Ukuqapha umfutho wegazi kuyindlela yokuqapha umfutho wegazi ohlaselayo futhi kwenziwa ngokunqanyulwa komthambo oseduze. Ukuqapha i-Hemodynamic kubalulekile ekunakekelweni kwanoma yisiphi isiguli esibhedlela. Ukuqapha njalo kubaluleke kakhulu ezigulini ezigula kakhulu kanye neziguli ezihlinzwayo ezinengozi eyengeziwe yokugula nokufa. Lokhu kungafezwa ngokuqapha ngezikhathi ezithile, okungahlanyisi kodwa okunikeza izifinyezo ngesikhathi, noma ngokuqapha okuqhubekayo okuhlaselayo.
Indlela ejwayeleke kakhulu yokwenza lokhu ukuqapha umfutho we-arterial ngokusebenzisa i-cannulation yomthambo we-peripheral. Ukufinyela kwenhliziyo ngakunye kusebenzisa ingcindezi, okuholela ekuhambeni kokugeleza kwemishini ngaphakathi kwe-catheter. Ukunyakaza komshini kudluliselwa ku-transducer ngeshubhu eliqinile eligcwele uketshezi. I-transducer iguqula lolu lwazi lube amasignali kagesi, adluliselwa kumonitha. Imonitha ibonisa i-waveform ye-arterial ye-beat-to-beat kanye nezingcindezi zamanani. Lokhu kunikeza ithimba lokunakekela ulwazi oluqhubekayo mayelana nesistimu yenhliziyo yesiguli futhi ingasetshenziselwa ukuxilongwa nokwelashwa.
Indawo ejwayeleke kakhulu yokukhanselwa komthambo i-radial artery ngenxa yokufinyeleleka kalula. Ezinye izingosi yi-brachial, femoral, kanye ne-dorsalis pedis artery.
Kulezi zimo ezilandelayo zokunakekelwa kwesiguli, umugqa we-arterial uzoboniswa:
① Iziguli ezigula kakhulu e-ICU ezidinga ukuqapha ngokucophelela i-hemodynamics. Kulezi ziguli, izilinganiso zomfutho wegazi ngezikhathi ezihlukene zingase zingaphephile njengoba zingase zibe nezinguquko ezisheshayo esimweni sazo se-hemodynamic futhi zidinga ukunakwa ngesikhathi.
② Iziguli zelashwa ngemithi ye-vasoactive. Lezi ziguli ziyazuza ekuqaphelweni kwe-arterial, okuvumela udokotela ukuthi agxilise imithi kumphumela womfutho wegazi oyifunayo ngokuphepha.
③Iziguli ezihlinzwa ezisengcupheni eyengeziwe yokugula noma yokufa, mhlawumbe ngenxa yezifo ezivele zikhona (inhliziyo, amaphaphu, i-anemia, njll.) noma ngenxa yezinqubo eziyinkimbinkimbi. Lokhu kufaka phakathi kodwa akukhawulelwe ezinkambisweni ze-neurosurgical, izinqubo ze-cardiopulmonary, nezinqubo lapho umthamo omkhulu wokulahleka kwegazi ulindelwe khona.
④Iziguli ezidinga ukutonyulwa kwelebhu njalo. Lokhu kufaka phakathi iziguli ezidonsa umoya isikhathi eside ngemishini, okwenza kudingeke ukuthi kuhlaziywe i-arterial blood gas ukuze kufakwe i-titration yezilungiselelo ze-vent. I-ABG iphinde ivumele ukuqapha i-hemoglobin ne-hematocrit, ukwelashwa kokungalingani kwe-electrolyte, nokuhlola ukusabela kwesiguli ekuvuseleleni uketshezi kanye nokuphathwa kwemikhiqizo yegazi ne-calcium. Kulezi ziguli, ukuba khona komugqa we-arterial kuvumela udokotela ukuthi athole kalula isampula yegazi ngaphandle kokuthi anamathele isiguli ngokuphindaphindiwe. Lokhu kunciphisa ukungaphatheki kahle kwesiguli futhi kunciphisa ubungozi bokutheleleka njengoba ubuqotho besikhumba kungadingeki ukuba buphulwa ngokudwetshwa kwelebhu ngayinye.
Nakuba ukuqapha umfutho wegazi we-arterial kunganikeza ulwazi olubalulekile, ukukhanselwa kwe-arterial akukhona ukunakekelwa kwesiguli okujwayelekile. Akudingekile kuso sonke isiguli esise-ICU noma sonke isiguli esihlinzwa. Ezigulini ezithile, i-cannulation yomthambo i-contraindicated. Lokhu kufaka phakathi ukutheleleka endaweni yokufakwa, okuhlukile kwe-anatomic lapho ukujikeleza kwesibambiso kungekho noma kuphazamiseka, ukuba khona kwe-peripheral arterial vascular insufficiency, kanye nezifo ze-peripheral arterial vascular ezifana ne-arteritis yomkhumbi omncane kuya ophakathi. Ukwengeza, nakuba kungenjalo ukuphikisana okuphelele, kufanele kucatshangelwe ngokucophelela ezigulini ezine-coagulopathies noma ezithatha imithi evimbela ukuhlangana okuvamile..
Isikhathi sokuthumela: Sep-28-2023
