Swan-Ganz - catheterization naʻau ʻākau

ʻO ka catheterization ʻo Swan-Ganz (i kapa ʻia hoʻi ka catheterization puʻuwai ʻākau a i ʻole ka catheterization pulmonary artery) ka hele ʻana o kahi paipu lahilahi (catheter) i ka ʻaoʻao ʻākau o ka puʻuwai a me nā aʻa e alakaʻi ai i nā māmā. Hana ʻia e nānā i ka hana o ka puʻuwai a me ke kahe o ke koko a me nā kaomi i loko a puni ka puʻuwai.

Hiki ke hana i ka hoʻokolohua ʻoiai ʻoe e moe ana i kahi keʻena mālama nui (ICU) o kahi haukapila. Hiki iā ia ke hana i nā kaʻina hana kūikawā e like me ka laboratory catheterization cardiac.

Ma mua o ka hoʻomaka ʻana o ka hoʻāʻo, hāʻawi ʻia ʻoe i lāʻau (sedative) e kōkua ai iā ʻoe e hoʻomaha.

E moe ʻoe ma luna o kahi pākaukau padded. E hana ana kāu kauka i kahi puncture i kahi aa koko kokoke i ke aʻa a i loko o kou lima, a i ʻole ʻāʻī. Hoʻokomo ʻia kahi ʻōmole maʻalahi (catheter a i ʻole sheath) ma o ka puncture. I kekahi manawa, e kau ʻia i kou wāwae a i kou lima. E ala ana ʻoe i ke kaʻina hana.

Hoʻokomo ʻia kahi catheter lōʻihi. Lawe ʻia ia i loko o ke keʻena ma luna o ka ʻaoʻao ʻākau o ka puʻuwai. Hoʻohana ʻia paha nā kiʻi X-ray e kōkua i ka mea mālama ola e ʻike i kahi e kau ai ka catheter.

Lawe ʻia paha ke koko mai ka catheter. Hōʻaia kēia koko e ana i ka nui o ka oxygen i loko o ke koko.

I ka wā o ke kaʻina hana, e kiaʻi mau ʻia ka leo o kou puʻuwai me ka hoʻohana ʻana i ka electrocardiogram (ECG).

ʻAʻole ʻoe e ʻai a inu paha i kekahi mea no 8 mau hola ma mua o ka hoʻomaka ʻana o ka hoʻāʻo. Pono ʻoe e noho i ka haukapila i ka pō ma mua o ka hoʻāʻo. Inā ʻole, e nānā ʻoe i ka haukapila i ke kakahiaka o ka hoʻāʻo.

E komo ʻoe i ke kapa komo haukapila. Pono ʻoe e kau inoa i kahi palapala ʻae ma mua o ka hoʻāʻo.E wehewehe kāu mea lawelawe i ke kaʻina hana a me kāna mau pilikia.

Hāʻawi ʻia ʻoe i ka lāʻau e kōkua iā ʻoe e hoʻomaha ma mua o ke kaʻina hana. E ala ana ʻoe a hiki ke hāhai i nā ʻōkuhi i ka wā o ka hoʻāʻo.

Hiki paha iā ʻoe ke ʻike i kahi hōʻoluʻolu ke waiho ʻia ka IV i loko o kou lima. Hoʻomaopopo paha ʻoe i kahi kaomi ma ka pūnaewele ke hoʻokomo ʻia ka catheter. I ka poʻe maʻi nui, noho ka catheter ma kahi no nā lā he nui.

Hiki paha iā ʻoe ke hōʻoluʻolu ke numbed ʻia kahi o ke aʻa me ka anesthetic.

Hana ʻia ke kaʻina hana e loiloi i ka neʻe ʻana o ke koko (circulate) i ka poʻe i loaʻa iā:

• Nā kaomi maʻamau i nā aʻa o ka puʻuwai
• Burns
• Maʻi maʻi ʻōpū
• Hewa puʻuwai
• ʻO ka maʻi kīwī
• Valve puʻuwai leaky
• Nā pilikia o ka lepa
• Shock (hoʻohaʻahaʻa koko kiʻekiʻe)

Hana ʻia paha ia e nānā i nā pilikia o ka puʻuwai puʻuwai. Hōʻike ia i ka maikaʻi o ka hana ʻana o kekahi mau lāʻau naʻau.

Hiki ke hoʻohana pū ʻia ʻo catwanter Swan-Ganz e ʻike i ke kahe o ke koko ma waena o nā wahi ʻelua o ka puʻuwai i pili ʻole.

Nā kūlana i hiki ke ʻike ʻia a loiloi ʻia paha me Swan-Ganz catheterization me:

• ʻO tamponade Cardiac
• Maʻi maʻi ʻōpū
• Hypertension pulmonary
• Hoʻopilikia a i ʻole dilated cardiomyopathy

Nā hopena maʻamau no kēia hoʻāʻo:

• ʻO ka helu kope Cardiac ka 2.8 a i ka 4.2 liters i kēlā me kēia minuke i kēlā me kēia mika mika (o ka ʻili o ke kino)
• ʻO ke kaomi systolic pulmonary artery 17 a 32 mau mile o ka mercury (mm Hg)
• ʻO ke kumu o ka pulmonary artery ka 9 a 19 mm Hg
• ʻO ke kaomi diastolic pulmonary ʻo 4 a 13 mm Hg
• ʻO ka pihi capillary capillary wedge ka 4 a 12 mm Hg
• 0 a 7 mm Hg kaomi o ke kaomi akau

Nā hopena kūpono ʻole ma muli o:

• Nā pilikia kahe o ke koko, e like me ka maikaʻi ʻole o ka puʻuwai a i ʻole haʻalulu
• Maʻi maʻi puʻuwai
• Maʻi maʻi
• Nā pilikia pili i ka naʻau me ka puʻuwai, e like me kahi shunt mai kahi hemahema atrial a ventricular septal paha

Nā pilikia o ke kaʻina hana:

• ʻUpala a puni kahi i hoʻokomo ʻia ai ka catheter
• Ka hōʻeha i ke aa
• Kuʻi i ka akemā inā hoʻohana ʻia ka ʻāʻī a i ʻole ka umauma umauma, e hana ana i ka hāʻule o ka māmā (pneumothorax)

Pākuʻi loa i nā pilikia me:

• ʻO nā arrhythmia Cardiac e koi ana i ka lāʻau
• ʻO tamponade Cardiac
• Hoʻokumu ʻia ka Embolism e ke kahe o ke koko ma ka piko o ka catheter
• Maʻi kīnā
• Kaomi haʻahaʻa

Catheterization naʻau ʻākau; Catheterization - puʻuwai kūpono

• ʻO Swan Ganz catheterization

ʻO Hermann J. Cardiac catheterization. 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 19.

ʻO Kapur NK, Sorajja P. Hemodynamics Invasive. I: Sorajja P, Lim MJ, Kern MJ, eds. ʻO Kern's Cardiac Catheterization Handbook. ʻEpekema 7 Piladelapia, PA: Elsevier; 2020: chap 4.

ʻO Shreenivas SS, Lilly SM, Herrmann HC. Nā hana i loko o ka haʻalulu cardiovascular. I: Topol EJ, Teirstein PS, eds. Puka o ka Cardiology Interventional. 8th ed. Piladelapia, PA: Elsevier; 2020: chap 22.