komzimba. Imithi ebizwa ngokuthi i-vasopressors ingasetshenziswa futhi. Imithi evame ukusetshenziswa kakhulu i-dopamine, i-dobutamine, ne-epinephrine. Le mithi isebenza ngokwandisa izinga lokushaya kwenhliziyo yengane, ukuvimbela imithwalo yegazi, nokwandisa ukugeleza kwegazi ezithombeni ezibalulekile.
Isilinganiso senhliziyo evamile yengane engakafiki isikhathi sikhona phakathi kuka 120-160 beeps ngomzuzu. Kuyinto engavamile ukubona isilinganiso senhliziyo yengane sifinyelela kufika ku-200 uma beshukunyiswa, belambile, noma becasuliwe. Isilinganiso sokuphefumula esiphezulu se-preemie sivela phakathi kokuphefumula okungama-30-60 ngomzuzu.
I-oxygen saturation amagugu ajwayelekile ahlukahluka ngokususelwa eminyakeni yobudala yengane. Ukwanda kwenhliziyo okwandayo kungaba uphawu lwe-anemia, ukwehla kwamaseli abomvu wegazi (amangqamuzana egazi abomvu athatha i-oxygen ezithombeni ezibalulekile zomzimba).
Ukuqapha kunemingcele ehlelwe ku-alamu uma izinombolo zingezansi noma ngaphezu kwalokho okulindelekile. Kuyinto engavamile ukuba ne-alamu yamanga lapho umntwana ehamba, noma uma ama-electrode ehlanjululwa. Kubalulekile ukungena kumkhuba wokubuka ingane yakho nokubona umbala wesikhumba sakho se-preemie nokunyakaza, futhi uma benza futhi bengavumelani nama-alamu wokuqapha kanye namafomu okuguqula.
Kuyini i-Bradycardia & Kungani Kuyenzeka?
I-Bradycardia ihamba kancane kwenhliziyo. Lapho inhliziyo yengane iqala ukuphuza, kunciphisa ukugeleza kwegazi emaphashini kanye ne-oksijeni kuya kwamaconsi amathishu. I-Bradycardia enganeni engakazalwa isho ukuthi isilinganiso senhliziyo esingaphansi kwama-beats angu-100 ngomzuzu. I-Bradycardia yinto ejwayelekile kulindeleke ukuthi i-prematurity ngoba isimiso sezinzwa sisanda. Inhliziyo ilawulwa yingxenye yesimiso sezinzwa esibizwa ngokuthi isimiso sezinzwa ze-autonomic (ANS). Ezimweni eziningi, asikwazi ukusebenza kwe-ANS ngoba isebenza ngendlela engavumelani, engqondweni futhi ingekho ekulawuleni kwethu.
I-ANS ihlukaniswe ohlelweni lomzwelo oluzwelayo kanye nesistimu yesifo se-parasympathetic. Isistimu yomzwelo enozwela isebenzisa ukulwa noma ukuphendula kwezindiza futhi kwandise ukucindezeleka kwegazi, futhi inhliziyo ishaya ngokushesha. Isistimu ye-neasympathetic ye-neervous isebenza ukugcina amandla nokunciphisa ukucindezelwa kwegazi futhi inhliziyo ishaya kancane. Esikhathini sesimiso somswakama ovuthiwe, lokhu kusebenza ku-cadence, okuvumela izinga lokuphefumula nomfutho wegazi libe liqinile. Ngesana esasanda kuzalwa, isimiso sezinzwa sisanda, ngakho-ke, lezi zinhlelo zingaphumelela kwisigqi ezibangelwa ukungahambi kahle okungabangela ibradycardia.
Izinsana zangaphambi kwesikhathi zingaba nezimbangela ezibangela ukuba babe neziqephu ze-bradycardia. Ukuvuselela okulula, ukudla, ukufaka i-tube yokudla, kanye ne-reflux kungabangela i-preemie ukuba ibe nesiqephu se-bradycardia. Kuye ngesibindi se-Brady kuzoxhomeka ekungeneni. I-preemie bradycardia ngezinye izikhathi ingase ixazulule ukuzixazulula lapho isimiso sezinzwa sikhishwa ukuba singene. Uma lokhu kungenzeki, umntwana uzodinga ukukhuthazwa, noma ngokuthinta ukukhanya noma ukugxila okunamandla noma ukugubha ngemuva. Kwezinye izimo, umntwana uzodinga oksijini noma ukwanda kwe-oxygen. I-caffeine imithi esetshenziswa uma i-bradycardia ibangelwa i-apnea (ikhefu lokuphefumula). Ngezinye izikhathi i-Brady iyimpawu zokuxwayisa ukuthi into ethile ingase ibe yiphutha ngokwemithi njengokutheleleka. Ezimweni eziningi, njengoba ingane ikhula futhi isimiso sezinzwa sikhula, siyokhula.
Kuyini i-Apnea?
I-apnea yigama lokungabikho ukuphefumula noma ukuyeka ukuphefumula futhi kuvame ukuba nengane ngaphambi kwesikhathi. Uma ingane isengaphambi kwesikhathi, amathuba amakhulu ukuthi i-apnea izokwenzeka. I-apnea ye-prematurity ivame ukubangelwa isimiso somswakama osencane. Izikhungo ezilawula ukuphefumula azitholakali ngokugcwele futhi zingathembeki. Kodwa-ke, i-apnea spell ingabangela ezinye izizathu futhi ingabonisa:
- Ukuthi ingane ingase ithole isifo.
- Ukulimala noma ukulimala kwezicubu ebuchosheni.
- izinkinga zamathunjini ezifana ne-reflux. (Uma isisu sesisu siphindela emuva ku-esophagus.)
- Amazinga amancane kakhulu noma aphakeme kakhulu amakhemikhali emzimbeni, njenge-glucose noma i-calcium.
- Ukukhuthazwa kwezimo ezibucayi ezingabangela i-apnea njengama-tubes yokudla noma ukuncelisa, nokushisa okungazinzile.
Uma i-apnea ivela, ukugqugquzela ngokugubha emuva noma unyawo kungasiza ukukhumbuza ingane ukuthi iqale ukuphefumula. Iningi lezingane ezingaphambi kwesikhathi lizokhipha i-apnea ye-prematurity ngokuvamile ngesikhathi ifika emavikini angama-36. Ukuhamba okuncane akuyona into eyingozi ku-preemie kodwa uma kwenzeka njalo, umntwana uzofakwa emithini (ikakhulukazi i-caffeine) ukusiza ukuvuselela isimiso sezinzwa zomphakathi.
Abaqaphi bayingxenye enkulu ye-NICU njengoba bebonisa ulwazi oluqhubekayo mayelana nezimpawu ezibalulekile zomntwana. Zonke izinsimbi kanye ne-bongs zingahle zidibanise kakhulu ekuqaleni. Kodwa ukwazi ukuthi i-alamu ngayinye iyini nokuthi kusho ukuthini kungasiza ukwenze ukhululeke ngokwengeziwe nengane yakho. Abaqaphi bavame ukuba umthombo obalulekile kakhulu olwazini kubazali, kanti empeleni kungase kube nzima ukulungisa ukungabi khona kwabo lapho ukhululwa ekhaya. Kungaba okuthakazelisayo kakhulu futhi okwethusa ngesikhathi esisodwa ukuze ekugcineni ube nezingane ezingenazintambo, ezingenantambo.
> Imithombo:
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> Ukucindezeleka kwegazi - ama-neonates: i-ehandbook e-Neonatal - uMnyango WezeMpilo kanye Nezinsizakalo Zabantu, eVictoria, e-Australia. (nd). Ibuyiselwe kusuka ku-http: //www.health.vic.gov.au/newshandbook/procedures/blood-pressure.htm
> Izinga lokucindezelwa kwegazi ezinganeni ezingakabiphi. I. Amahora okuqala okuphila. - I-PubMed - i-NCBI. (nd). Ibuyiselwe kusuka ku-http: //www.ncbi.nlm.nih.gov/pubmed/8151481
> I-Epidemiology ye-Apnea ne-Bradycardia Ukuxazulula kwezinsana ezinganeni zakudala. (nd). Ibuyiselwe kusuka ku- http://pediatrics.aappublications.org/content/128/2/e366.full
> I-Neonatal Hypertension. (nd). Ibuyiselwe kusuka ku-http://emedicine.medscape.com/article/979588- ukubukwa kokubukwa
> I-Neonatal Monitoring, Umdwebo Ongaphezulu Wokunakekela - RT: Abenzi Bezinqumo Zokunakekelwa Ukuphefumula. (nd). Ibuyiselwe kusuka ku-http: //www.rtmagazine.com/2013/10/neonatal-monitoring-an-extra-layer-of-care/
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