ʻOki kino naʻau Pediatric

Hana ʻia ka puʻuwai puʻuwai i nā keiki e hoʻoponopono i nā kīnā o ka naʻau i hānau ʻia kahi keiki me (nā maʻi puʻuwai congenital) a me nā maʻi puʻuwai i loaʻa i kahi keiki ma hope o ka hānau ʻana e pono ai ke ʻoki. Pono ke ʻoki no ke ola o ke keiki.

Nui a hewahewa nā ʻano kīnā o ka puʻuwai. Liʻiliʻi kekahi, a ʻoi aku ka koʻikoʻi o kekahi. Hiki i nā kīnā i loko o ka puʻuwai a i ʻole nā ​​kīʻaha koko nui ma waho o ka puʻuwai. Pono paha kekahi kīnā o ka puʻuwai i ke kāʻoki ma hope pono o ka hānau ʻana o ka pēpē. No nā mea ʻē aʻe, hiki i kāu keiki ke kali palekana no nā mahina a i ʻole mau makahiki e hana ai i ke kaʻi.

Hoʻokahi paha ke kaha ʻana e hoʻoponopono ai i ka kīnā o ka puʻuwai, akā i kekahi manawa pono ʻia kahi kaʻina hana. ʻEkolu mau ʻano ʻokoʻa no ka hoʻoponopono ʻana i nā kīnā o ka naʻau i nā keiki e wehewehe ʻia ma lalo nei.

ʻO ke kīʻaha puʻuwai puʻuwai ke hoʻohana ka lāʻau lapaʻau i ka mīkini bypass puʻuwai puʻuwai.

• Hana ʻia kahi ʻokiʻoki ma o ka umauma (sternum) ʻoiai ke keiki ma lalo o ka anesthesia laulā (hiamoe ke keiki a manu ʻole ka ʻeha).
• Hoʻohana ʻia nā paipu e ala hou i ke koko ma o ka pauma kūikawā i kapa ʻia he mīkini bypass puʻuwai puʻuwai. Hoʻohui kēia mīkini i ka oxygen i ke koko a mālama i ke koko mehana a neʻe i loko o ke koena o ke kino ʻoiai ke hoʻoponopono nei ke kauka.
• ʻO ka hoʻohana ʻana i ka mīkini e ʻoki ʻia ka puʻuwai. ʻO ke kū ʻana o ka puʻuwai e hiki ai ke hoʻoponopono i ka mākala o ka naʻau ponoʻī, nā kiʻikuhi puʻuwai, a i ʻole nā ​​kīʻaha koko ma waho o ka puʻuwai. Ma hope o ka hoʻoponopono ʻana, hoʻomaka hou ka puʻuwai, a hemo ka mīkini. Hoʻopaʻa ʻia ka umauma a me ka ʻoki o ka ʻili.

No kekahi hoʻoponopono kīnā ʻole o ka naʻau, hana ʻia ka ʻokiʻoki ma ka ʻaoʻao o ka umauma, ma waena o nā iwi ʻaoʻao. Kāhea ʻia kēia he thoracotomy. Kapa ʻia i kekahi manawa he ʻoki pani puʻuwai. Hiki ke hana i kēia ʻoki ʻana me ka hoʻohana ʻana i nā mea kani kūikawā a me kahi kāmela.

ʻO kekahi ala e hoʻoponopono ai i nā kīnā i ka puʻuwai e hoʻokomo i nā paipu liʻiliʻi i loko o ke aʻa i ka wāwae a hoʻoili iā lākou i ka puʻuwai. ʻO kahi hemahema puʻuwai wale nō ke hoʻoponopono i kēia ala.

ʻO kahi kumuhana e pili ana i nā ʻōpū o ka naʻau congenital defect.

Pono e hoʻoponopono hou kekahi kīnā o ka naʻau ma hope koke o ka hānau ʻana. No kekahi poʻe, ʻoi aku ka maikaʻi o ke kali ʻana i mau mahina a i ʻole mau makahiki. ʻAʻole pono e hoʻoponopono hou i kekahi kīnā o ka puʻuwai.

Ma ke ʻano laulā, nā ʻōuli e hōʻike ana he pono ke ʻoki kino:

• ʻO kaʻili polū a hina paha, nā lehelehe, a me nā moena kui (cyanosis). ʻO kēia mau hōʻailona ʻaʻole lawa ka oxygen i loko o ke koko (hypoxia).
• Ka hanu paʻakikī ʻana no ka mea "mākū" nā akemāmā, hoʻopīpī, a i ʻole piha i ka wai.
• Nā pilikia me ka helu o ka puʻuwai a i ʻole ka puʻuwai puʻuwai (arrhythmia).
• ʻO ka hānai maikaʻi ʻole a hiamoe paha, a me ka nele o ka ulu a ulu ʻana o ke keiki.

ʻO nā haukapila a me nā kikowaena lapaʻau e hana ai i ka ʻoki puʻuwai ma nā keiki he kauka, kahu, a me nā ʻenehana i hoʻomaʻamaʻa kūikawā ʻia e hana i kēia mau ʻoki. He limahana pū kekahi nāna lākou e mālama i kāu keiki ma hope o ke kahakaha ʻana.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Kahe i ka wā o ke ʻoki a i nā lā ma hope o ke ʻoki ʻana
• Nā hopena maikaʻi ʻole i nā lāʻau
• Pilikia i ka hanu ʻana
• Maʻi kīnā

ʻO nā pilikia hou aʻe o ka ʻoki puʻuwai ʻana:

• Koko koko (thrombi)
• Nā huʻa ea (emboli lewa)
• Pulumonia
• Nā pilikia o ka naʻau (arrhythmia)
• Maʻi hohola
• Hahau

Inā kamaʻilio kāu keiki, e haʻi e pili ana i ke ʻoki ʻana. Inā loaʻa iā ʻoe kahi keiki o ke kula kamaliʻi, e haʻi iā lākou i ka lā ma mua o ka mea e hiki mai ana. ʻ Saylelo, no ka laʻana, "E hele ana mākou i ka haukapila e noho ai no kekahi mau lā. E hana ana ke kauka i kou puʻuwai e hoʻomaikaʻi maikaʻi ai."

Inā ʻelemakule kāu keiki, e hoʻomaka e kamaʻilio e pili ana i ke kaʻina hana 1 hebedoma ma mua o ke kaha. Pono ʻoe e hoʻopili i ke loea o ke ola o ke keiki (kekahi e kōkua i nā keiki a me ko lākou mau ʻohana i nā manawa e like me ke ʻoki nui) a hōʻike i ke keiki i ka haukapila a me nā wahi ʻoki.

Pono paha i kāu keiki i nā hoʻokolohua like ʻole.

• Nā hoʻokolohua koko (helu piha i ke koko, nā electrolytes, nā kumu hoʻohui, a me "keʻa keʻa")
• X-kukuna o ka umauma
• Electrocardiogram (ECG)
• Echocardiogram (ECHO, a i ʻole ultrasound o ka puʻuwai)
• ʻO ka catheterization Cardiac
• Mōʻaukala a me ke kino

E haʻi mau i ka mea mālama ola o kāu keiki i nā lāʻau a kāu keiki e lawe nei. Hoʻopili i nā lāʻau, nā lau nahele, a me nā huaora āu i kūʻai ai me ka ʻole o ka lāʻau.

I nā lā ma mua o ke kaha ʻana:

• Inā lawe kāu keiki i nā mea lahilahi o ke koko (nā lāʻau i hana i mea paʻakikī no ke kōpē ʻana o ke koko), e like me warfarin (Coumadin) a i ʻole heparin, e kamaʻilio pū me ka mea hāʻawi i kāu keiki e pili ana i ka manawa e hōʻoki ai i ka hāʻawi ʻana i kēia mau lāʻau i ke keiki.
• E nīnau i nā lāʻau a ke keiki e pono ai e lawe i ka lā o ke ʻoki.

I ka lā o ke kaha:

• E noi pinepine ʻia kāu keiki mai inu a ʻai ʻole i kekahi mea ma hope o ke aumoe i ka pō ma mua o ke kaha.
• E hāʻawi i kāu keiki i nā lāʻau i kauoha ʻia iā ʻoe e hāʻawi me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

ʻO ka hapa nui o nā keiki i ʻoki ʻia me ka puʻuwai puʻuwai e pono e noho i ke keʻena mālama nui (ICU) no 2 a 4 mau lā ma hope pono o ke kaha ʻana. Noho pinepine lākou i ka haukapila no 5 a 7 mau lā hou aʻe ma hope o ko lākou haʻalele ʻana i ka ICU. Noho i loko o ke keʻena mālama maʻi maʻi a me ka haukapila e pōkole pinepine ia no ka poʻe i loaʻa i ka ʻoki pani puʻuwai.

I ko lākou manawa i ka ICU, loaʻa i kāu keiki:

• ʻO kahi paipu i ke alaloa (endotracheal tube) a me kahi hanu e kōkua i ka hanu ʻana. E hiamoe ana kāu keiki (hoʻohiamoe ʻia) ʻoiai ma ka hanu.
• Hoʻokahi aʻoi aʻe paha o nā paipu liʻiliʻi i kahi aa (laina IV) e hāʻawi i nā wai a me nā lāʻau.
• ʻO kahi paipu liʻiliʻi i loko o kahi aʻa (laina arterial).
• Hoʻokahi a i ʻole 2 mau paipu umauma e hoʻokahe i ka ea, ke koko, a me ka wai mai ka lua o ka umauma.
• ʻO kahi paipu ma o ka ihu i loko o ka ʻōpū (nasogastric tube) e hoʻoneʻe ai i ka ʻōpū a lawe i nā lāʻau a me nā hānai no kekahi mau lā.
• ʻO kahi paipu i loko o ka pahu wai e hoʻokahe a ana i ka mimi no kekahi mau lā.
• Ua hoʻohana ʻia nā laina uila a me nā paipu e nānā i ke keiki.

I ka manawa e haʻalele ai kāu keiki i ka ICU, e hoʻoneʻe ʻia ka hapa nui o nā paipu a me nā uea. E paipai ʻia kāu keiki e hoʻomaka i nā hana maʻamau o kēlā me kēia lā. Hoʻomaka kekahi mau keiki e ʻai a inu paha ma kā lākou iho ma waena o 1 a 2 mau lā, akā ʻoi aku paha ka lōʻihi o kekahi.

Ke hoʻokuʻu ʻia kāu keiki mai ka haukapila, aʻo ʻia nā mākua a me nā mea mālama i nā hana OK no kā lākou keiki e hana ai, pehea e mālama ai i nā ʻokiʻoki, a pehea e hāʻawi ai i nā lāʻau e pono ai kā lākou keiki.

Pono kāu keiki ma kahi o kekahi mau pule i ka home e ola hou ai. E kamaʻilio me kāu mea hoʻolako e pili ana i ka wā e hoʻi ai kāu keiki i ke kula a i ʻole mālama mālama lā.

Pono kāu keiki i nā kipa ukali me ke kauka lāʻau (kauka puʻuwai) i kēlā me kēia 6 a 12 mau mahina. Pono paha kāu keiki e lawe i nā lāʻau antibiotic ma mua o ka hele ʻana i ka kauka niho no ka hoʻomaʻemaʻe ʻana o nā niho a me nā kaʻina hana niho e pale ai i nā maʻi puʻuwai koʻikoʻi. E nīnau i ka cardiologist inā pono kēia.

ʻO ka hopena o ka ʻoki puʻuwai e pili ana i ke kūlana o ke keiki, ke ʻano o ka hemahema, a me ke ʻano o ke ʻoki i hana ʻia. Nui nā keiki e hoʻōla piha a alakaʻi i ke ola maʻamau a me ka hana.

ʻOki kino puʻuwai - pediatric; ʻO ke kīʻaha puʻuwai no nā keiki; Loaʻa maʻi puʻuwai; ʻOki kino puʻuwai - keiki

• Ka palekana o ka lumipaku - keiki
• Ke lawe nei i kāu keiki e kipa i kahi kaikaina maʻi loa
• Keʻai nei i nā calorie keu ke maʻi - keiki
• Ka palekana o oxygen
• ʻOki puʻuwai Pediatric - hoʻokuʻu
• Mālama ʻeha ʻeha - wehe
• Ke hoʻohana nei i ka oxygen ma ka home

• ʻOki puʻuwai puuwai hamama

ʻO Ginther RM, Forbess JM. Holo ka cardiopulmonary pēpē. I: Fuhrman BP, Zimmerman JJ, eds. Mālama Nui ʻo Pediatric. 5th lā. Piladelapia, PA: Elsevier; 2017: chap 37.

LeRoy S, Elixson EM, O'Brien P, et al. Nā ʻōlelo paipai no ka hoʻomākaukau ʻana i nā keiki a me nā ʻōpio no ka hana naʻau cardiac invasive: kahi ʻōlelo a ka American Heart Association Pediatric Nursing Subcommite o ka ʻAha Kūkā no Cardiovascular Nursing me ka hui pū ʻana me ka Council on Cardiovascular Diseases of the Young. Kaapuni. 2003; 108 (20): 2550-2564. PMID: 14623793 www.ncbi.nlm.nih.gov/pubmed/14623793.

Steward RD, Vinnakota A, Mill MR. Nā hana ʻoki lāʻau no ka maʻi puʻuwai congenital. I: Stouffer GA, Runge MS, Patterson C, Rossi JS, eds. ʻO Netter's Cardiology. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2019: chap 53.

Webb GD, Smallhorn JF, Therrien J, Redington AN. ʻO ka maʻi puʻuwai Congenital i ke kanaka makua a me ka mea maʻi pediatric. 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 75.