Esikhathini esivela njalo semithi yanamuhla, ukuphathwa okunembile futhi okulawulwa ngokucophelela kwamanzi kubamba iqhaza emiphumeleni yokwelashwa kweziguli ephumelelayo. Iminyaka eminingi, isethi yendabuko yokumiliselwa yendabuko ibe khona ubukhona obukhulu ezikhungweni zezempilo, ukufeza iqhaza ngokuzithandela indima yalo. Kodwa-ke, ngemizamo emangalisayo ebukhwini bezokwelapha, ipompo yokumiliselwa ivele njengomdlalo - iguqula umdlalo futhi inembile ngokweqiniso, eveza enye indawo yayo ebaluleke kakhulu yezimo ezibucayi zezokwelapha.
I. Izimo zemitholampilo ezidinga amaphampu wokumnika
A. Amayunithi wokunakekelwa okubucayi
Amayunithi wokunakekelwa okuthe xaxa (i-ICUS) kanye neminyango yezimo eziphuthumayo evamile yokuma njengezinkinga zezinkinga zezokwelapha, lapho iziguli zivame ukufika khona esimweni sobunzima, izibonakaliso zazo ezibalulekile zingazinzi kalula. Kulezi zinkundla eziphakeme, amaphampu wokumnika akhombisa ukungabi nalutho olufushane lwezimpahla ezisindisa impilo. Isibonelo, cabanga ngokwelashwa kweziguli ezilwela ukwethuka kwe-septic. Ebusweni obukhulu, imishanguzo yama-vasoactive afana ne-norepinephrine iba ama-linchpins ukuze ilondoloze umfutho wegazi ovumayo. Ukunemba okumangazayo kwe-infusion okumangazayo kufaka amaqembu ezokwelapha anika amandla ezokwelashwa enza izinguquko ezingapheli ezilinganisweni zokugeleza, kwesinye isikhathi zilinganise izingxenyana ezinkulu kakhulu ze-millilitter ngehora. Leli zinga lokuvuselelwa limane nje alitholakali ngesethi yokumnika yendabuko, ethembele kakhulu kwindlela ye-archaic yokubala ukulahla. Ngaphezu kwalokho, leli zinga lokudonsa lingaphonswa kalula ngaphandle kwezici ezingezinhle kakhulu - ishubhu le-kinkled, i-turned shift yesiguli isesikhundleni - eholela emiphumeleni eyinhlekelele.
Ngokwesimo sokuphatha ukwehluleka kwenhliziyo, imithi efana ne-dobutamine ichazwe njalo ukuze kuqinise ukuphuma kwenhliziyo. Lapha, i-infusion pump ithatha isigaba sesikhungo, iqinisekisa ukuthi umuthi ulethwa ngesilinganiso esinembile esibuhlungu esinqunywe ngudokotela. Noma yikuphi ukuphambuka kulo mthamo oqondile, noma ngabe kuyinto engaphansi, kungahle kunciphise i-cardiac arryhythmias noma ubeke engcupheni isimo esithambile sesiguli. Amakhono okuqashwa okuqhubekayo okuqhubekayo kanye nama-automatic athomathikhi anikela ngokulethwa kwezidakamizwa okuthembekile futhi okuqinile, okufaka umuzwa wokuzola nokuzethemba eqenjini lezokwelapha kulezi zimo eziphakeme, zokuphila noma zokufa.
B. Ukunakekelwa Kwezingane NezeNeonatal
Uma kukhulunywa ngokunakekela izingane, ikakhulukazi izinsana ezisengozini kakhulu nama-neonates, imajini yephutha kwi-Drug Dosing incipha ezingeni elicishe libe lingafinyeleleki. Amafreyimu abo amancanyana nezinhlelo ezibucayi kakhulu zomzimba zifuna ukunemba okuphezulu kakhulu. Amaphampu wokumilisi, kule ndawo, hhayi okunethezeka kepha okufunwa ngokuphelele. Thatha icala lengane ngaphambi kwesikhathi ebhekene ne-reliratory design syndrome. Ukuphathwa kwama-surffactants, okudlala indima ebaluleke kakhulu ekwenzeni amandla umsebenzi wamaphaphu afanele, kudinga izinga lokunemba elingatholakala kuphela ngempompo yokumfaka. Kungalinganiswa ngobungcweti ukuthi bakhiphe amavolumu ama-minuscule adingekayo, asebenze njengokuvikela ekulimazeni okungenzeka okungahle kube nomphumela wokungaziphathi kahle kokudonswayo.
Emhlabeni onzima we-Hediatric Chemotherapy, ubuthi bezidakamizwa abahilelekile basebenzise amandla okulawula ukumnika isilinganiso. Isisindo sengane ngayinye eyingqayizivele kanye nephrothokholi ethile ye-chemotherapy kumele ibekwe amandla, kanye namaPumps we-invision ahlomisa abahlinzeki bezokunakekelwa kwezempilo ngamathuluzi okwenza lokho. Ngokubeka kahle izinga, banganciphisa imiphumela emibi enzima evame ukuhambisana nokufakwa kwezidakamizwa okusheshayo noma okucacile, okuqinisekisa ukuthi lezi ziguli ezincane zinokudutshulwa okungcono kakhulu komphumela wezempilo ngenkathi uvikela impilo yabo.
C. Izinqubo zokuhlinzwa ezikhethekile
Lapho amakamelo okusebenza enyuka avulekele ukuhlinzwa okuyinkimbinkimbi njengokuhlinzwa kwenhliziyo evulekile noma i-ballet eyinkimbinkimbi ye-neurosurgery, ukulondolozela ibhalansi eqinile yezidakamizwa kanye nokwenza ukuphathwa kwezidakamizwa okunembile kuba yindaba yokuphila nokufa. Esikhathini esime enhliziyweni yokuhlinzwa kwenhliziyo evulekile, izixazululo ze-Cardioplegic kumele zifakwe ngezikhathi ezithile zesikhathi namanani okubopha inhliziyo ngokuphepha, okuvumela abahlinzayo ukuba benze umsebenzi wabo wokusindisa impilo. I-infusion mpompisi isebenza njenge-Sentinel ethule, iqinisekise ukuthi isixazululo silethwa ngokunemba kokunemba, ngaleyo ndlela sigwemeka izinkinga ezihlobene nokuvikelwa okungafanele kwenhliziyo, njengomonakalo we-myocardial noma ukulimala kwenhliziyo ye-myocardial noma ukuma kwenhliziyo noma ukuma kwenhliziyo noma ukuma kwenhliziyo ye-myOCARIC
Esikhathini esifuna ukufunwa yi-neurosurgery, lapho ukwakhiwa kobuchopho okubucayi kanye nemisebenzi eyinkimbinkimbi kulayini, izidakamizwa ezilawula ingcindezi ye-intracranial noma ukulondolozwa kwe-cerebral Pherecrion kumele ziphathwe ngezinga lokunemba okuthe xaxa. Noma yikuphi ukusesha kwe-ERRATATEN CEFTAGE CATES kungavusa amakhembu wemiphumela emibi yokusebenza kobuchopho besiguli, okuholela ekushoneni kwemizwa okungapheli. Kuyinto ebaluleke kakhulu lezi zilungiselelo zokuhlinza ezibucayi zokuthembela kwe-infusion yokumfaka kanye nokunemba okukhanyayo ngempela, okwenza kube yindlela ekhethwe ngokungakhethi ukuthi odokotela abahlinzayo kanye nodokotela bokubulala izinzwa ngokufanayo.
II. Izinzuzo zamaphampu wokumnika phezu kwamasethi woku-in infusion ajwayelekile
A. Ukunemba kokulawulwa kwesilinganiso sokugeleza
Inzuzo evelele kakhulu yokuthengwa kwamaphampu kulele ekuqondeni kwabo okungenangqondo. Njengoba kubhalwe ngaphambili, lezi zimangaliso zezobuchwepheshe zingakhipha uketshezi ngamanani abonakala ecishe acishe acishe acishe acishe acishe acishe acishe abe ngumzwelonke, kwesinye isikhathi aphansi njengengxenye ye-millilit ngomzuzu. Leli zinga lobugayako liyiminyaka engcono ngaphambi kwalokho okwenziwa yi-infusion yendabuko ebekiwe. Cabanga ngosizi lweziguli ezinesifo sikashukela kuncike kwi-insulin. Iwindi lokwelapha ngalolu sidakamizwa esindisa impilo lucishe lube mncane; I-microalcalcation encane ye-dosing ingathumela amazinga kashukela wegazi angena kwi-hypoglycemia noma i-skyrocketing ibe yi-hyperglycemia. Nge-infusion pump, noma kunjalo, abahlinzeki bezokunakekelwa kwezempilo bangaphumula kalula ukuthi inani elifanele le-insulin lizophathwa ngokuvumelana okungapheli, ihora ngemuva kwehora, usuku nosuku.
Ngokuphikisana ngokuqinile, ukunqunyelwa kwezinga lokugeleza kokufakwa kwendabuko okusethelwe ama-hinges esenzweni somuntu esibonakalayo sokubala amaconsi. Le ndlela ayigciniswa nephutha lomuntu kuphela kepha futhi ithambekele kakhulu ekuphazamisweni kwangaphandle. Ukuphazamiseka okulula okubangela umhlengikazi ukuba kubize amaconsi noma ukushintshwa okuncane endaweni yesiguli kuguqula isimo se-drip kungavezwa isikhathi sokungafani kwezidakamizwa noma uketshezi oluthunyelwe ngokuhamba kwesikhathi.
B. Izici Zokuphepha
Amaphampu we-infusion eza alayishwe nge-cornucopia yezici zokuphepha ezingekho emvelweni ophikisana nazo ngokwengeziwe. Lezi zivikelo ezakhelwe ngaphakathi zisebenza njenge-bulwark enamandla ngokumelene nezinhlekelele ezingaba khona. Isibonelo, uma ishubhu liqala ukufakwa - ukwenzeka okujwayelekile ngenxa yokwakhiwa kwe-clot noma i-kink enengozi - izinzwa ezibucayi zepompo zizophuma zisebenze ngaso leso sikhathi, zikhale i-alamu eshisayo kanye nokumisa ukumnika okufile kumathrekhi ayo. Lesi sinyathelo sokutholwa sinokungenelela kokonga impilo, ukuvimbela ukwakhiwa komoya okwethusayo noma ukwakha okukhohlisayo kwengcindezi eyeqile ngaphakathi kweTibing, noma yikuphi kwako kungapela i-doom yesiguli.
Enye into yokuphepha ebucayi yindlela yokutholwa komoya. Ngisho ne-bubble encane kunazo zonke, ecishe ingafinyeleleki enesibindi sokungena ekutholeni ishubhu izotholwa yizinzwa zepompo ezivuthayo, kubangele isexwayiso esisheshayo. Lokhu kubaluleke kakhulu lapho kufakwa izidakamizwa ezizwela kakhulu emoyeni, njenge-immunologlobulin ye-intravenous. Ukuba khona kwama-bubble omoya ezimweni ezinjalo kungadala ukuthi umuthi uhlanganise, uwunikeze amandla futhi kungenzeka abeke engcupheni ukusebenza kwentengo yesiguli.
C. Ukusebenziseka kalula nokusebenza kwesikhathi
Ngenkathi kuyiqiniso ukuthi amaphampu wokumila ekuqaleni angahle abonakale eyinkimbinkimbi futhi asabise nalabo abasha kubo, ekugcineni abelokhu esonga isikhathi futhi enciphisa izimangaliso zabahlinzeki bezokunakekelwa kwempilo. Lapho amapharamitha okuqala asethwe kahle - inqubo, enokuqeqeshwa kancane, iba yimvelo yesibili - ipompo ithathe ama-reins, ukulondolozela okuncane okunempilo okunembile ngokunemba kwemishini. Lokhu kukhulula abahlengikazi nodokotela ukuthi baqondise kabusha ukunakwa kwabo kanye nakwezinye izici ezibalulekile zokunakekelwa kweziguli, kungakubheka izimpawu ezibalulekile, ukuhlola induduzo yesiguli, noma ukuhlanganisa namanye amalungu eqembu lezokwelapha.
E-Hustle ne-Bustle yewadi esibhedlela esimatasa, lapho wonke amacala wesibili nezinsizakusebenza zelulwa khona, lesi sixazululo esizenzakalelayo sinikeza umphefumulo osamukelayo. Uma kuqhathaniswa nomsebenzi onzima futhi odla isikhathi sokubheka njalo nokushintshana ngezinga le-drin yesethi yendabuko yendabuko - inqubo edinga ukuhlolwa okubonakalayo okuvame ukubonwa kanye nokuqina kwe-tweaking - ukuhanjiswa kwephampu okubuhlungu - kunciphisa kakhulu umthwalo. Iphinde ihlabe amathuba okuba amaphutha angena ngaphakathi ngesikhathi sokuphathwa kwesandla, okwenza ngcono ukuphepha kweziguli kanye nokusebenza kahle kwezempilo.
Ekuphetheni, amaphampu we-invision aqoshwe ngokungafanele i-niche ebalulekile futhi ebaluleke kakhulu emthini wanamuhla. Amandla abo okukhipha uketshezi kanye nezidakamizwa ngokunemba kwe-Pintoint, aqiniswe ngohlobo lwezinto zokuphepha ezithuthukisiwe kanye nokufukula ekusebenzeni kahle, kubenza bazikhethele ezimweni eziningi zemitholampilo. Kwabachwepheshe bezempilo, ukuqonda ama-nuances athi futhi ngani nokuthi kungani ipompo yokumfaka akuyona nje into yamakhono wobungcweti kodwa okubaluleke kakhulu, njengoba kuthinta kahle impilo yokunakekelwa kanye nenhlala-kahle yokugcina yeziguli zabo. Njengoba ubuchwepheshe buyaqhubekela phambili, singalindela ukuthuthukiswa okwengeziwe kanye nokwanda kokusetshenziswa kwalawa madivayisi esindisa impilo emangalisayo, aqede inkathi entsha yokwelashwa okunembile futhi okusebenzayo.
