What is a Capnograph?

I-capnograph iyithuluzi lezokwelapha elibalulekile elisetshenziswa ngokuyinhloko ukuhlola impilo yokuphefumula. Ikala ukugcwala kwe-CO₂ ekuphefumuleni okukhishwe umoya futhi ivame ukubizwa ngokuthi i-i-end-tidal CO₂ (EtCO2) qapha.Le divayisi inikeza izilinganiso zesikhathi sangempela kanye nezibonisi zegraphical waveform (ama-capnogram), enikeza imininingwane ebalulekile ngesimo sokuphefumula sesiguli.

I-Capnography isebenza kanjani?

Nansi indlela osebenza ngayo emzimbeni: umoya-mpilo ungena egazini ngamaphaphu futhi usekele izinqubo zomzimba zomzimba. Njengomphumela we-metabolism, i-carbon dioxide iyakhiqizwa, ibuyiselwe emaphashini, bese ikhishwa. Ukulinganisa inani le-CO₂ emoyeni okhishiwe kunikeza ulwazi olubalulekile mayelana nokusebenza kwesiguli sokuphefumula kanye nokusebenza komzimba.

Indlela i-Capnograph Measures CO2?

Imonitha ye-capnograph ikala umoya okhishiwe ngokubonisa ingcindezi eyingxenye ye-CO₂ ngefomethi ye-waveform kugridi ye-x- kanye ne-y-eksisi. Ibonisa kokubili ama-waveform nezilinganiso zezinombolo. Ukufundwa okujwayelekile kokuphela kwe-CO₂ (EtCO₂) kuvame ukusukela ku-30 kuye ku-40 mmHg. Uma i-EtCO yesiguli2iwela ngaphansi kuka-30 mmHg, ingase ibonise izinkinga ezifana nokungasebenzi kahle kweshubhu le-endotracheal noma ezinye izinkinga zezokwelapha ezithinta ukuthathwa komoyampilo.

Okujwayelekile (EtCO₂) _ 30 kuya ku-40 mmHg

Izindlela Ezimbili Eziyinhloko Zokukala Igesi Ekhishiwe

I-Mainstream EtCO2 Monitoring

Ngale ndlela, i-adaptha yomzila womoya enekamelo lesampula elihlanganisiwe ibekwe ngokuqondile endleleni yokuphefumula phakathi kwesifunda sokuphefumula kanye neshubhu endotracheal.

I-Sidestream EtCO2Monitoring

Inzwa itholakala ngaphakathi kweyunithi enkulu, kude nomgwaqo womoya. Iphampu elincane lilokhu lifuna amasampula egesi akhishwe esigulini ngomugqa wamasampula kuya kuyunithi eyinhloko. Umugqa wamasampula ungaxhunywa kusiqeshana se-T kushubhu endotracheal, i-adaptha yemaski ebulala izinzwa, noma ngokuqondile emgodini wamakhala ngesampula ye-cannula yamakhala enama-adaptha ekhala.

Kukhona futhi izinhlobo ezimbili eziyinhloko zama-monitor.

Enye i-capnograph ephathekayo ezinikele ye-EtCO₂, egxile kuphela kulesi silinganiso.

I-Micro Capnometer (3)

Enye imojula ye-EtCO₂ ehlanganiswe kumonitha we-multiparameter, engakala amapharamitha amaningi esiguli ngesikhathi esisodwa. Iziqapha eziseceleni kombhede, imishini yegumbi lokusebenza, kanye nama-defibrillator e-EMS ngokuvamile ahlanganisa amakhono okulinganisa we-EtCO₂.

Inikukhona Izicelo Zomtholampilo ze-Capnograph?

Impendulo Ephuthumayo: Uma isiguli sibhekene nokuboshwa kokuphefumula noma ukuboshwa kwenhliziyo, ukuqapha kwe-EtCO2 kusiza abasebenzi bezokwelapha bahlole ngokushesha isimo sokuphefumula sesiguli.
Ukuqapha Okuqhubekayo: Ezigulini ezigula kakhulu ezisengozini yokuwohloka kokuphefumula okungazelelwe, ukuqapha okuqhubekayo kokuphela kwe-CO₂ kunikeza idatha yesikhathi sangempela ukuze kutholwe futhi kuphendule izinguquko ngokushesha.
Inqubo Yokuthulisa: Kungakhathaliseki ukuthi ukuhlinzwa okuncane noma okukhulu, lapho isiguli sithulisiwe, ukuqapha kwe-EtCO2 kuqinisekisa ukuthi isiguli sigcina umoya owanele kuyo yonke inqubo.
Ukuhlolwa Komsebenzi Wamaphaphu: Ezigulini ezinezimo ezingelapheki ezifana nesifo sokuphelelwa umoya nesifo se-chronic obstructive pulmonary disease (COPD), ama-capnographs asiza ekuhloleni ukusebenza kwamaphaphu azo.

Kungani Ukuqapha Kwe-EtCO₂ Kuthathwa Njengezinga Lokunakekela?

I-Capnography manje isiqashelwa kabanzi njengezinga elingcono kakhulu lokunakekela ezilungiselelweni eziningi zomtholampilo. Izinhlangano zezokwelapha eziphambili nezindikimba ezilawulayo—njenge-American Heart Association (AHA) kanye ne-American Academy of Pediatrics (AAP)—zifake i-capnography emihlahlandlela yazo yomtholampilo nezincomo. Ezimweni eziningi, kubhekwa njengengxenye ebalulekile yokuqapha isiguli nokunakekelwa kokuphefumula.

I-AAAPSF (Inhlangano YaseMelika Yokugunyazwa Kwezindawo Zokuhlinza Ngepulasitiki Ye-Ambulatory, Inc.)2003

“UKUQWASHWA KWE-ANESTHESIA – kusebenza kukho konke ukulaliswa kwezinzwa…Ukungenisa umoya njengoba kuphawulwe ngu:…Ukuqapha ukuphela kwe-CO2 ephelelwe yisikhathi okuhlanganisa ivolumu, i-Capnography/Capnometry, noma i-mass spectroscopy”

I-AAP (American Academy of Pediatrics)

Abahlinzeki bezempilo kufanele baqinisekise ukubekwa kweshubhu le-endotracheal ngokushesha ngemva kokuthuthwa, ngesikhathi sokuthutha kanye nanoma nini lapho isiguli sisuswa. I-CO2 ekhishiwe kufanele iqashelwe ezigulini ezineshubhu le-endotracheal kokubili kuzilungiselelo zangaphambi kwesibhedlela nesibhedlela, kanye nangazo zonke izinto zokuhamba, ngokusebenzisa umtshina we-colorimetric noma i-capnography.

I-AHA (American Heart Association) 2010

I-American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) kanye ne-Emer gency Cardiovascular Care (ECC) Yeziguli Zezingane Nezinsana: Imihlahlandlela Yokuvuselela Ingane Yezingane
Ingxenye 8: Usekelo Lwempilo Yabantu Abadala Oluthuthukisiwe
8.1: Izithasiselo Zokulawula Umoya Nokungenisa umoya
Izindiza Ezithuthukisiwe - I-Endotracheal Intubation I-capnography ye-waveform eqhubekayo iyanconywa ngaphezu kokuhlolwa komtholampilo njengendlela ethembeke kakhulu yokuqinisekisa nokuqapha ukubekwa okulungile kweshubhu le-endotracheal (Ikilasi I, LOE A). Abahlinzeki kufanele babheke i-capnographic waveform eqhubekayo enokuphefumula ukuze kuqinisekiswe futhi kuqashwe ukubekwa kweshubhu le-endotracheal ensimini, emotweni yokuthutha, lapho befika esibhedlela, nangemuva kwanoma yikuphi ukudluliselwa kwesiguli ukuze kuncishiswe ingcuphe yokuduka kweshubhu engaziwa noma ukususwa. Ukungena komoya okusebenzayo ngomshini womoya we-supraglottic kufanele kubangele i-capnograph waveform ngesikhathi se-CPR nangemuva kwe-ROSC (S733).

I-EtCO2 Monitoring vs SpO2Ukuqapha

Uma kuqhathaniswa ne-pulse oximetry (SpO₂),EtCO2ukuqapha kunikeza izinzuzo ezihluke kakhulu. Ngenxa yokuthi i-EtCO₂ inikeza ukuqonda kwesikhathi sangempela ekungeneni komoya we-alveolar, isabela ngokushesha ezinguqukweni zesimo sokuphefumula. Ezimeni zokuyekethisa ukuphefumula, amazinga e-EtCO₂ ashintshashintsha ngokushesha, kanti ukwehla kwe-SpO₂ kungase kubambezeleke ngemizuzwana embalwa ukuya emaminithini. Ukuqapha okuqhubekayo kwe-EtCO2 kwenza odokotela bakwazi ukubona ukuwohloka kokuphefumula kusenesikhathi, okunikeza isikhathi sokuhola esibalulekile sokungenelela okufika ngesikhathi ngaphambi kokuncipha kokugcwala komoyampilo.

I-EtCO2 Monitoring

Ukuqapha kwe-EtCO2 kunikeza ukuhlolwa kwesikhathi sangempela kokushintshisana kwegesi yokuphefumula kanye nokungena komoya we-alveolar. Amazinga e-EtCO2 aphendula ngokushesha ekuziphatheni okungavamile kokuphefumula futhi awathonywa kakhulu umoya-mpilo owengeziwe. Njengendlela yokuqapha engahlaseli, i-EtCO2 isetshenziswa kabanzi ezindaweni ezihlukahlukene zemitholampilo.

I-Pulse Oximetry Monitoring

Ukuqapha kwe-Pulse oximetry (SpO₂).isebenzisa inzwa yomunwe engahlaseli ukukala amazinga okugcwala komoyampilo egazini, okuvumela ukutholwa okuphumelelayo kwe-hypoxemia. Le nqubo isebenziseka kalula futhi ifaneleka kahle ukuqapha okuqhubekayo eceleni kombhede kweziguli ezingaguli kakhulu.

	Isicelo somtholampilo	I-SpO₂	EtCO2
I-Mechanical Ventilator	I-esophageal intubation ye-endotracheal tube	Kancane	Ngokushesha
	I-intubation ye-bronchial ye-endotracheal tube	Kancane	Ngokushesha
	Ukuboshwa kokuphefumula noma ukuxhumana okuxekethile	Kancane	Ngokushesha
	I-Hypoventilation	x	Ngokushesha
	I-Hyperventilation	x	Ngokushesha
	Ukunciphisa izinga lokugeleza komoyampilo	Ngokushesha	Kancane
Umshini Wokubulala Izinzwa	Ukukhathala kwe-soda lime / ukuphefumula kabusha	Kancane	Ngokushesha
Isiguli	I-oxygen ephefumulelwe ephansi	Ngokushesha	Kancane
	I-Intrapulmonary shunt	Ngokushesha	Kancane
	I-pulmonary embolism	x	Ngokushesha
	I-hyperthermia eyingozi	Ngokushesha	Ngokushesha
	Ukuboshwa kwe-circulatory	Ngokushesha	Ngokushesha

Ungakhetha Kanjani Izesekeli Nezinto Ezisetshenziswayo ze-CO₂?

INyakatho Melika njengamanje iphethe imakethe, ibalwa cishe ngama-40% emali engenayo yomhlaba, kanti isifunda sase-Asia-Pacific kulindeleke ukuthi sibhalise ukukhula okusheshayo, nge-CAGR ebikezelwe ye-8.3% ngasikhathi sinye. Okuhamba phambili emhlabeni jikeleleukuqapha isiguliabakhiqizi-njengabanjaloI-Philips (I-Respironics), I-Medtronic (Oridion), UMasimo, kanye ne-Mindray-baqhubeka besungula ubuchwepheshe be-EtCO2 ukuze bahlangabezane nezidingo eziguqukayo ze-anesthesia, ukunakekelwa okubucayi, kanye nemithi ephuthumayo.

Ukuze kuhlangatshezwane nezidingo zomtholampilo futhi kuthuthukiswe ukusebenza kahle komsebenzi kubasebenzi bezokwelapha, i-MedLinket igxile ekuthuthukiseni nasekukhiqizeni izinto ezisebenzisekayo zekhwalithi ephezulu, njengemigqa yamasampula, ama-adaptha wendlela yomoya, nezicupho zamanzi. Le nkampani izinikezele ekuhlinzekeni izikhungo zokunakekelwa kwezempilo ngezixazululo ezinokwethenjelwa ezisebenzisekayo kokubili ukuqapha okujwayelekile kanye nomgwaqo oseceleni, okuhambisana nemikhiqizo eminingi yokuqapha isiguli ehamba phambili, okunikela ekuthuthukiseni inkambu yokuqapha ukuphefumula.

Izinzwa ezijwayelekile ze-eco2futhiama-adaptha omoyayizinto ezisetshenziswayo nezisetshenziswa kakhulu zokuqapha okujwayelekile.

Okokuqapha komfula oseceleni,ukucatshangelwa kufaka phakathi, izinzwa ze-sidestream, kanyeizingibe zamanzi，CO2 Sampling line, kuye ngokusetha kwakho kanye nezidingo zokugcinwa.

Amanzi Trap Series
Umkhiqizi we-OEM namamodeli	Ref Isithombe	I-OEM #	Ikhodi ye-oda	Izincazelo
I-Mindray Ehambisanayo (e-China)
OkweBeneView, i-iPM, iMEC, PM, MEC-2000 series monitors, PM-9000/7000/6000 series, BeneHeart defibrillator		115-043022-00 (9200-10-10530)	RE-WT001A	I-Dryline water trap, i-Adult/Pediatirc ye-dual-slot module, 10pcs/ibhokisi
		115-043023-00 (9200-10-10574)	I-RE-WT001N	I-Dryline water trap, i-Neonatal ye-dual-slot module, 10pcs/ibhokisi
OkweBeneVision, amamonitha ochungechunge lwe-BeneView		115-043024-00 (100-000080-00)	RE-WT002A	I-Dryline II isicupho samanzi, I-Adult / Pediatirc ye-single-slot module, 10pcs/ibhokisi
		115-043025-00 (100-000081-00)	I-RE-WT002N	I-Dryline II isicupho samanzi, I-Neonatal ye-single-slot module, 10pcs/ibhokisi
Ihambisana ne-GE
I-GE Solar Sidestream EtCO₂ Module, GE MGA-1100 Mass Spectrometer GE Advantage System, EtCO₂ Sampling Systems		402668-008	I-CA20-013	Isiguli esisodwa sisebenzisa i-0.8 micron Fitter, i-Luer Lock evamile, 20pcs/ibhokisi
I-GE Healthcare gventilator, qapha, umshini wokubulala izinzwa onemojula yegesi ye-E-miniC		8002174	I-CA20-053	Ivolumu yesiqukathi sangaphakathi ngu-> 5.5mL, 25pcs/ibhokisi
I-Drager Ehambisanayo
I-Drager Babytherm 8004/8010 ehambisanayo ne-Babylog VN500 ventilator		6872130	WL-01	Isiguli esisodwa sisebenzisa i-Waterlock, 10pcs/box
I-Philips ehambisanayo
Imojula Ehambisanayo:Philips - IntelliVue G5		M1657B / 989803110871	I-CA20-008	Umgibe wamanzi we-Philips, ama-15pcs / ibhokisi
I-Philips ehambisanayo			I-CA20-009	I-Philips water trap Rack
Imojula Ehambisanayo:Philips – IntelliVue G7ᵐ		989803191081	WL-01	Isiguli esisodwa sisebenzisa i-Waterlock, 10pcs/box