Nā kinoea koko

ʻO nā kinoea koko he ana o ka nui o ka oxygen a me carbon dioxide i loko o kou koko. Hoʻoholo pū lākou i ka acidity (pH) o kou koko.

ʻO ka maʻamau, lawe ʻia ke koko mai kahi aʻa. I kekahi mau hihia, hoʻohana ʻia ke koko mai kahi aa koko (gas venous blood).

ʻO ka mea maʻamau, ʻohiʻohi ʻia paha ke koko mai kekahi o nā aʻa e hiki mai ana:

• ʻO ke aʻa Radial i ka lima
• ʻO ke aʻa wahine i ke aʻa
• ʻO ke aʻa brachial i ka lima

Hiki paha i ka mea mālama ola ke hoʻāʻo i ka holo i ka lima ma mua o ka lawe ʻana i kahi laulau o ke koko mai ka wahi o ka lima.

Hoʻokomo ka mea hāʻawi i kahi nila liʻiliʻi ma o ka ʻili i loko o ke aʻa. Hoʻouna koke ʻia kahi laʻana i kahi keʻena hoʻokolohua no ka loiloi.

ʻAʻohe hoʻomākaukau kūikawā. Inā ʻoe ma ka oxygen therapy, pono mau ka oxygen ma 20 mau minuke ma mua o ka hoʻāʻo.

E haʻi i kāu mea hāʻawi inā ʻoe e lawe i nā lāʻau hoʻomāliʻi i ke koko (anticoagulants), me aspirin.

Ke hoʻokomo ʻia ke kui kele e huki i ke koko, manaʻo kekahi poʻe i ka ʻeha kaulike. ʻIke wale kekahi i kahi ʻōniʻu a i ʻole kui. Ma hope, loaʻa paha i kahi kūpikipiki a i ʻole ʻeha iki. Hele koke kēia. ʻOi aku ka maikaʻi o ka ʻeha a me ka hōʻoluʻolu ʻole ma mua o ke kahe ʻana o ke koko mai kahi aa koko.

Hoʻohana ʻia ka hoʻāʻo e loiloi i nā maʻi hanu a me nā kūlana e hoʻopili i nā māmā. Kōkua ia i ka hoʻoholo ʻana i ka pono o ka hoʻokele oxygen a i ʻole ka hoʻokomo ea non-invasive (BiPAP). Hāʻawi pū ka hōʻike i ka ʻike e pili ana i ke koena o ke kino a me ke kumu, hiki ke hōʻike i nā kuhi nui e pili ana i ka hana o ka māmā a me nā puʻupaʻa a me ke kūlana metabolic maʻamau o ke kino.

Nā waiwai ma ka pae kai:

• Kaomi puʻupuʻu o ka oxygen (PaO2): 75 a 100 millimeter o ka mercury (mm Hg), a i ʻole 10.5 a 13.5 kilopascal (kPa)
• Kaomi ʻāpana o carbon dioxide (PaCO2): 38 a 42 mm Hg (5.1 a 5.6 kPa)
• ʻO ke ake koko Arterial: 7.38 a 7.42
• Oxygen ma saturation (SaO2): 94% a 100%
• Bicarbonate (HCO3): 22 a 28 mau milliequivalents i kēlā me kēia lita (mEq / L)

Ma nā kiʻekiʻe o 3,000 kapuaʻi (900 mika) a ʻoi aku, ua emi ka waiwai o ka oxygen.

Hiki ke loli iki nā pae waiwai maʻamau i waena o nā hale hana ʻokoʻa. Pili kekahi mau hale hana i nā ana ʻokoʻa. E kamaʻilio me kāu kauka e pili ana i ke ʻano o kāu mau hopena hōʻike kikoʻī.

Nā hualoaʻa kūpono ʻole ma muli o ka akemāmā, hakuʻala, nā maʻi metabolic, a i ʻole nā ​​lāʻau. ʻO nā hōʻeha poʻo poʻo a ʻāʻī paha a i ʻole nā ​​ʻeha ʻē aʻe e pili i ka hanu ʻana hiki ke alakaʻi i nā hopena maʻamau.

ʻAʻohe liʻiliʻi inā hana pololei ʻia ke kaʻina hana. ʻOkoʻa nā aʻa a me nā aʻa i ka nui mai kekahi kanaka a i kekahi ʻē aʻe a mai kekahi ʻaoʻao o ke kino i kekahi. ʻOi aku ka paʻakikī o ka lawe ʻana i ke koko mai kekahi poʻe ma mua o nā poʻe ʻē aʻe.

ʻO nā pilikia ʻē aʻe e pili ana i ke kau ʻana o ke koko he liʻiliʻi, akā hiki ke hoʻopili ʻia:

• Pāleʻale a ʻoluʻolu paha
• Nā punctures he nui e ʻike i nā kīʻaha koko
• Hematoma (kūkulu koko ma lalo o ka ʻili)
• Kahe nui ke koko
• Maʻiʻaʻai (i iki kamepiula i kēlā me kēia manawa ka ʻili i haki)

Nānā kinoea koko Arterial; ABG; Hypoxia - ABG; Hewa ʻole hanu - ABG

• Hōʻike kinoea koko

Chernecky CC, Berger BJ. Kinoea koko, arterial (ABG) - koko. I: Chernecky CC, Berger BJ, hua. Nā Hoʻokolohua Laboratory a me nā kaʻina hana Diagnostic. ʻElua huaʻōlelo St Louis, MO: Elsevier Saunders; 2013: 208-213.

Weinberger SE, Cockrill BA, Mandel J. Loiloi ʻia o ka mea maʻi me ka maʻi pulmonary. I: Weinberger SE, ʻo Cockrill BA, Mandel J, eds. Nā Kumu o ka lāʻau lapaʻau pulmonary. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 3.