ʻO ka maʻi Corona a me kahi puʻupuʻu hou e pili ana i nā maʻi ʻino

Ke hoʻomaka nei nā kauka i ka mālama ʻana i nā maʻi maʻi COVID-19 me nā hoʻopiʻi koʻikoʻi, ʻike lākou i nā ʻokoʻa i ka pōʻino o ko lākou mau māmā, hōʻike ʻo WebMD.

ʻO kekahi poʻe maʻi e hele mai ana i nā hale maʻi e loaʻa i ka haʻahaʻa haʻahaʻa o ka oxygen i loko o ke koko, akā ʻaʻole hiki ke ʻike ʻia kēia maʻi ma ke kamaʻilio wale ʻana me lākou, no ka mea, ʻaʻole ʻike ʻia ka hapa nui o lākou i ka hypoxia, hōʻike wale lākou i kahi huikau a luhi paha akā paʻakikī. e hopu i ko lakou hanu. ʻO ka ʻoiaʻiʻo, ke lawe ʻia nā x-ray a i ʻole CT scans o nā māmā, ʻike ʻia lākou he olakino.

Loaʻa paha i nā māmā kekahi mau wahi o ke ao, e hōʻike ana i nā ʻāpana o ka pōʻino mai ka maʻi, akā ʻeleʻele ka hapa nui o nā māmā, e hōʻike ana ua piha lākou i ka ea.

A ʻo kekahi o nā kauka, i komo i ka mālama ʻana i nā hihia Covid-19 ma New York, ua ʻōlelo ʻia nā kukuna ma ka māmā o kekahi mau maʻi e like me ka loaʻa ʻana o nā maʻi e like me nā mea e pili ana i nā poʻe noho o nā uka a me nā wahi ma luna o ka ʻilikai. "Me he mea lā he ʻumi kaukani o nā maʻi ma New York… Paʻa mākou i ka mokulele ma 30000 kapuaʻi, a ke emi mālie nei ke kaomi o ka lewa i loko o ke keʻena kaʻa."

mea hanu

Ke hele mālie nei kēia mau maʻi i ka hypoxic, hoʻohui ʻo Dr. Cameron Kyle-Seidel, he kauka mālama koʻikoʻi ma Maimonides Medical Center ma Brooklyn, ka mea makemake nui e kaʻana like i kāna mau ʻike me nā hoa hana ma ka ʻoihana pūnaewele.

"ʻO ka nui o kēia mau maʻi e maʻi nei i ke koko haʻahaʻa o ka oxygen, a ʻaʻole like ko lākou māmā," wahi a Kauka Todd Ball, ka luna o ka Center for Lungs and Respiration ma ke Kulanui o Colorado. Ua ʻike nā kauka ma Italia i ka mea like, a ʻo kekahi o kēia mau hihia e pono ke mālama ʻia i kahi ʻokoʻa iki e hōʻoia i nā hopena maikaʻi loa.

I loko o kahi hoʻoponopono i ka Intensive Care Medicine, ua kākau ʻo Kauka Luciano Gattinoni, he kaukaʻi kipa o ka anesthesia a me ka mālama koʻikoʻi ma ke Kulanui o Göttingen ma Kelemānia a me kekahi o nā loea o ka honua i ka hanu ʻana, ua kākau ʻo ia ma mua o ka hapalua o nā maʻi ʻo ia a me kāna mau hoa. i mālama ʻia ma ka ʻĀkau ʻo Italia e ʻeha ʻia. Ma waena o ia mau hōʻailona maʻamau, hiki i nā maʻi ke hanu maikaʻi, akā i ka manawa like ke loaʻa i ka nele o ka oxygen i loko o ke koko.

Wahi a Dr. Gattinoni, ma kahi o 30% o nā maʻi maʻi Covid-19 e hōʻike ana i nā hōʻailona maʻamau o ARDS, a hōʻike nā radiographs i nā wahi opua i loko o ka māmā, ʻo ia hoʻi, ua paʻakikī a i ʻole lākou, e hōʻike ana ʻaʻole lākou e hana maikaʻi, a no laila. aia nā pae haʻahaʻa o ka oxygen i loko o ke koko, a hopu lākou i ko lākou hanu me ka pilikia nui. He mea maʻamau kēia ʻano pilikia o ka māmā ma waena o kekahi mau maʻi koʻikoʻi o nā maʻi hanu e like me ka influenza a me SARS.

Manaʻo ʻo Gattinoni e pono i nā kauka ke nānā pono i ka hopena o Covid-19 i ka māmā, a ʻo ka pinepine o kēia mau maʻi e pono ai i ka hanu kūlohelohe koke, e kōkua i ka pana ʻana i ka ea i loko o ka māmā e hoʻonui ai i ka oxygen.

Ke manaʻoʻiʻo nei ʻo ia e pono ai ka mālama ʻana me ka hoʻohana ʻana i nā respirator artificial, akā me nā hoʻonohonoho kūikawā e puhi i ka oxygen ma ke kaomi haʻahaʻa.

Ke manaʻoʻiʻo nei ʻo Gattinoni ʻaʻole ʻo ka pehu a ʻoʻoleʻa ka pilikia o kēia mau maʻi i ka ʻiʻo māmā, e like me ka mea maʻamau i nā hihia o ka maʻi pneumonia, akā aia ka pilikia ma ka pūnaewele paʻakikī o nā aʻa koko i loko o ka māmā, pono e hoʻopaʻa i ka wā e paʻa ai ka māmā. i poino, i hiki ai ke hooki hou ia lakou a i ole e paniia , i hoohuliia ke koko mai ka wahi i poino i kekahi wahi o ka mama, e hana pono ana, e pale ana i ke kino mai ka oxygen haahaa.

Ke hoʻomau nei ʻo Gatinoni i ka wehewehe ʻana ʻaʻole loaʻa kēia i kekahi mau maʻi Covid-19, ʻoiai ke kahe mau nei ke koko i nā ʻāpana ʻeha o ka māmā, a no laila ke manaʻo nei ka mea maʻi hiki iā ia ke hanu maikaʻi, ʻoiai ke hāʻule nui nei ka oxygen i loko o ke koko.

Hōʻike ʻo Kauka Ball e like ka pilikia vascular me ka mea i hana ʻia i kahi kūlana i kapa ʻia ʻo ka edema pulmonary kiʻekiʻe.

Hoʻōla ka poʻe maʻi edema pulmonary i ka wā e iho ai lākou mai nā kiʻekiʻe kiʻekiʻe a hāʻawi ʻia i ka oxygen. Hāʻawi ʻia lākou me ka oxygen, i kekahi manawa, ma o nā respirator artificial me nā lāʻau lapaʻau, me nā diuretics, e hoʻopau i ka wai e kahe ana i ka māmā. Akā ʻoi aku ka nui o ka noiʻi e ʻike inā kōkua kekahi o kēia mau hoʻolālā i nā mea maʻi me COVID-19.

Ua hāpai ʻo Kauka Ball i nā nīnau e pili ana i ka pololei o ke kuhiakau he pilikia i ka hoʻoponopono ʻana o nā kīʻaha koko i ke kahe ʻana o ke koko, me ka ʻōlelo ʻana "he kuhiakau wale nō ia i kēia manawa, a pono e hōʻoia ʻia ʻo ia ma ka noiʻi hou ʻana a me ke aʻo ʻana."

He mea koʻikoʻi nō hoʻi e hoʻomaopopo, ʻōlelo ʻo Gattinoni, hiki i nā mea maʻi me nā māmā maʻamau ke hele i loko o ARDS no ka mea ke hoʻouka ʻia ka coronavirus i ka ʻiʻo māmā.

Hoʻemi ʻia ka oxygen i loko o ke koko

Malia paha o kēia mau maʻi, ka mea maʻamau ka māmā a loaʻa i ka oxygen koko haʻahaʻa, hiki ke pilikia i ka ʻeha o ka māmā e pili ana i ka hoʻohana ʻana i nā ventilators, kahi e hoʻopōʻino ai ke kaomi mai ka ea i loko o ka māmā i nā alaloa palupalu. I ka hihia o ka hanu maʻamau, hoʻonui ka māmā ma muli o ke kaomi maikaʻi ʻole a huki ka diaphragm i lalo no ka hoʻonui ʻana i ka māmā. Akā ke hana nei nā ventilator ma ka hoʻokuʻu ʻana i ka ea i loko o ka māmā, ʻo ia ke kaomi maikaʻi, e like me ka wā e hoʻonui ʻia ai ka baluna.

Hiki i kēia mau mea hana ke kōkua i nā poʻe maʻi i nāwaliwali loa ko lākou māmā no ka hana ʻana, akā i ka manawa like hiki ke hōʻeha ʻia ma ke koi ʻana i ka māmā e hana ma ke ʻano i manaʻo ʻole ʻia.

"I ka piʻi ʻana o ke kaomi ʻana o ka māmā, hiki iā ia ke hoʻopūhoihoi i kēia mau ʻeke ea liʻiliʻi a palupalu loa," wahi a Kauka Michael Mohening, he pulmonologist a me ka loea mālama koʻikoʻi ma National Jewish Health ma Denver.

Hōʻike ʻo Gattinoni ʻo ka hoʻokomo ʻana i ka mea maʻi me kēia maʻi ma luna o ka ventilator ma lalo o ke kaomi kiʻekiʻe loa e hōʻeha ʻia ai ka māmā.

I loko o kahi ninaninau me ka MDEdge magazine, ua haʻi ʻo Gattinoni i kekahi o nā kikowaena ma Central Europe, ka mea i hoʻomaka i ka hoʻohana ʻana i nā lāʻau lapaʻau like ʻole no nā ʻano like ʻole o nā maʻi maʻi Covid-19, ʻaʻole i ʻike i kahi make i waena o kēia mau mea maʻi i loko o ka hale mālama koʻikoʻi, ʻoiai ka nui o ka make. Ua hōʻea i ka 60% i loko o ka ʻāpana. ʻO ka mālama koʻikoʻi ma kahi haukapila kokoke no ka mea e mālama ana i nā maʻi maʻi Covid-19 a pau ma muli o nā ʻōlelo kuhikuhi like, me ka nānā ʻole i nā ʻokoʻa ma waena o kēlā me kēia hihia.

Ua hoʻopaʻapaʻa ʻo Gattinoni ʻo COVID-19 kahi ʻano maʻi e koi ai i nā kauka e noʻonoʻo i kahi lapaʻau e like me ka physiology. "Eia naʻe, ʻaʻole hiki i nā kauka he nui a puni ka honua ke noʻonoʻo ma waho o ka protocol maʻamau i hoʻokumu ʻia no ka mālama ʻana i kēlā me kēia maʻi."

Ua hoʻokūpaʻa pū ʻo Kauka Paul i ka hoʻonui ʻana a me ka mālama nui ʻana me nā respirator artificial, a ʻo ka hopena ʻo ia ka ʻeha o ka māmā i hiki ʻole ke hoʻōla ʻia.

Ua wehewehe ʻo Paul ua holomua nui ka poʻe pulmonologists i ka hoʻohana ʻana i nā respirator artificial i mea e palekana ai lākou no ka poʻe maʻi, ʻoiai lākou e hana nei e mālama i ke kaomi ma ka māmā i hiki ke pale i ka pōʻino.

Ua kōkua kekahi mau noiʻi hou e hōʻemi i ka make o ka poʻe maʻi e pono e hoʻohana i ka respirator, no ka mea, ʻaʻole i ʻoi aku ka nui o ka pakeneka ma mua o 16%, e like me ka noiʻi ʻepekema, i paʻi ʻia ma ka New England Journal of Medicine, ma muli o ka hahai ʻana i ka ikaika ikaika. nā ʻanuʻu mālama.

Eia nō naʻe, ʻoi aku ka kiʻekiʻe o ka make o nā maʻi maʻi COVID-19, nona ka māmā. ʻO ke kumu paha ʻo kekahi mau mea maʻi COVID-19 e pono e noho ma luna o nā ventilator no kahi manawa lōʻihi, i kekahi manawa a hiki i ʻelua pule. Ke waiho nei ka noiʻi hou aku e hoʻomaopopo i ke kumu.