Umhlahlandlela wakho ophelele wezinsiza ze-NICU
Mhlawumbe ingxenye eyingozi kunazo zonke yokuba nengane ku-NICU yizo zonke izixhobo ezingazijwayele kanye nezinqubo ezingxenyeni zokunakekelwa ezikhungathekile ze-neonatal. Ukubona ukuthi ingane yakho ifakwe emshinini futhi igcwele izintambo kungesabeka, kodwa imishini yilapho eyosiza ingane yakho ukuba iphile kahle.
Imishini ye-NICU ingasebenzisa izinhloso eziningi ezihlukene ngokuqapha impilo nemithi yakho ye-preemie ukusekela ukuphefumula.
Enye yezinto ezibuzwa kakhulu ngamadivaysi yi-ECMO, ngakho-ke ngaphambi kokuba sibheke ezinye izinto ze-NICU nezinqubo, ake sibheke kuqala ku-ECMO.
Kuyini i-ECMO?
I-ECMO yisifinyelelo esibhekisela kumbranini we-extracorporeal oxygenation. Umshini we-ECMO umshini othatha igazi emzimbeni, uwuphefumula ngokusebenzisa i-lung yangokwenziwe futhi awuphonsele emzimbeni esebenzisa inhliziyo yokufakelwa. I-ECMO ifana nomshini wenhliziyo / wamaphaphu owawusetshenziselwa ukuhlinzwa ngenhliziyo evulekile kodwa ingasetshenziswa isikhathi eside.
Ngokuqondile, i-ECMO igxila igazi nge-oksijini futhi isusa i-carbon dioxide, umkhiqizo wokudoba wokuphefumula. Ukwengeza, i-ECMO inganikeza ukuxhaswa kwegazi. Nakuba imishini yokusekela i-cardiopulmonary ephelele noma imishini "ye-heart-lung" ingasetshenziswa kuphela amahora ambalwa ekamelweni lokusebenza, i-ECMO ingasetshenziswa isikhathi eside kuzilungiselelo ngaphandle kwekamelo lokusebenza njenge-NICU.
Nazi izingxenye ze-ECMO:
- Isibhamu sesifunda
- I-membrane oxygenator
- Amakhemikhali acacile abuyele igazi kuhlelo oluyingozi noma ohlelweni lokuguqula umzimba
- Ipompo ye-centrifugal noma i-roller
- Umthengisi wokushisa
Ubani Okudingayo ECMO?
I-ECMO yindlela yokwelapha okunzima, ngakho isetshenziselwa kuphela izingane ezigula kakhulu futhi mhlawumbe ziyafa ngaphandle kwayo. I-ECMO ingabhekwa njengabantwana abane:
- I-Meconium aspiration syndrome
- Ukucindezeleka okuqhubekayo kwe-pulmonary of the newborn (PPHN)
- Isifo esiphezulu sokucindezeleka ukucindezeleka
- Ukutheleleka kokuphila noma i-pneumonia
I-ECMO ingasetshenziselwa nanoma yisiphi isimo esibi esibangela inhliziyo yengane noma amaphaphu ukuba ayeke ukusebenza kahle. Ngenxa yokuthi i-ECMO ingasetshenziswa kuphela amasonto ambalwa, isetshenziselwa kuphela iziguli ezilindeleke ukuthi zilulame ngemuva kokwelashwa noma ukuhlinzwa.
I-ECMO isebenza kanjani?
Ukuze uqale ukwelashwa kwe-ECMO, odokotela bazobeka amathole amade abizwa ngokuthi ama-catheter emithonjeni yegazi yengane. I-catheters ingangena ngokungenwa okuncane entanyeni yomntwana noma ekuguleni futhi iyohamba eya ezitokisini ezinkulu eduze nenhliziyo yomntwana.
Uma izidakamizwa sezikhona, odokotela bazozihlanganisa nabo emgqonyeni womshini we-ECMO, ozobe usugcwaliswe ngegazi lomnikelo. Uma umshini we-ECMO uvuliwe, uzokhipha igazi kusuka emntwaneni, uwuthulule ngekhanda elifaka i-oxygen bese ususa i-carbon dioxide futhi abuyisele ingane okwe-oxygen.
Yiziphi Izingozi ze-ECMO?
Ngenxa yokuthi kunezingozi eziningi ezihlobene ne-ECMO, isetshenziswa kuphela ezinganeni ezigula kakhulu ukuze zife ngaphandle kokwelashwa. Izingozi zifaka:
- Ukweqa: I- Heparin, igazi elincane, lisetshenziselwa ukuvimbela ama-blood clots ngesikhatsi ukwelashwa kwe-ECMO. I-Heparin ingabangela ukuphuma kwegazi kusuka lapho amashubhu afakwa khona noma kwezinye izingxenye zomzimba.
- Ukwelashwa: Noma nini lapho into yangaphandle, njenge-catheter ye-ECMO, ifakwa emzimbeni, ingabangela ukutheleleka.
- Ukuvunguza kwegazi (IVH): Ukukhipha isisu ebuchosheni kuyinkinga enkulu yokwelapha kwe-ECMO.
- Ama-clots egazi: Ama- clots amancane egazi angase abe nesibhakabhaka se-ECMO. Lezi zindwangu zingase zihambe ngegazi futhi zidale ukulimala noma ngisho nokufa.
- Ukumpontshelwa igazi: Ukumpontshelwa igazi njalo kungadingeka lapho umntwana e-ECMO. Nakuba igazi liphephile kakhulu, kuhlale kunengozi yezifo ezivela egazini lomnikelo.
Ezinye izinto zokuphefumula ku-NICU
Ngaphezu kwe-ECMO, ungase uhlangane nezinye izinto zokuphefumula ku-NICU.
Izinsana ze-NICU zingadinga usizo lokuphefumula noma ukugcina igazi labo liphefumula. Imishini yokuphefumula eNICU ingafaka:
- Ama-cannulas e-nasal: I- cannula yamasongo iyisethi yamapulangwe amancane angase ahlinzeke ukuxilongwa okuphakeme kwe-oxygen kunekamelo lomoya. Bangase futhi banikele umoya wokulala endaweni ehamba phambili, okusiza ukugcina umoya uvuleke futhi ukhuthaze izingane ukuba ziphefumule.
- I-CPAP: Ukucindezela okungahambi kahle kwe-airway, noma i- CPAP , i-mask noma iqoqo elikhethekile lezintambo zomzimba ezibekwa ngokuqinile ekhaleni lomntwana ukuze ziqhube umoya njalo. Ukucindezela okuqhubekayo kukhuthaza ukuhamba kwemimoya evulekile futhi kukhumbuza izingane ukuba ziphefumule, futhi ingasetshenziswa ukujula okuphakeme kwe-oksijeni.
- Ama-ventilators: Uma umntwana efakwa efrijini , inqubo ebizwa ngokuthi i-intubation izosetshenziswa ukubeka ithubhu ekhethekile ebizwa ngokuthi i-endotracheal tube emoyeni ngomlomo noma ekhaleni. I-ventilator, noma umoya wokuphefumula, umshini oletha ukuphefumula ezinganeni ezingenakuphefumula noma ezingaphefumuli kahle.
Izinsiza zokuqapha ezenzelwe izitha
Ngaphandle kwemishini yokuphefumula, izinsana ezinakekela izingane ezikhethekile zigcinwa ngokuqapha ukuze ziqiniseke ukuthi ziphilile. Izibukeli ezivame ukusetshenziswa zihlanganisa:
- Abaqaphi be-cardiac: Lawa asebentisa izikhonkwane esifubeni esixhunywe ezintambo (ezibizwa ngokuthi imikhombandlela) esivumelana nomqapha ukuqinisekisa ukuthi inhliziyo yenhliziyo ibetha ngesivinini esifanele kanye nesigqi esifanele.
- Abaqaphi bokuphefumula: Ngokuvamile ingxenye yabaqapheli benhliziyo, lokhu kuholela ekuqapheleni izinga lokuphefumula komntwana kanye nephethini.
- Ama-oximeter okuyi- pulse: Lezi zibopha nxazonke zesandla somntwana wakho noma unyawo futhi zibe nokukhanya okubomvu okuqapha inani le-oxygen egazini.
Izinsiza Ze-IV Zezitha
Ungase ujwayelane ne-IVs, noma amashubhu amancane angena emithanjeni ukuze avumele abasebenzi ukuba bafeze amanzi noma imithi ngqo emithanjeni. Njengengxenye yenqubo ejwayelekile ye-NICU, izinsana ku-NICU zingaba nezinhlobo eziningana zemigqa engu-IV:
- I-Peripheral IVs: Lezi yizona "ezivamile" IV eziya emvuthweni wemithi noma izikhukhula. I-Peripheral IVs ingase ibe ezinyaweni, izandla, izingalo, noma izicathulo ezinganeni ezingaphambi kwesikhathi . Nakuba i-scalp IVs ibonakala iyesabeka kubazali, ijwayele kakhulu ku-NICU kusukela ezinsana ezingakazalwa zisenayo imithanjeni emihle ye-IV ezandleni nasezinyaweni.
- Imigqa ye-PICC: Ngamaphethelo afaka ama-cathter central, noma imigqa ye- PICC emfushane, ibheka njenge-IVs evamile. Banama-catheter angaphezulu, noma amashubhu, kunama-IV avamile, futhi ahamba phakathi kwe-vein emithanjeni emikhulu engenalutho enhliziyweni. Ukufakwa kwale migqa kungenye yezinqubo zezingane ze-NICU ezivame ukungena.
- Ama-catheter ama-umbilical: Lawa afakwa emgodleni wezintambo ze-umbilical futhi ahambela emithanjeni emikhulu nemisipha eduze kwenhliziyo. Imigqa ye-umbilical ingangeniswa emthini wezintambo zomzimba, umgogodla ohlangothini lwe-umbilical, noma kokubili, ukuvumela ukuphathwa kwe-fluid kanye nemithi, ukuqapha kwengcindezi yegazi, isampuli yegazi elingenabuhlungu kanye nezinye izinqubo.
Ezinye izinto zokusebenza ku-NICU
Ngenkathi ku-NICU, ingane yakho ingadinga imishini eyengeziwe.
- Ukondla ama-tubes: I- tube yokudla isuka emlonyeni (orogastric- ebizwa ngokuthi i-OG) noma ekhaleni (i-nasogastric- ebizwa nge-NG) esiswini. Izinsana ezigula kakhulu noma ezibuthakathaka ukudla esilweni noma kusuka ebhodleleni zithola ukudla ngalezi zilimo. Ukufaka ama-tubes nokunikeza ukudla ngezinqubo ezivamile phakathi kwezinsana ezingakazalwa.
- Ama- incubators : Izinsana ezingakazalwa zihlupha ukuzigcina zifudumele, ngakho-ke ama- incubators asetshenziselwa ukuhlinzeka indawo efudumele yomntwana ukuphumula. I-skin probes ilinganisa njalo izinga lokushisa komntwana, ngakho-ke akafudumala noma ayanda kakhulu.
- I-Phototherapy: Izitha zegazi zingase zibe nezinkinga ezivela e-jaundice. Izibani ze-phototherapy, ezibizwa nangokuthi izibani ze-bili, ziyizibani ezikhethekile ezisiza umzimba wezingane ukuba wehla i- bilirubin , i-chemicals edala i- jaundice .
Imithombo:
I-American Academy of Pediatrics. "Izinga Lokunakekelwa Kwesifo Sokubelethwa Kwesifo Sokubeletha" Izingane Zengane 2004 114: 1341-1347. > http://pediatrics.aappublications.org/content/114/5/1341.full.
Isibhedlela sezingane sasePittsburgh. "Izinqubo Nezinsiza ku-NICU."
Isibhedlela sezingane eNtshonalanga. "Abasebenzi bethu be-NICU abakhathalelayo." 2008. https://www.mhs.net/locations/memorial-west/neonatal/staff.
I-Cincinnati Izingane. Izinketho zokuhlinza: I-Membrane yangaphandle ye-Oxygenation (ECMO). Https://www.cincinnatichildrens.org/health/e/ecmo.
March we-Dimes. "I-Glossary: Izinsiza ezivamile ze-NICU." Okthoba 2008.
Nemours Foundation. "Lapho Izingane Zakho Ku-NICU."
I-Stanford School of Medicine Lane Medical Library. "Isingeniso ku-ECMO yabazali" http://lane.stanford.edu/portals/cvicu/HCP_CV_Tab_1/ecmo_for_parents.pdf.