Ati: “Ntuzigere ushidikanya ko itsinda rito ry'abaturage batekereza, bitanze bashobora guhindura isi.Nkako, ni yo yonyine ihari. ”
Inshingano za Cureus nuguhindura uburyo bumaze igihe cyo gutangaza ubuvuzi, aho gutanga ubushakashatsi bishobora kuba bihenze, bigoye, kandi bitwara igihe.
Tanga iyi ngingo nka: Kojima Y., Sendo R., Okayama N. n'abandi.(Gicurasi 18, 2022) Ikigereranyo cya ogisijeni yashizwemo mubikoresho bito kandi byinshi: ubushakashatsi bwikigereranyo.Umuti 14 (5): e25122.doi: 10.7759 / gukiza.25122
Intego: Igice cya ogisijeni yashizwemo kigomba gupimwa mugihe umwuka wa ogisijeni uhabwa umurwayi, kubera ko ugereranya umwuka wa ogisijeni wa alveolar, ukaba ari ingenzi uhereye ku myumvire y'ubuhumekero.Kubwibyo, intego yubu bushakashatsi kwari ukugereranya igipimo cya ogisijeni ihumeka yabonetse hamwe nibikoresho bitandukanye byo gutanga ogisijeni.
Uburyo: Uburyo bwo kwigana guhumeka bidatinze bwakoreshejwe.Gupima igipimo cya ogisijeni ihumeka yakiriwe binyuze mumazi maremare kandi maremare hamwe na masike yoroshye ya ogisijeni.Nyuma ya s 120 ya ogisijeni, igice cyumwuka uhumeka cyapimwe buri segonda kuri 30 s.Ibipimo bitatu byafashwe kuri buri kintu.
IBISUBIZO: Umwuka wo mu kirere wagabanutse uduce duto twa ogisijeni duhumeka hamwe na ogisijeni idasanzwe iyo ukoresheje urumogi ruto rutemba, byerekana ko guhumeka kurangira byabaye mugihe cyo guhumeka kandi bishobora kuba bifitanye isano no kwiyongera kwagace ka ogisijeni ihumeka.
Umwanzuro.Guhumeka Oxygene mugihe cyo guhumeka birashobora gutuma kwiyongera kwa ogisijeni mu mwanya wapfuye wa anatomique, bishobora kuba bifitanye isano no kwiyongera k'umubare wa ogisijeni uhumeka.Ukoresheje urujya n'uruza rw'amazuru, ijanisha ryinshi rya ogisijeni ihumeka irashobora kuboneka no ku kigero cya 10 L / min.Mugihe hamenyekanye urugero rwiza rwa ogisijeni, birakenewe gushyiraho umuvuduko ukwiye wumurwayi nuburyo bwihariye, hatitawe ku gaciro k’igice cya ogisijeni ihumeka.Iyo ukoresheje amazuru mabi atemba hamwe na masike yoroshye ya ogisijeni mugihe cyamavuriro, birashobora kugorana kugereranya igipimo cya ogisijeni yashizwemo.
Imiyoborere ya ogisijeni mugihe cyicyiciro gikomeye kandi cyigihe cyo kunanirwa kwubuhumekero nuburyo busanzwe mubuvuzi bwamavuriro.Uburyo butandukanye bwo kuyobora ogisijeni burimo urumogi, urumogi rwamazuru, masike ya ogisijeni, mask yikigega, mask ya venturi, hamwe n’amazi menshi yo mu mazuru (HFNC) [1-5].Ijanisha rya ogisijeni mu mwuka uhumeka (FiO2) ni ijanisha rya ogisijeni mu mwuka uhumeka ugira uruhare mu guhana gaze ya alveolar.Urwego rwa ogisijeni (igipimo cya P / F) ni igipimo cyumuvuduko wigice cya ogisijeni (PaO2) na FiO2 mumaraso ya arterial.Nubwo agaciro ko gusuzuma igipimo cya P / F gikomeje kutavugwaho rumwe, ni ikimenyetso gikoreshwa cyane cya ogisijeni mu mavuriro [6-8].Niyo mpamvu, mubuvuzi ni ngombwa kumenya agaciro ka FiO2 mugihe uhaye umurwayi ogisijeni.
Mugihe cyo kwinjizamo, FiO2 irashobora gupimwa neza hamwe na monitor ya ogisijeni irimo uruziga ruhumeka, mugihe mugihe ogisijene itanzwe hamwe na kannula yizuru hamwe na mask ya ogisijeni, hashobora gupimwa gusa "igereranya" rya FiO2 hashingiwe kumwanya wo guhumeka.Iyi "manota" ni igipimo cyo gutanga ogisijeni nubunini bwamazi.Ariko, ibi ntibireba ibintu bimwe na bimwe duhereye kuri physiologiya yo guhumeka.Ubushakashatsi bwerekanye ko ibipimo bya FiO2 bishobora guterwa nimpamvu zitandukanye [2,3].Nubwo imiyoborere ya ogisijeni mugihe cyo guhumeka ishobora gutuma kwiyongera kwa ogisijeni ahantu hapfuye nka anatomique yapfuye nko mu kanwa, umunwa na trachea, nta raporo kuri iki kibazo mubitabo byubu.Nyamara, abaganga bamwe bemeza ko mubikorwa ibyo bintu bidafite akamaro kandi ko "amanota" ahagije kugirango bakemure ibibazo byubuvuzi.
Mu myaka yashize, HFNC yakunze cyane ubuvuzi bwihutirwa no kuvurwa cyane [9].HFNC itanga FiO2 nini na ogisijeni nyinshi hamwe ninyungu ebyiri zingenzi - guhanagura umwanya wapfuye wururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururururungimungiru N [(10,11].Byongeye kandi, birashobora kuba ngombwa gutekereza ko agaciro FiO2 yapimwe igereranya imyuka ya ogisijeni ihumeka cyangwa alveoli, kubera ko umwuka wa ogisijeni muri alveoli mugihe cyo guhumeka ari ngombwa ukurikije igipimo cya P / F.
Uburyo bwa Oxygene bwo gutanga butari intubation bukoreshwa mubikorwa bisanzwe byubuvuzi.Niyo mpamvu, ni ngombwa gukusanya amakuru menshi kuri FiO2 yapimwe hamwe n’ibikoresho byo gutanga ogisijeni mu rwego rwo kwirinda gukabya gukabije ndetse no kumenya neza umutekano wo guhumeka mu gihe cya ogisijeni.Ariko, gupima FiO2 muri trachea yabantu biragoye.Abashakashatsi bamwe bagerageje kwigana FiO2 bakoresheje uburyo bwo guhumeka bidatinze [4,12,13].Kubwibyo, muri ubu bushakashatsi, twari tugamije gupima FiO2 dukoresheje urugero rwigero rwo guhumeka bidatinze.
Ubu ni ubushakashatsi bwikigereranyo budasaba kwemerwa neza kuko ntabwo burimo abantu.Kugira ngo twigane guhumeka bidatinze, twateguye uburyo bwo guhumeka bidatinze twifashishije urugero rwakozwe na Hsu n'abandi.(Isanamu 1) [12].Ventilator hamwe n'ibihaha bipima (Dual Adult TTL; Grand Rapids, MI: Michigan Instruments, Inc.) bivuye mubikoresho bya anesthesia (Fabius Plus; Lübeck, Ubudage: Draeger, Inc.) bari biteguye kwigana guhumeka bidatinze.Ibikoresho byombi byahujwe nintoki nu byuma bikomeye.Inzogera imwe (kuruhande) yo guhaha ibihaha ihujwe na ventilator.Ubundi inzogera (uruhande rwa pasiporo) rw'ibihaha bipimisha ihujwe na “Oxygene yo gucunga Oxygene”.Umuyaga ukimara gutanga gaze nshya kugirango ugerageze ibihaha (uruhande rwo gutwara), inzogera zuzuzwa no gukurura ku gahato ku rundi ruhande (uruhande rwa pasiporo).Uru rugendo ruhumeka gaze binyuze muri trachea ya manikin, bityo bigereranya guhumeka bidatinze.
.
Igikoresho cyo guhumeka cyari ibi bikurikira: ingano ya tide 500 ml, igipimo cyubuhumekero 10 guhumeka / min, guhumeka ku kigereranyo cyo guhumeka (guhumeka / kugereranya igihe) 1: 2 (igihe cyo guhumeka = 1 s).Kubushakashatsi, kubahiriza ibihaha byapimwe byashyizwe kuri 0.5.
Monitor ya ogisijeni (MiniOx 3000; Pittsburgh, PA: American Medical Services Corporation) na manikin (MW13; Kyoto, Ubuyapani: Kyoto Kagaku Co., Ltd.) byakoreshejwe muburyo bwo gucunga ogisijeni.Umwuka mwiza wa ogisijeni watewe ku gipimo cya 1, 2, 3, 4 na 5 L / min kandi hapimwe FiO2 kuri buri.Kuri HFNC (MaxVenturi; Coleraine, Irilande y'Amajyaruguru: Ubuvuzi bwa Armstrong), imvange ya ogisijeni n'umwuka yatanzwe mu mubumbe wa 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, na 60 L, kandi FiO2 yari bisuzumwa kuri buri rubanza.Kuri HFNC, ubushakashatsi bwakozwe kuri 45%, 60% na 90% bya ogisijeni.
Imyunyungugu ya ogisijeni idasanzwe (BSM-6301; Tokiyo, Ubuyapani: Nihon Kohden Co) yapimwe cm 3 hejuru y’imisemburo ya maxillary hamwe na ogisijeni yatanzwe binyuze mu mazuru (Finefit; Osaka, Ubuyapani: Japan Medicalnext Co) (Ishusho 1).) Intubation ikoresheje umuyaga w'amashanyarazi (HEF-33YR; Tokiyo, Ubuyapani: Hitachi) kugirango uhumeke umwuka mumutwe wa manikin kugirango ukureho umwuka uhumeka, kandi FiO2 yapimwe nyuma yiminota 2.
Nyuma yamasegonda 120 yo guhura na ogisijeni, FiO2 yapimwe buri segonda kumasegonda 30.Ventilate manikin na laboratoire nyuma yo gupima.FiO2 yapimwe inshuro 3 muri buri kintu.Ubushakashatsi bwatangiye nyuma ya kalibrasi ya buri gikoresho cyo gupima.
Ubusanzwe, ogisijeni isuzumwa binyuze mu mazuru kugira ngo FiO2 ipimwe.Uburyo bwo kubara bwakoreshejwe muri ubu bushakashatsi bwatandukanye bitewe nibiri mu guhumeka bidatinze (Imbonerahamwe 1).Amanota abarwa hashingiwe ku miterere yo guhumeka yashyizwe mu gikoresho cya anesteziya (ingano y’amazi: ml 500, igipimo cy’ubuhumekero: 10 guhumeka / min, guhumeka ku kigereranyo kirangiye {guhumeka: igipimo cyo guhumeka} = 1: 2).
“Amanota” abarwa kuri buri gipimo cya ogisijeni.Cannula yizuru yakoreshejwe mugutanga ogisijeni muri LFNC.
Isesengura ryose ryakozwe hifashishijwe porogaramu yinkomoko (Northampton, MA: OriginLab Corporation).Ibisubizo bigaragazwa nkibisobanuro iation gutandukana bisanzwe (SD) byumubare wibizamini (N) [12].Twazengurutse ibisubizo byose ahantu habiri.
Kubara "amanota", ingano ya ogisijeni ihumeka mu bihaha mu mwuka umwe ihwanye na ogisijeni iri mu kanwa ka mazuru, naho ibindi bikaba hanze y'umwuka.Rero, hamwe nigihe cyo guhumeka cya 2 s, ogisijeni itangwa na kannula yizuru muri 2 s ni 1000/30 ml.Igipimo cya ogisijeni cyabonetse mu kirere cyo hanze cyari 21% yubunini bwamazi (1000/30 ml).FiO2 yanyuma ni ingano ya ogisijeni igezwa ku bwinshi bwamazi.Kubwibyo, “igereranya” FiO2 irashobora kubarwa mugabanye igiteranyo cya ogisijeni ikoreshwa nubunini bwamazi.
Mbere ya buri gipimo, monitor ya ogisijeni ya intratracheal yahinduwe kuri 20.8% naho monitor ya ogisijeni idasanzwe yahinduwe kuri 21%.Imbonerahamwe 1 irerekana agaciro ka FiO2 LFNC kuri buri gipimo.Indangagaciro zikubye inshuro 1.5-1.9 kurenza indangagaciro "zabazwe" (Imbonerahamwe 1).Ubwinshi bwa ogisijeni hanze yumunwa buri hejuru kuruta mu kirere cyo mu nzu (21%).Impuzandengo yagabanutse mbere yo kwinjiza umwuka uva mumashanyarazi.Indangagaciro zisa n "agaciro kagereranijwe".Hamwe n'umwuka uhumeka, iyo umwuka wa ogisijeni hanze yumunwa wegereye umwuka wicyumba, agaciro ka FiO2 muri trachea karenze "agaciro kabaruwe" karenze 2 L / min.Hamwe no kutagira umwuka, itandukaniro rya FiO2 ryaragabanutse uko umuvuduko wiyongera (Ishusho 2).
Imbonerahamwe 2 irerekana impuzandengo ya FiO2 kuri buri ogisijeni yibanze kuri masike yoroshye ya ogisijeni (mask ya ogisijeni ya Ecolite; Osaka, Ubuyapani: Japan Medicalnext Co., Ltd.).Indangagaciro ziyongereye hamwe no kongera umwuka wa ogisijeni (Imbonerahamwe 2).Hamwe nogukoresha ogisijeni imwe, FiO2 ya LFNK irarenze iy'amasike yoroshye ya ogisijeni.Kuri 1-5 L / min, itandukaniro muri FiO2 ni 11-24%.
Imbonerahamwe 3 irerekana impuzandengo ya FiO2 kuri HFNC kuri buri kigero cyo gutembera hamwe na ogisijeni yibanze.Indangagaciro zari hafi yintego ya ogisijeni ititaye ku kuba umuvuduko w’amazi wari muke cyangwa hejuru (Imbonerahamwe 3).
Indangagaciro za FiO2 zari hejuru kurenza 'igereranijwe' agaciro kandi indangagaciro zidasanzwe za FiO2 zari hejuru yumuyaga wicyumba mugihe ukoresheje LFNC.Umwuka wo mu kirere wasangaga ugabanya intratracheal na FiO2 idasanzwe.Ibisubizo byerekana ko guhumeka kurangira byabaye mugihe cya LFNC.Hamwe cyangwa idafite umwuka, itandukaniro rya FiO2 rigabanuka uko umuvuduko wiyongera.Igisubizo cyerekana ko ikindi kintu gishobora kuba gifitanye isano na FiO2 yazamutse muri trachea.Byongeye kandi, berekanye kandi ko ogisijeni yongerera umwuka wa ogisijeni ahantu hapfuye anatomiki, bishobora guterwa no kwiyongera kwa FiO2 [2].Muri rusange biremewe ko LFNC idatera guhumeka neza.Biteganijwe ko ibyo bishobora guhindura cyane itandukaniro riri hagati yindangagaciro zapimwe na "zigereranijwe" kuri kanseri yizuru.
Ku gipimo gito cya 1-5 L / min, FiO2 ya mask isanzwe yari munsi ugereranije niy'amazuru ya mazuru, birashoboka ko umwuka wa ogisijeni utiyongera byoroshye mugihe igice cya mask gihindutse agace kapfuye.Imyuka ya Oxygene igabanya umwuka wo mu cyumba kandi igahindura FiO2 hejuru ya 5 L / min [12].Munsi ya 5 L / min, indangagaciro za FiO2 zibaho bitewe no guhinduranya umwuka wibyumba no guhumeka ahantu hapfuye [12].Mubyukuri, uburebure bwa metero ya ogisijeni irashobora gutandukana cyane.MiniOx 3000 ikoreshwa mugukurikirana umwuka wa ogisijeni, icyakora igikoresho ntigifite imyanzuro ihagije yigihe gito cyo gupima impinduka ziterwa na ogisijeni isohotse (abayikora bagaragaza amasegonda 20 kugirango bagaragaze igisubizo cya 90%).Ibi bisaba monitor ya ogisijeni hamwe nigisubizo cyihuse.
Mubikorwa byubuvuzi nyabyo, morphologie yu myanya yizuru, umunwa wo mu kanwa, na pharynx iratandukanye kubantu, kandi agaciro ka FiO2 karashobora gutandukana nibisubizo byabonetse muri ubu bushakashatsi.Byongeye kandi, uko ubuhumekero bw’abarwayi buratandukanye, kandi gukoresha ogisijeni nyinshi biganisha kuri ogisijeni nkeya mu myuka ihumeka.Ibi bintu birashobora kuganisha kumurongo wa FiO2.Kubwibyo, biragoye gusuzuma FiO2 yizewe mugihe ukoresheje LFNK hamwe na masike yoroshye ya ogisijeni mubihe byukuri byubuvuzi.Nyamara, ubu bushakashatsi bwerekana ko imyumvire yumwanya wapfuye no guhumeka inshuro nyinshi bishobora kugira ingaruka kuri FiO2.Urebye uku kuvumbura, FiO2 irashobora kwiyongera cyane no ku gipimo gito cyo gutemba, bitewe nuburyo aho kuba "igereranya".
Umuryango w’Abongereza Thoracic urasaba ko abaganga bandika ogisijeni bakurikije urugero rwuzuye kandi bakagenzura umurwayi kugira ngo yuzuze intego [14].Nubwo "agaciro kabaruwe" ka FiO2 muri ubu bushakashatsi kari hasi cyane, birashoboka kugera kuri FiO2 nyayo irenze "agaciro kabaruwe" ukurikije uko umurwayi ameze.
Iyo ukoresheje HFNC, agaciro ka FiO2 kegereye icyerekezo cya ogisijeni cyashyizweho utitaye ku kigero cyo gutemba.Ibyavuye muri ubu bushakashatsi byerekana ko urwego rwo hejuru rwa FiO2 rushobora kugerwaho no ku kigero cya 10 L / min.Ubushakashatsi nk'ubwo bwerekanye ko nta gihinduka muri FiO2 hagati ya 10 na 30 L [12,15].Umuvuduko mwinshi wa HFNC bivugwa ko ukuraho icyifuzo cyo gutekereza ahantu hapfuye anatomique [2,16].Umwanya wapfuye wa Anatomique urashobora gusohorwa kumuvuduko wa ogisijeni urenze 10 L / min.Dysart n'abandi.Biravugwa ko uburyo bwibanze bwibikorwa bya VPT bushobora kuba uguhindura umwanya wapfuye wurwobo rwa nasofaryngeal, bityo bikagabanya umwanya wapfuye kandi bikongerera igipimo cyo guhumeka umunota (ni ukuvuga guhumeka alveolar) [17].
Ubushakashatsi bwibanze bwa HFNC bwakoresheje catheter mu gupima FiO2 mu mazuru, ariko FiO2 yari hasi ugereranije no muri ubu bushakashatsi [15,18-20].Ritchie n'abandi.Byavuzwe ko agaciro kabaruwe ka FiO2 kegera 0.60 kuko umuvuduko wa gazi wiyongera hejuru ya 30 L / min mugihe cyo guhumeka amazuru [15].Mu myitozo, HFNCs isaba umuvuduko wa 10-30 L / min cyangwa irenga.Bitewe nimiterere ya HFNC, imiterere mumyanya yizuru igira ingaruka zikomeye, kandi HFNC ikora cyane kumuvuduko mwinshi.Niba guhumeka neza, kugabanuka k'umuvuduko nabyo birashobora gukenerwa, kuko FiO2 irashobora kuba ihagije.
Ibisubizo bishingiye kubigereranyo kandi ntibisobanura ko ibisubizo bya FiO2 bishobora gukoreshwa kubarwayi nyabo.Ariko, ukurikije ibisubizo, mugihe cya intubation cyangwa ibikoresho bitari HFNC, indangagaciro za FiO2 zirashobora gutegurwa guhinduka cyane bitewe nibihe.Iyo utanga ogisijeni hamwe na LFNC cyangwa masike yoroshye ya ogisijeni mu mavuriro, ubuvuzi busanzwe busuzumwa gusa n’agaciro ka “periferique arterial ogisijeni yuzuye” (SpO2) ukoresheje oximeter ya pulse.Hamwe no gukura amaraso make, birasabwa gucunga neza umurwayi, hatitawe kuri SpO2, PaO2 hamwe na ogisijeni mumaraso ya arterial.Mubyongeyeho, Downes n'abandi.na Beasley n'abandi.Byagaragaye ko abarwayi badahungabana bashobora rwose guhura n’akaga kubera gukoresha imiti igabanya ubukana bwa ogisijeni yibanze cyane [21-24].Mu gihe cyo kwangirika kwumubiri, abarwayi bahabwa imiti ivura ogisijeni yibanze cyane bazasoma impiswi nyinshi za okisimeteri, zishobora gutuma igabanuka rya gahoro gahoro ku kigereranyo cya P / F bityo ntirishobora kumenyesha abakozi mugihe gikwiye, bigatuma habaho kwangirika gukenera kwifashisha imashini.inkunga.Mbere twatekerezaga ko FiO2 yo hejuru itanga uburinzi n’umutekano ku barwayi, ariko iyi nyigisho ntabwo ikoreshwa ku mavuriro [14].
Niyo mpamvu, hagomba kwitonderwa nubwo wanditse ogisijeni mugihe cya perioperative cyangwa mugihe cyambere cyo kunanirwa guhumeka.Ibyavuye mu bushakashatsi byerekana ko ibipimo nyabyo bya FiO2 bishobora kuboneka gusa hamwe na intubation cyangwa HFNC.Iyo ukoresheje LFNC cyangwa maskike yoroshye ya ogisijeni, hagomba gutangwa ogisijeni ya profilaktike kugirango wirinde guhumeka neza.Ibi bikoresho ntibishobora kuba byiza mugihe hagomba gusuzumwa neza imiterere yubuhumekero, cyane cyane iyo ibisubizo bya FiO2 ari ngombwa.Ndetse no ku gipimo gito, FiO2 yiyongera hamwe na ogisijeni kandi irashobora guhisha kunanirwa guhumeka.Mubyongeyeho, niyo ukoresha SpO2 mukuvura nyuma yubuvuzi, hifujwe kugira umuvuduko muke ushoboka.Ibi birakenewe kugirango hamenyekane hakiri kare kunanirwa guhumeka.Umwuka mwinshi wa ogisijeni wongera ibyago byo kunanirwa gutahura hakiri kare.Igipimo cya ogisijeni kigomba kugenwa nyuma yo kumenya ibimenyetso byingenzi bitezimbere hamwe nubuyobozi bwa ogisijeni.Ukurikije ibyavuye muri ubu bushakashatsi byonyine, ntabwo bisabwa guhindura imyumvire yo gucunga ogisijeni.Ariko, twizera ko ibitekerezo bishya byatanzwe muri ubu bushakashatsi bigomba gutekerezwa muburyo bukoreshwa mubikorwa byubuvuzi.Byongeye kandi, mugihe hamenyekanye ingano ya ogisijeni isabwa nubuyobozi, birakenewe gushyiraho umurwayi ukwiye umurwayi, hatitawe ku gaciro ka FiO2 kubipimo bisanzwe bipima ibintu.
Turasaba ko twakongera gutekereza ku gitekerezo cya FiO2, hitawe ku rwego rwo kuvura ogisijeni ndetse no ku mavuriro, kubera ko FiO2 ari ikintu cy'ingenzi mu gucunga ubuyobozi bwa ogisijeni.Nyamara, ubu bushakashatsi bufite aho bugarukira.Niba FiO2 ishobora gupimwa muri trachea yumuntu, hashobora kuboneka agaciro nyako.Ariko, kuri ubu biragoye gukora ibipimo nkibi utiriwe utera.Ubundi bushakashatsi ukoresheje ibikoresho byo gupima bidatera bigomba gukorwa mugihe kizaza.
Muri ubu bushakashatsi, twapimye intratracheal FiO2 dukoresheje uburyo bwo kwigana LFNC bwihuse bwo guhumeka, masike yoroshye ya ogisijeni, na HFNC.Gucunga ogisijeni mugihe cyo guhumeka birashobora gutuma kwiyongera kwa ogisijeni mu mwanya wapfuye wa anatomique, bishobora kuba bifitanye isano no kwiyongera kwa ogisijeni ihumeka.Hamwe na HFNC, igice kinini cya ogisijeni ihumeka irashobora kuboneka no ku kigero cya 10 l / min.Mugihe cyo kumenya urugero rwiza rwa ogisijeni, birakenewe ko hashyirwaho umuvuduko ukwiye wumurwayi nuburyo bwihariye, ntibishingiye gusa ku gaciro k’igice cya ogisijeni yashizwemo.Kugereranya ijanisha rya ogisijeni ihumeka mugihe ukoresheje LFNC hamwe na masike yoroshye ya ogisijeni mumavuriro birashobora kugorana.
Amakuru yabonetse yerekana ko guhumeka kurangira bifitanye isano no kwiyongera kwa FiO2 muri trachea ya LFNC.Mugihe cyo kumenya ingano ya ogisijeni isabwa nubuyobozi, birakenewe gushyiraho umurwayi ukwiye umurwayi, hatitawe ku gaciro ka FiO2 yapimwe hifashishijwe imigezi gakondo.
Ibintu byabantu: Abanditsi bose bemeje ko nta muntu cyangwa inyama zagize uruhare muri ubu bushakashatsi.Ibikoko: Abanditsi bose bemeje ko nta nyamaswa cyangwa inyama zagize uruhare muri ubu bushakashatsi.Amakimbirane y'inyungu: Dukurikije ifishi yo kumenyekanisha ICMJE Uniform, abanditsi bose batangaza ibi bikurikira: Amakuru yo Kwishura / Serivisi: Abanditsi bose batangaza ko batabonye inkunga y'amafaranga n'umuryango uwo ariwo wose ku mirimo yatanzwe.Isano ry’imari: Abanditsi bose batangaza ko badafite muri iki gihe cyangwa mu myaka itatu ishize bafitanye umubano w’amafaranga n’umuryango uwo ariwo wose ushobora gushishikarira umurimo watanzwe.Ubundi busabane: Abanditsi bose batangaza ko ntayindi mibanire cyangwa ibikorwa bishobora kugira ingaruka kumurimo watanzwe.
Turashaka gushimira Bwana Toru Shida (IMI Co, Ltd, Kumamoto Service Customer Service Centre, Ubuyapani) ubufasha yatanze muri ubu bushakashatsi.
Kojima Y., Sendo R., Okayama N. n'abandi.(Gicurasi 18, 2022) Ikigereranyo cya ogisijeni yashizwemo mubikoresho bito kandi byinshi: ubushakashatsi bwikigereranyo.Umuti 14 (5): e25122.doi: 10.7759 / gukiza.25122
© Copyright 2022 Kojima n'abandi.Iyi ni ingingo ifunguye yinjira yatanzwe hakurikijwe amategeko ya Creative Commons Attribution Licence CC-BY 4.0.Gukoresha imipaka, gukwirakwiza, no kubyara muburyo ubwo aribwo bwose biremewe, mugihe umwanditsi wambere ninkomoko yatanzwe.
Iyi ni ingingo ifunguye yatanzwe munsi yuburenganzira bwa Creative Commons Attribution Licence, yemerera gukoresha, gukwirakwiza, no kubyara bitagabanijwe muburyo ubwo aribwo bwose, mugihe umwanditsi ninkomoko yatanzwe.
.
Igikoresho cyo guhumeka cyari ibi bikurikira: ingano ya tide 500 ml, igipimo cyubuhumekero 10 guhumeka / min, guhumeka ku kigereranyo cyo guhumeka (guhumeka / kugereranya igihe) 1: 2 (igihe cyo guhumeka = 1 s).Kubushakashatsi, kubahiriza ibihaha byapimwe byashyizwe kuri 0.5.
“Amanota” abarwa kuri buri gipimo cya ogisijeni.Cannula yizuru yakoreshejwe mugutanga ogisijeni muri LFNC.
Impuguke Yimpinduka Quotient ™ (SIQ ™) ninzira yacu idasanzwe nyuma yo gutangaza urungano rwo gusuzuma isuzuma.Shakisha byinshi hano.
Ihuza rizakujyana kurubuga rwagatatu rudafitanye isano na Cureus, Inc. Nyamuneka menya ko Cureus idashinzwe kubintu byose cyangwa ibikorwa bikubiye mubufatanye cyangwa kurubuga rwishamikiyeho.
Impuguke Yimpinduka Quotient ™ (SIQ ™) ninzira yacu idasanzwe nyuma yo gutangaza urungano rwo gusuzuma isuzuma.SIQ ™ isuzuma akamaro nubwiza bwingingo ukoresheje ubwenge rusange bwumuryango wose wa Cureus.Abakoresha bose biyandikishije barashishikarizwa gutanga umusanzu kuri SIQ ™ yingingo zose zasohotse.(Abanditsi ntibashobora kugereranya ingingo zabo.)
Ibipimo bihanitse bigomba kubikwa kubikorwa bishya rwose mubikorwa byabo.Agaciro ako ari ko kose kari hejuru ya 5 kagomba kurebwa hejuru yikigereranyo.Mugihe abakoresha biyandikishije bose ba Cureus bashobora kugereranya ingingo yatangajwe, ibitekerezo byinzobere mu ngingo bifite uburemere burenze ubw'abatari inzobere.SIQ ™ yingingo izagaragara kuruhande rwingingo imaze guhabwa inshuro ebyiri, kandi izongera kubarwa hamwe n amanota yinyongera.
Impuguke Yimpinduka Quotient ™ (SIQ ™) ninzira yacu idasanzwe nyuma yo gutangaza urungano rwo gusuzuma isuzuma.SIQ ™ isuzuma akamaro nubwiza bwingingo ukoresheje ubwenge rusange bwumuryango wose wa Cureus.Abakoresha bose biyandikishije barashishikarizwa gutanga umusanzu kuri SIQ ™ yingingo zose zasohotse.(Abanditsi ntibashobora kugereranya ingingo zabo.)
Nyamuneka menya ko kubikora wemeye kongerwaho kurutonde rwa imeri ya imeri ya buri kwezi.