COVID-19 Inokoshesa Kukosha KweVhidhiyo Laryngoscopy

Mumadhipatimendi ekukurumidzira uye zvikamu zvekuchengetedza zvakanyanya munyika yese COVID-19 zvachinja mashandiro anoita zvipatara. Nekuwedzera kwekuda kwekutsigira varwere mukutambudzika kwekufema, tarisiro nyowani iri kuiswa pavhidhiyo laryngoscopy (VL) yekumisikidza varwere vachiiswa pamhepo.

VL yakakunda kugamuchirwa kuri kukura nekuti kuwedzererwa kwekuona kunoita kuti ive mukana wekuti intubation ibudirire pakuedza kwekutanga, zvichiita kuti maitiro acho ave akachengeteka kuvanachiremba nevarwere zvichienzaniswa neyechinyakare yakananga laryngoscopy (DL). Uyezve, VL inoderedza njodzi yekuparadzira hutachiona hunopararira.

"Kuwanikwa kwevhidhiyo laryngoscope pane yega yega intubation kunodzora kukanganisa uye kusatarisika matambudziko, kunowedzera mhinduro, kudzidza uye kudzidzisa," anodaro Marco Zaccagnini, Akanyoreswa Kufema Therapists / Certified Clinical Anesthesia Assistant. "Inogovana intubation neboka rezvechiremba uye inopa nzvimbo yakachengeteka kune vese vanoshanda nevarwere."

Tsika intubation

Endotracheal intubation inosanganisira kuisa yepurasitiki endotracheal chubhu kuburikidza nemuromo kana mhino, kuburikidza nehuro (iyo inosanganisira tambo dzenzwi), uye pakupedzisira mu trachea (windpipe). Iyo chubhu inotungamirwa munzvimbo ine mudziyo unozivikanwa seyaryngoscope, usati wabatanidzwa nemhepo inofema.

Mune yakajairwa DL intubation, chiremba anogona kuona muromo we laryngoscope painopinda mumuromo, asi anofanira kubva avimba ne "kunzwa" uye neruzivo kuti ave nechokwadi chekuti inodzivirira ezopu uye yakamiswa nenzira kwayo. Direct laryngoscopy inogona kunge yakaoma nevamwe varwere. Kuwana maonero eruzhinji ndiyo kiyi yeiyi michina uye kunogona kukanganiswa nezvinhu zvakaita sekuumbwa uye kufamba kwemutsipa neshaya, pamwe neatomia yekumusoro nzira.

Intubation inzira yakajairika, kunyanya panguva yedenda re COVID-19, asi haina njodzi. Pane imwe nguva, kukuvara kunogona kuitwa kumeno, muromo kana trachea, uye iyo laryngoscope inogona kuiswa netsaona mukati medziyo. Dzimwe nguva kuyedza kwekutanga kwekunyora hakubudirire, kuchida kuyedza kwakatevera. Njodzi kumurwere dzinowedzera nenhamba yekuyedza. Muzviitiko zveCOVID-19, vatapi vezvehutano vanoita laryngoscopy vanogona kunge vari panjodzi huru yekubatira hutachiona.

DL iri kunetsa kugona, asi neruzivo, anesthesiologists uye vekufema varapi vanogona nehunyanzvi neiyi nzira uye kazhinji vanowana kubudirira pane yekutanga-kupasa kuyedza. Zvidzidzo zvakaratidza[i], zvisinei, kuti vadzidzi vezvechiremba uye novice anesthesia vagari vane zvakadzikira zvakanyanya kutanga kwekutanga huwandu kupfuura vane ruzivo maanesthesiologists.

Uchapupu hwekupedzisira

Vhidhiyo laryngoscopy, kune rimwe divi, iri nyore kudzidza nekuti inopa chiratidzo chekuona chekufambira mberi kwepombi yekufema mune trachea. Izvi zvinovandudza mukana wekuti intubation ichabudirira pakuedza kwekutanga kunyangwe kana mupi wezvehutano asina ruzivo, kana kana mamiriro emurwere achiita kuti maitiro acho anetse. Iine VL, kamera pamagumo e laryngoscope inopa maonero akasimbiswa enzira yekumusoro yepamusoro, kusanganisira tambo dzemazwi, kuratidza mifananidzo yevhidhiyo munguva chaiyo pachiratidziri chakabatanidzwa mubato re laryngoscope.

Kubudirira kwepamusoro kweVL kwakasimbiswa muchidzidzo che2019 chakatungamirwa naDr Ruediger Noppens, purofesa weanesthesiology kuWestern University muLondon, Ontario. Uku kuyedzwa kwepasi rese kwaisanganisira vanopfuura zviuru zviviri zvevarwere uye vachifananidza yekutanga-kupasa yekubudirira kwehuwandu hwekushandisa uchishandisa yakajairwa laryngoscope uye McGrath MAC vhidhiyo laryngoscope, yakaitwa naMedtronic.

Chidzidzo ichi chakawana kuti VL yaive nepasuru-yekubudirira chiyero che94 muzana, zvichienzaniswa ne82 muzana yeDL, uye zvakare zvakakonzera kukuvara kwemurwere kushoma. Sekureva kwaDr. Noppens, chidzidzo ichi chaive chekutanga humbowo hwekutsigira kushandiswa kweVL kweyakajairika intubation. Vatsvagiridzi vakagumisa kuti mukana wega weDL waive mutengo, kunyangwe iyo yepamusoro mari yekutanga kweiyo vhidhiyo chishandiso inogona kupfuurwa nekuchengetedza munguva uye zvekurapa zvinetso.

Idzo inhau dzakanaka dzekukurumidzira uye ICU vanachiremba, avo vanowanzoita mashoma maitiro echinyakare kupfuura anesthesiologists. VL zvakare yakachengeteka kune varapi vanobata neCOVID-19 nekuti havafanirwe kuswedera padyo nechiso chemurwere sezvavanoita neDL. Zvakachengeteka kuvarwere zvakare, nekuti zvinoguma nekukuvara kushoma.

Sezvo zvipatara zvinokakavara kubata varwere vane hutachiona hwakakomba hweCOVID-19, nzanga dzehunyanzvi[ii] munyika zhinji vatanga kukurudzira kushandiswa kweVL kubatsira kudzikisira kupararira kweutachiona. Aya mazano anobva kune humbowo hwekuvandudzwa kwekutanga-kuyedza intubation kubudirira uye nekuwedzera chinhambwe pakati pemupi uye murwere panguva yekuita.

Kunyangwe iwo mabhenefiti eVL ari kuramba achijeka, DL inoramba iri chiyero chekutarisira muCanada, nepo VL ichiwanzochengeterwa yakaoma intubation. Ramangwana reVL parizvino riri nyaya yekukakavadzana mukati memunharaunda yeanesthesia, nevazhinji vachitenda kuti mubvunzo chaiwo hausi wekutsiva DL seyero yekutarisira, asi riini.


Post nguva: 25-07-21