Chiyero chechiyero chekuzara kweokisijeni ndeyekuongorora kunoita kuti zvikwanise kuongorora basa rehematosis: iyo oxygenation yeropa. Kuongorora uku kwekuzara kweokisijeni kunonyanya kushandiswa kune vanhu vane chirwere chekufema.

Ropa rinopa okisijeni kumatishu ese uye rinotakura kabhoni dhaikisaidhi kuenda kumapapu kuti ribviswe kubva mumuviri. Okisijeni shoma shoma inotakurwa neplasma. Yakawanda yacho inotakurwa nehemoglobin mumasero matsvuku eropa.

Okisijeni yeropa inoratidzwa nenzira nhatu:

• iyo muzana yekuzara kweiyo main transporter hemoglobin (SaO2),
• kumanikidzwa kunoitwa muropa rakanyungudika (PaO2)
• huwandu hwayo muropa (CaO2).

Mukusashanda zvakanaka kwekufema, ropa rine oxygen shoma uye yakawanda kabhoni dhaikisaidhi. Chiyero cheokisijeni chinogona kuyerwa nenzira mbiri: oxygen saturation (SaO2, inoyerwa muropa re arterial, SpO2 inoyerwa nepulse oximeter kana saturometer) uye oxygen partial pressure (PaO2).

Oxygen saturation (SaO2) inomiririra chikamu chemazana chehemoglobin yakazara neokisijeni (oxyhemoglobin) maererano nehuwandu hwehuwandu hwehemoglobin huri muropa. Oxygen saturation inoyerwa kuongorora basa rehematosis: oxygenation yeropa.

Mwero wekuzara kweokisijeni unogona kuyerwa nenzira mbiri:

Nekutora ropa reropa (zviyero zvegasi reropa).

Izvi zvinosanganisira kuongororwa ropa kubva mutsinga. Ndiyo chete nzira inobvumira kuyerwa kwakavimbika uye kwakajeka kwemagasi eropa. Kuzadzikiswa kweyero yekuyera gasi inobvumira kuongororwa kweasidhi-base chiyero (pH) uye kuyerwa kweiyo arterial pressure muokisijeni (PaO2) uye iyo yecarbon dioxide (PaCO2) inoita kuti zvikwanise kuziva mamiriro ekufema. Kuzara kwehemoglobin neokisijeni kuyerwa nearerial sampling yeropa kunoratidzwa muSao2. Oxygen saturation inoyerwa zvakananga mumasero matsvuku eropa.

Iine pulse oximeter kana saturometer (nzira iri nyore kushandisa)

A pulse oximeter kana oximeter mudziyo usingapindiki unoyera kuzara kweokisijeni muropa. Chishandiso ichi chinowanzoshandiswa muzvipatara kutarisa varwere vane dambudziko rekufema kana vari pamhepo kana kuti isiri-invasive ventilatory inotsigira (oxygen therapy). Iyo ine emitter uye inogashira mwenje iyo inoita kuti zvikwanise kuona iyo ropa oxygen saturation.

Inotumira mwaranzi wechiedza kuburikidza nematishu, kazhinji chigunwe kana chigunwe muvakuru, asiwo mhuno kana nzeve, kana ruoko kana tsoka muvana vadiki. Oxygen saturation yehemoglobin inoyerwa nepulse oximetry inoratidzwa seSpO2 (iyo p inoreva pulsed saturation). Isu tinotaura nezve pulsed saturation yehemoglobin neokisijeni.

Pane akati wandei zviratidzo zvekuyera mwero weokisijeni saturation nesaturometer muvakuru:

• panguva yeanesthesia kana muimba yekucherechedza mushure mekuvhiyiwa
• Mumadhipatimendi emishonga yechimbichimbi
• Mukuchengetwa kwakanyanya, kunyanya kune vanhu vanoiswa pamhepo kana kuti vangangove.

Muvana, kuyerwa kweiyo oxygen saturation rate inewo akati wandei zviratidzo:

• kuongororwa kwekuoma kwechirwere chekufema (bronchiolitis, pneumonia, asthma, nezvimwewo).
• kuongororwa kwekuoma kwemucheche bronchiolitis; saturation isingasviki 94% ndeimwe yezviratidzo zvekuoma
• kuongororwa kwekushanda kweaerosol
• kuonekwa kwechirwere chemoyo chinogona kuitika mumwana achangoberekwa ane cyanotic

Arterial gasi kuyerwa kunoitwa muhupo hwemamiriro ekufema kwakanyanya uye pamberi pekufungidzirwa kwechirwere chikuru chemetabolism.

Normal oxygen saturation yemunhu ane hutano iri pakati pe95% ne100% zvichienderana nezera. SpO2 (Pulsed saturation yakayerwa nepulse oximeter). Izvo hazvina kukwana pasi pe95%. Tiri kutaura nezve hypoxemia. Pfungwa ye hypoxemia inoshanda kune chero kusakwana kweokisijeni yeropa uye naizvozvo nokukurumidza iyo SpO2 iri pasi pe95%. Iyo 90% muganho inoratidza hypoxemia inoenderana neyakafanana nekutadza kufema.

Normal arterial oxygen saturation (SaO2) iri pakati pe96% ne98% mumunhu mukuru wechidiki ndeye 95% mumunhu anopfuura makore makumi manomwe. Kana iri pasi pe70%, munhu anonzi ari mudesaturation. Desaturation inoenderanawo nekudonha kwe 90 saturation point kana ichienzaniswa neiyo base value (semuenzaniso panguva yekuedza).

A "yakajairika" SpO2 kumwana inofananidzwa nekukosha kukuru kupfuura 95%. Chiyero cheSpO2 chepasi pe94% mumwana ndiyo chiyero chekukomba uye chinotungamirira kuchipatara. Kuyera SpO2 kunokosha zvikuru muvana, nokuti mwana anongoratidzika cyanotic (bluish complexion) apo SaO2 iri pasi pe75% uye nokuti zviyero zvegasi zvemagetsi hazviwanzoiti muvana. Iyo pulse oximeter yakakosha pakuona yekutanga hypoxia.

Isu tinotaura nezve hypoxemia apo iyo oxygen saturation kukosha iri pasi pe93%. Njodzi huru ndeyekutambura kweserura (ischemia) inokonzerwa nekusakwana kweokisijeni kune akasiyana matishu emuviri. Acute hypoxemia inogona kuitika zvichitevera kuwedzera kwakanyanya kweasima, kutadza kwemoyo kwakanyanya, mabayo kana kuwedzera kwakanyanya kweChronic Obstructive Pulmonary Disease (COPD), kutevera pulmonary embolism, pleural effusion, pneumothorax.

Hypoxemia (oxygen saturation rate isingasviki 93%) inoratidzwa nekupfupika kwekufema, kukurumidza kudzika kufema, bluish ganda (cyanosis) asi zvese izvi zviratidzo hazvina kunyanya kujeka uye zvinonzwisisika pane pulse oximetry.

COVID-19 inogona kukonzera yakaderera oxygen saturation rate. Mhosva dzakanyanya dzeCOVID dzinogona kukonzera pneumonia inokonzera acute respiratory distress syndrome. Zviratidzo zvacho hazvina kunyatsojeka pakutanga. Ichi ndicho chikonzero vanachiremba vanogona kutarisa mwero weokisijeni saturation ne oximeter. Kutadza kufema uye kutadza kufema zviratidzo zvekuti unofanira kufonera emergency emergency.

Yambiro: Kushandisa pulse oximeter kunopawo njodzi dzekukanganisa uye zvakanakisa kudzidza mashandisiro ayo nenyanzvi yehutano.

Kuwedzerwa kweokisijeni panguva yekurapa kweokisijeni kunogona kutungamirira ku hyperoxia. Hyperoxia ine ngozi kune vanhu vane kutadza kufema.

Muchiitiko che hypoxemia (oxygen saturation isingasviki 93), kurapwa neokisijeni therapy inogona kushandiswa. Okisijeni inogona kupihwa nemumhuno (magirazi) kana nemhino nemuromo nzira (masiki) asiwo neyakagadzirwa ventilation (ventilator, intubation) kana neextracorporeal circulation (ECMO). Huwandu hweokisijeni hunounzwa hunotungamirirwa nearterial blood gases kana pulse oximetry kuchengetedza Pao2 pakati pe60-80 mmHg (92-100% saturation) pasina kukonzera oksijeni toxicity.