Edema pulmonary

ʻO ka edema pulmonary kahi kūkulu kino ʻole o ka wai i nā akemāmā. ʻO kēia buildup o ka wai e alakaʻi i ka liʻiliʻi o ka hanu.

Hoʻokumu pinepine ʻia ka edema pulmonary e ka puʻuwai puʻuwai ʻole. Ke hiki ʻole i ka puʻuwai ke pauma me ka maikaʻi, hiki i ke koko ke hoʻi i loko o nā uaua e lawe i ke koko ma o nā ake māmā.

Ke piʻi nei ke kaomi i loko o kēia mau kīʻaha koko, kaomi ʻia ka wai i nā wahi lewa (alveoli) i nā ake māmā. Hoʻoemi kēia wai i ka neʻe ʻana o ka oxygen ma o nā māmā. Hoʻohui kēia mau mea ʻelua i mea e hōʻemi ai i ka hanu.

ʻO ke kūpikipiki ʻole o ka naʻau e alakaʻi i ka edema pulmonary e kumu ʻia e:

• ʻO ka puʻuwai puʻuwai, a i ʻole kekahi maʻi o ka puʻuwai e hoʻonāwaliwali ai ʻoʻoleʻa paha i ka puʻuwai puʻuwai (cardiomyopathy)
• ʻO nā kiwikā puʻuwai a hoʻopili paha (valves mitral a i ʻole aortic)
• Koke, kiʻekiʻe ke koko kiʻekiʻe (hypertension)

Hoʻokumu ʻia paha ka edema pulmonary e:

• Nā lāʻau lapaʻau kekahi
• Hōʻike kiʻekiʻe kiʻekiʻe
• Hewa ʻole nā ​​hakuʻala
• ʻO nā aʻa ākea e lawe i ke koko i nā puʻupaʻa
• ʻO ka hōʻino ʻia o ka maʻi e ke kinoea ʻino a i ʻole ka maʻi nui
• Poino nui

Pākuʻi ʻia paha nā ʻōuli o ka edema pulmonary:

• Hoʻomaʻamaʻa i ke koko a i ʻole ke koko
• Ka hanu paʻakikī ke moe ʻana i lalo (orthopnea)
• Ke manaʻo nei i ka "pololi lewa" a i ʻole "make ʻana" (kapa ʻia kēia manaʻo ʻo "paroxysmal nocturnal dyspnea" inā e ala ʻoe i 1 a 2 mau hola ma hope o ka hiamoe ʻana a me ka hakakā e hopu i kou hanu.)
• ʻO ke kani ʻana, ke kaniʻuhū ʻana, a me ke kani ʻana o ke kani me ka hanu ʻana
• Nā pilikia e kamaʻilio ana i nā ʻōlelo piha no ka liʻiliʻi o ka hanu

Hiki i nā ʻōuli ʻē aʻe ke:

• Ka pīhoihoi a hoʻomaha ʻole paha
• Hoʻoemi i ke kiʻekiʻe o ka makaʻala
• Pāhu ka wāwae a ʻōpū paha
• ʻIli pale
• Hoʻoulu (nui)

E hana ka mea mālama ola i kahi hoʻokolohua kino piha.

E hoʻolohe ka mea hāʻawi i kāu mau māmā a me kou puʻuwai me kahi stethoscope e nānā ai:

• Kani ka puʻuwai maʻamau
• ʻO nā māwae i kou mau māmā, i kapa ʻia ʻo rales
• Hoʻonui i ka helu o ka puʻuwai (tachycardia)
• Ka hanu wikiwiki ʻana (tachypnea)

ʻO nā mea ʻē aʻe i ʻike ʻia i ka wā o ka hōʻike me kēia:

• Pāhu ka wāwae a ʻōpū paha
• Nā kūpono ʻole o kou ʻāʻī o ka ʻāʻī (hiki ke hōʻike he nui ka wai i kou kino)
• ʻO kaʻili o ka pale keʻokeʻo a polū paha (pallor a cyanosis)

ʻO nā hoʻokolohua hiki ke hoʻopili ʻia:

• Nā kemika koko
• Nā pae oxygen o ke koko (oximetry a i ʻole nā ​​kinoea arterial koko)
• Pākuʻi x-ray
• Helu piha koko (CBC)
• ʻO Echocardiogram (ultrasound o ka puʻuwai) e ʻike inā aia kekahi pilikia me ka puʻuwai puʻuwai
• Electrocardiogram (ECG) e nānā i nā hōʻailona o ka puʻuwai puʻuwai a i ʻole nā ​​pilikia me ka puʻuwai puʻuwai

Hoʻomaʻamaʻa pinepine ʻia ka edema pulmonary i ka lumi pilikia a i ka haukapila paha. Pono ʻoe i loko o kahi keʻena mālama nui (ICU).

• Hāʻawi ʻia ka oxygen ma o ka pale maka a i ʻole hoʻokau ʻia nā paipu plastic i ka ihu.
• Hiki ke hoʻokomo ʻia kahi pahu hanu i loko o ka aniani (trachea) i hiki ai iā ʻoe ke hoʻopili ʻia i kahi mīkini hanu (ventilator) inā ʻaʻole hiki iā ʻoe ke hanu pono iā ʻoe iho.

Pono e ʻike ʻia ke kumu o ka edema a mālama koke ʻia. ʻO kahi laʻana, inā he kuʻi puʻuwai i hana i ke ʻano, pono e mālama koke ʻia.

ʻO nā lāʻau e hiki ke hoʻohana ʻia:

• ʻO nā diuretics e hemo ai ka nui o ka wai mai ke kino
• ʻO nā lāʻau e hoʻoikaika i ka puʻuwai o ka puʻuwai, kaohi i ka puʻuwai o ka puʻuwai, a i ʻole e hoʻomaha i ka kaomi ma ka puʻuwai
• ʻO nā lāʻau ʻē aʻe inā ʻaʻole kū ka puʻuwai i ke kumu o ka edema pulmonary

Aia ke kuanaʻike i ke kumu. E hoʻomaikaʻi a lohi paha ke kūlana. Pono paha kekahi poʻe e hoʻohana i ka mīkini hanu no ka manawa lōʻihi. Inā mālama ʻole ʻia, hiki i kēia ʻano ke hoʻoweliweli i ke ola.

E hele i ka lumi pilikia a kāhea paha iā 911 a i ʻole ka helu kūloko kūloko inā he pilikia hanu kāu.

Lawe i kāu mau lāʻau āpau e like me ke kuhikuhi inā loaʻa ʻoe i kahi maʻi e hiki ai ke alakaʻi i ka edema pulmonary a i ʻole ka puʻuwai puʻuwai nāwaliwali.

Ma hope o ka papaʻai olakino haʻahaʻa i ka paʻakai a me ka momona, a me ka kaohi ʻana i kāu mau mea ʻē aʻe e hiki ke hōʻemi i ka makaʻu o ka hoʻomohala ʻana i kēia ʻano.

ʻEhu polū; Wai puna; ʻUme pulmonary; Hewa puʻuwai - edema pulmonary

• Lungs
• ʻŌnaehana hanu

ʻO Felker GM, ʻo Teerlink JR. ʻIke a me ka hoʻokele o ka hōʻeha puʻuwai koʻikoʻi. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 24.

Matthay MA, Murray JF. Edema pulmonary. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 62.

Rogers JG, O'Connor CM. Hōʻino puʻuwai: pathophysiology a me kahi hōʻailona. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 52.