Ventilator Associated Pneumonia (VAP), nke a makwaara dị ka Ventilator Pneumonia na-ebute ya bụ ọrịa oyi nke na-amalite 48 awa ma ọ bụ ogologo oge mgbe ọnyá na- agwụ . Ọrịa bụ nke na - amalite n'ime awa 48 mbụ nke oge onye ọrịa na ventilator, ma ọ bụ nọ mgbe a na - etinye onye ọrịa ahụ na ventilator, anaghị ewere ya na ventilator dị na ya n'ihi na oyi baa dị tupu a na - eji ventilator.
Na-egbochi nje ventilator metụtara ọrịa oyi
Onye ọrịa nwere ike inyere aka gbochie ventilator ịchọrọ na oyi baa site na ịnweta ike kachasị mma tupu ịwa ahụ. Nke a pụtara ịṅụ sịga n'ihu ịwa ahụ , na-elekọta nlekọta ahụike ọ bụla nwere ike ịnọ ma na-eme nlezianya dị ọcha. N'ozuzu, ime mgbalị iji nweta ahụ ike kachasị mma site na iri nri nke ọma, ịme ihe na ịgbaso ntụziaka maka iji ọgwụ eme ihe nwere ike ime ka ahụike dị mma ma gbochie nsogbu mgbe ịwachara ahụ.
Dịka ọmụmaatụ, onye nwere ọrịa ịwa ahụ na-arịa ọrịa shuga nke na-enyocha shuga shuga ha mgbe nile ma na-ewe ọgwụ ha n'ụzọ kwesịrị ekwesị na ahụike dị mma karịa onye ọrịa mamịrị nke na-ajụ shuga shuga ha. Inyocha ike gị tupu ịwa ahụ ga-enyere gị aka meziwanye ọrịa gị, ma ọrịa oyi baa na-etolite ma ọ bụ.
Mgbochi
Ụlọ ọgwụ amalitela usoro iwu iji gbochie ndị ọrịa na-ahụ maka ventilator site na ịmalite ịba oyi n'ahụ.
Ịnwere ike ịnụrụ okwu nlekọta gbasara "protocol VAP" ma ọ bụ "VAP bundle" nke pụtara ịbịnye mgbochi na atụmatụ nlekọta.
Ogbugba ndu na - agụnye:
- Ugboro ugboro na-elekọta ụlọ: Kwa abụọ ruo awa anọ, ọnụ kwesịrị ikpochapụchasị ọcha iji gbochie nje bacteria na-amụba n'ọnụ na akpịrị.
- Idozi ihe ndina nke nwere isi elu ruo ogo 30 ruo 45: Ụfọdụ ndị ọrịa, nwere ike ọ gaghị anabata ọnọdụ a n'ihi nhụjuanya ma ọ bụ ọrịa ha, mana ndị nwere ike ịnagide ikwe isi ha ga-adịkarịrị ka ha nwere ike ịmịnye oyi n'ahụ mgbe ha nọ na ventilator.
- Gbanyụọ ngwa ngwa: Ụzọ kasị mma iji gbochie ventilator metụtara ọrịa oyi oyi bụ ka ọ ghara ịdị na ventilator. Iwepu iku ume ma na-ekwe ka onye ahụ na-eku ume n'onwe ya ozugbo o kwere omume bụ isi maka mgbochi.
- Jiri ngwá ọrụ nwere ike ịnweta ma ọ bụ nyefee onye na-arịa ya ihe ọ bụla iji gbochie igbochi ọrịa n'etiti ndị ọrịa.
- Na-agwọ onye ọrịa mgbe niile: Idebe onye ahụ dị ọcha, yana ịsa ahụ kwa ụbọchị site na iji ọcha anụcha mara nke a maara iji belata nje bacteria na akpụkpọ ahụ nwere ike ibelata mmịnye bacteria si akpụkpọ ahụ gaa n'ọnụ na akpa ume.
- A ga-emecha nchacha aka na-eme ihe ike tupu ị emetụ tubing ventilator, na-enye nlekọta anya ma ọ bụ nsị.
Onye Na-enwe Nsogbu Maka Ọrịa Na-akpata Ọkpụkpụ-Njikọ
Ndị na-arịa ọrịa na-adịghị ala ala, dị ka COPD na ụkwara ume ọkụ na-enwekarị ike ịmepụta ventilator nwetara na oyi baa. Ọnụnọ nke okwu ahụ na-adịghị ahụ anya, dị ka isi ụbụrụ ma ọ bụ na-agbake site na ntaneturgery, bụkwa otu ihe kpatara nsogbu nwere ike ịnweta oyi n'ahụ.
Ndị na-aṅụ sịga na ndị ọrịa nwere ọnọdụ na-adịghị ala ala na-enwekwa ihe ize ndụ karịa ọrịa ahụ.
Ihe Ndị Na-akpata Ọdachi
Mbibi ogologo : ogologo oge onye ọrịa ahụ na-anọgide na ventilator nke dị elu karịa VAP, ụbọchị 1 na ventilator dị mma karịa 4. Ndị ọrịa nọ n'ọnọdụ kachasị elu n'oge ụbọchị ise mbụ na ventilator.
Ntughari: Onye ọrịa ahụ na-agbanye ume iku ume n'onwe ya wee weghachite ya ma tinye ya na ventilator mgbe ha na-enweghị ike ịgazu mkpa ha oxygen.
Tracheostomy: N'aka n'olu, a na-emepụta ihe a na-arụ ọrụ nke ogwugwu, a na-eme tracheostomy iji gbochie mmebi nke ihe na-adịghị ike nke akpịrị n'oge oge dị ogologo na ventilator.
Nmeghe a bụ ihe kpatara nsogbu maka ọrịa dịka ọ na-enye ụzọ ọzọ maka nje bacteria na-abanye.
Mgbanwe elekere oge: Nke a bụ mgbe a gbanwere tubing ejikọta onye ọrịa ahụ na ventilator.
Nsogbu ngwugwu na-adịkarị ala: Mkpanaka nke na-abanye n'akpa onye ọrịa na-ejikarị nwayọọ nwayọọ gbadaa iji gbochie ikuku si na-eri. Akpụ nke dị n'okpuru ala ga-eme ka ikuku kwụsị, ma ọ ga-ekwekwa ka nzuzo zoo n'ime akpa ume, bụ isi ihe ize ndụ maka oyi baa.
Ogbenye subglottic na-arụ ọrụ: Ọ bụrụ na onye ọrịa enweghi ike ịnweta ebe ọnụ na akpịrị n'ihu ngwụcha ngwụcha ngwụcha nke ọma iji wepu nzuzo, enwere ohere dị elu nke nzuzo na-abanye na ngụgụ.
Ịgbagharị ndị ọrịa site na ICU: Nke a pụtara na a na-ewere ya, n'ihe ndina, maka ule ma ọ bụ usoro, dị ka nyocha CT.
NG tube ebe: Otu nkuzi nasogastric bụ tube nke a na-etinye n'ime imi ma banye n'ime esophagus iji wepụ mmiri site na nsị ma ọ bụ iji nyefee ọgwụ, ọgwụ ma ọ bụ tube ịba n'ime afo. Mgbe ụfọdụ, a ga - etinye tube dị ogologo n'otu ụdị ahụ mana a na - etinyekwu ya n'ime akụkụ GI. Ụdị tube a na-akpọkarị NJ tube (naso-jejeunal tube) na-ebutekwa nsogbu nke ịnweta oyi n'ahụ.
Ọgwụgwọ
Mgbe o kwere omume, a na -enweta ọdịbendị na ịchọta uche iji chọpụta nje ndị na-akpata ọrịa oyi baa. A na-enyekarị ọgwụ nje, nke na-agwọ ụdị ọrịa dịgasị iche iche, mgbe a chọpụtara ọrịa oyi. Ọ bụrụ na nsonaazụ ahụ gosipụtara na ude ọzọ nwere ike ịdịkwu irè, enwere ike gbanwee ọgwụ nje ahụ maka nsonaazụ dị mma.
> Isi:
> Ihe Nmetụta Egwu Maka ICU Na-enweta Pneumonia. JAMA. > ftp://72.167.42.190/cardinal/pdf/Risk_factors_for_ICU_acquired_pneumonia_VAP_Cook_JAMA_052798.pdf
> Ventilator Associated > Na oyi baa na ICU. Nnukwu nlekọta. > http://www.ccforum.com/content/18/2/208