Imi i ka cardioverter-defibrillator

ʻO kahi cardioverter-defibrillator implantable (ICD) kahi hāmeʻa e ʻike i nā mea hoʻoweliweli ola, ka puʻuwai wikiwiki. Kapa ʻia kēia kuʻi puʻuwai maʻamau he arrhythmia. Inā kū ʻia, hoʻouna koke ka ICD i kahi uila uila i ka puʻuwai. Hoʻololi ka pīhoihoi i ka ritme i ka maʻamau. Kapa ʻia kēia defibrillation.

Hana ʻia kahi ICD o kēia mau ʻāpana:

• ʻO ka mea hana pulse e like me ka nui o ka uaki nui. Loaʻa iā ia kahi pākeke a me nā kaʻa uila e heluhelu i ka hana uila o kou puʻuwai.
• ʻO nā uila he uea, i kapa ʻia he alakaʻi, e hele i waena o kou mau uaua i kou puʻuwai. Hoʻopili lākou i kou puʻuwai i ke koena o ka hāmeʻa. Loaʻa i kāu ICD nā uila uila 1, 2, a i ʻole 3.
• ʻO ka hapa nui o nā ICD he pacemaker i kūkulu ʻia. Pono paha kou puʻuwai e holo inā ke lohi nei a wikiwiki paha, a inā ua haʻalulu ʻoe mai ka ICD.
• Aia kekahi ʻano ICD kūikawā i kapa ʻia he ICD subcutaneus. He kēpau ko kēia hāmeʻa i hoʻonoho ʻia i loko o nā kiko i ka hema o ka umauma ma mua o ka puʻuwai. ʻAʻole hiki i kēia ʻano ICD ke lilo i mea mālama i ka pacemaker.

Hoʻokomo pinepine kahi kauka lāʻau a mea lapaʻau paha i kāu ICD ke ala ʻoe. ʻO ka ʻāpana o kou paia umauma ma lalo o kou iwi iwi e hoʻopili ʻia me ka anesthesia, no laila ʻaʻole ʻoe e ʻeha. E hana ka mea lapaʻau i kahi ʻoki (ʻoki) ma loko o kou ʻili a hana i kahi ma lalo o kou ʻili a me nā mākala no ka mea hana ICD. I ka hapanui o nā hihia, hana ʻia kēia wahi ma kahi o kou poʻohiwi hema.

E hoʻokau ka mea hoʻopuka i ka uila i loko o ke aa, a laila i kou puʻuwai. Hana ʻia kēia i ka hoʻohana ʻana i kahi x-ray kūikawā e ʻike ai i loko o kou umauma. A laila e hoʻopili ka mea hoʻopuka i nā electrodes i ka mea hana lāʻau ikiʻai a me ka mea mālama pono.

Lawe pinepine ke kaʻina hana i 2 a 3 mau hola.

ʻO kekahi poʻe me kēia ʻano e loaʻa kahi lakohana kūikawā e hoʻohui i kahi defibrillator a me ka pacemaker biventricular i hoʻonoho ʻia. Kōkua ka mea pacemaker i ka puʻuwai e hoʻokuʻi i ke ʻano hoʻohui like.

Hoʻokomo ʻia kahi ICD i ka poʻe i makaʻu nui i ka make koke ʻana o ka naʻau mai kahi puʻuwai puʻuwai e hoʻoweliweli i ke ola. Hoʻopili kēia i ka tachycardia ventricular (VT) a i ʻole ka fibrillation ventricular (VF).

ʻO nā kumu e hopohopo nui paha ʻoe:

• Ua loaʻa iā ʻoe nā māhele o kekahi o kēia mau puʻuwai puʻuwai abnormal.
• Nawaliwali kou puʻuwai, nui loa, a ʻaʻole maikaʻi ke pauma i ke koko. ʻO kēia paha mai nā puʻuwai puʻuwai mua, ʻole ka puʻuwai, a i ʻole cardiomyopathy (nā puʻuwai puʻuwai maʻi).
• He ʻano hānau kou (ma ka hānau ʻana) pilikia puʻuwai a i ʻole ke olakino olakino.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Nā pilikia hanu
• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• ʻO nā hopena āpau i nā lāʻau (anesthesia) i hoʻohana ʻia i ke kahakaha ʻana
• Maʻi kīnā

ʻO nā pilikia kūpono no kēia ʻoki kino penei:

• Ka maʻi hōʻeha
• ʻO ka hōʻeha i kou puʻuwai a i ʻole nā ​​ake māmā
• ʻO nā arrhythmia puʻuwai weliweli

Hāʻawi kahi ICD i kekahi manawa i nā haʻalulu i kou puʻuwai ke makemake ʻole ʻoe iā lākou. ʻOiai ʻoi aku ka pīhoihoi i kahi manawa pōkole loa, hiki iā ʻoe ke haha ​​iā ia i ka nui o nā hihia.

ʻO kēia a me nā pilikia ICD ʻē aʻe hiki ke pale ʻia i kekahi manawa e ka hoʻololi ʻana pehea e hoʻolālā ʻia ai kāu ICD. Hiki iā ia ke hoʻonohonoho ʻia e kani ke ala inā he pilikia. Hiki i ke kauka nāna ʻoe e mālama i kāu mālama ICD ke polokalamu i kāu polokalamu.

E haʻi mau i kāu mea mālama ola i nā lāʻau āu e lawe nei, ʻo nā lāʻau a lāʻau paha āu i kūʻai ai me ka ʻole o ka lāʻau.

ʻO ka lā ma mua o kou ʻoki ʻana:

• E hoʻomaopopo i kāu mea hāʻawi e pili ana i kekahi anuanu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe āu e loaʻa ai.
• ʻO Shower a me ka shampoo maikaʻi. E noi ʻia ʻoe e holoi i kou kino holoʻokoʻa ma lalo o kou ʻāʻī me kahi kopa kūikawā.
• E noi ʻia paha ʻoe e lawe i kahi lāʻau antibiotic, e kiaʻi ai i ka maʻi.

I ka lā o ke kaha:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai ʻole i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki kino ʻana. Hoʻopili pū kēia me ka nau ʻana i ka gum a me nā mints hanu. E holoi i kou waha me ka wai inā e maloʻo, akā e akahele e ʻole e ale.
• Lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku wale nō.

E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

ʻO ka hapa nui o nā poʻe i loaʻa kahi ICD i hiki ke hoʻi i ka home mai ka haukapila i 1 lā. Hoʻi wikiwiki ka hapa nui i kā lākou pae hana maʻamau. Loaʻa ka loaʻa hou ma kahi o 4 a 6 mau pule.

E noi i kāu mea hoʻolako i ka nui o hiki iā ʻoe ke hoʻohana i ka lima ma ka ʻaoʻao o kou kino kahi i kau ai ka ICD. E aʻo ʻia paha ʻoe ʻaʻole e hāpai i kekahi mea ʻoi aku ka nui ma mua o 10 a 15 mau paona (4.5 a 6.75 kilokilo) a hōʻalo i ka pahu ʻana, huki ʻana, a wili ʻana paha i kou lima no 2 a 3 mau pule. ʻ belelo ʻia aku paha ʻoe ʻaʻole e hāpai i kou lima ma luna o kou poʻohiwi no kekahi mau pule.

Ke haʻalele ʻoe i ka haukapila, hāʻawi ʻia ʻoe i kāleka e mālama ai i loko o kāu ʻeke. Ke papa nei kēia kāleka i nā kikoʻī o kāu ICD a loaʻa iā ia ka ʻike pili no nā ulia pōpilikia. Lawe mau ʻoe i kēia kāleka ʻeke me ʻoe.

Pono ʻoe i nā hōʻoia maʻamau i hiki ke nānā ʻia kāu ICD. E nānā ka mea hāʻawi e ʻike inā:

• Hoʻomaopopo pono ka hāmeʻa i kou puʻuwai puʻuwai
• Ehia mau haʻalulu i hāʻawi ʻia
• Ehia mau mana i koe i nā paila.

E kiaʻi mau ana kāu ICD i kou puʻuwai puʻuwai e paʻa mau. E hāʻawi ia i kahi mea haʻalulu i ka puʻuwai ke ʻike ʻo ia i kahi mele hoʻoweliweli ola. Hiki i ka hapa nui o kēia mau hāmeʻa ke hana ma ke ʻano he pacemaker.

ICD; Defibrillation

• Angina - hoʻokuʻu
• Angina - ke loaʻa iā ʻoe ka ʻeha o ka umauma
• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• ʻO ka aspirin a me ka maʻi puʻuwai
• ʻO ka pata, ka margarine, a me nā aila kuke
• ʻO Cholesterol a me ka nohona
• Ke kaohi nei i kou kiʻekiʻe o ke koko
• Ua wehewehe ʻia nā momona momona
• ʻLelo aʻoaʻo ʻai wikiwiki
• Puʻuwai puʻuwai - hoʻokuʻu
• Maʻi maʻi puʻuwai - nā mea weliweli
• Hewa ka puʻuwai - hoʻokuʻu
• Pehea e heluhelu ai i nā lepili ʻai
• Papaʻai paʻakai haʻahaʻa
• Papaʻai Mediterranean
• Mālama ʻeha ʻeha - wehe

• Imi i ka cardioverter-defibrillator

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA / ACC / HRS alakaʻi no ka mālama ʻana i nā mea maʻi me nā arrhythmia ventricular a me ka pale ʻana i ka make o ka puʻuwai hikiwawe: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines a me ka Heart Rhythm Society. ʻO J Am Coll Cardiol. 2018: 72 (14): e91-e220. PMID: 29097296 pubmed.ncbi.nlm.nih.gov/29097296/.

Epstein AE, DiMarco JP, Ellenbogen KA, et al. 2012 ACCF / AHA / HRS i hoʻomālama ʻia i hoʻohui ʻia i loko o ka ACCF / AHA / HRS 2008 mau alakaʻi no ka hoʻomaʻamaʻa ʻana i ka hana o nā mea pono ʻole o ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force e pili ana i nā kulekele hana a me ka Heart Rhythm ʻAhahui. ʻO J Am Coll Cardiol. 2013; 61 (3): e6-e75. PMID: 23265327 pubmed.ncbi.nlm.nih.gov/23265327/.

ʻO Miller JM, ʻo Tomaselli GF, ʻo Zipe DP. Therapy no nā arrhythmia naʻau. 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 36.

ʻO Pfaff JA, Gerhardt RT. Loiloi i nā hāmeʻa implantable. I: Roberts JR, Custalow CB, Thomsen TW, eds. ʻO Roberts a me Hedges 'Nā Kauka Lapaʻau i ka Medicine Emergency a me ka Care Acute. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 13.

CD Swerdlow, Wang PJ, Zipe DP. Pacemakers a me implantable cardioverter-defibrillators. 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 41.