OXYGEN TOXICITY

หัวข้อ : OXYGEN TOXICITY
ข้อความ : ออกซิเจน จะเป็นพิษ เมื่อหายใจ ภายใต้ความกดดัน 0.4 ATA ซึ่งจะเกิดปัญหากับร่างกาย 2 ส่วน คือ ปอด และ สมอง

เกิดจากการหายใจระหว่าง 0.4 - 1.8 ATA จะเกิดอาการ TOXIC ที่ปอด และหลังจาก 1.8 ATA จะเกิด TOXIC ที่สมอง ผลสะท้อนกลับของอาการจะแสดงออกอย่างรวดเร็ว หรืออาจไม่ปรากฎแน่ชัด การแทรกตัวของออกซิเจนเข้าสู่การทำงานของเอ็มไซด์ภายในเซลของร่างกาย จะถูกแยกออกจากกระบวนการเคมีของร่างกาย โดยเฉพาะที่บริเวณ "สมอง" และ "ปอด"

ในปอดการเสียหายส่วนมากเกิดจากการแข็งตัวของถุงลมปอด (ALVEOLI) ซึ่งปกติจะมีการยืดหยุ่นได้ดี ส่วนในสมองจะเกิดกับเส้นประสาท ซึ่งจะทำหน้าที่ในการส่งผ่านระบบเคมีในร่างกายให้ได้รับความเสียหายและจะเกิดอาการ "ชัก" ตามมาในที่สุด

OXYGEN TOXICITY
Resuscitation (การทำให้ฟื้น) การให้ 100% oxygen สามารถให้ได้กับผู้ป่วยที่จำนวนoxygen ในสมองลดต่ำลง หรือในการรักษา decompression sickness, Air Embolism ในการรักษาดังกล่าวต้องได้รับความดูแลโดยแพทย์ทางการดำน้ำ เพราะมีผลเกี่ยวกับอาการ oxygen Toxic
Oxygen Re-breathing Equipment
จากการทดลองทางทหาร ในการใช้ Re-breathing โดยให้อยู่ที่ระดับความลึก 9 เมตร สำหรับนักดำน้ำที่อยู่เฉย ๆ และที่ความลึก 7 เมตร สำหรับทำงานใต้น้ำ ผลก็คือ "การชัก" เพราะ ในการดำน้ำแบบ Re-breathing, Scuba, Nitrox ถูกจำกัดที่ 1.6 ATA เท่านั้น
Deepdiving
การดำน้ำลึกโดยการใช้ helium, nitrogen และ oxygen ต้องอยู่ภายใต้ข้อจำกัดของการ Toxic ด้วย
Recompriession
100 % oxygen ในการรักษานักดำน้ำที่ 2.8 atm ต้องระวังในเรื่องของปอด และสมอง อยู่ภายใต้ความดูแลของแพทย์เท่านั้น

ผลสะท้องกลับของสมอง
"การชัก" อาจเกิดขึ้นได้โดยปราศจากการเตือนใด ๆ บางครั้งอาจมีอาการหลายอย่าง เช่น เกิดการรบกวนการมองเห็นของประสาทตา, หน้ามืด, กล้ามเนื้อบริเวณใบหน้าเกิดการกระตุก ซึ่งอาจเป็นการเตือนล่วงหน้าก่อนเกิดอาการ "ชัก" และอาการคลื่นไส้ อาเจียร เป็นอาการปกติของ oxygen toixc ที่สมอง และที่สำคัญคือความรู้สึกไวต่อการรับรู้ของ oxygen toxic ที่สมองในแต่ละคนที่แตกต่างกัน และในการรักษาโรคเกี่ยวกับความดัน โดยการใช้ oxygen "อาการชัก" ของผู้ป่วยเป็นสิ่งสำคัญที่อาจเกิดได้ในขณะทำการรักษา decompression sickness หรือ Air embolism

ผลสะท้อนกลับจากปอด
การอักเสบภายในทรวงอก อาจมีการเจ็บเพิ่มมากขึ้นและจะเลวร้ายลง เช่น อาจเกิดอาการไออย่างรุนแรง หรือเกิดภาวะการหายใจติดขัด และสั้น ซึ่งเกิดจากภาวะโรคปอดอักเสบแทรกซ้อน

การรักษา
จำเป็นต้องระวังอาการ Toxic ทางสมอง (อาการขัก) โดยที่ผู้ป่วยจำเป็นต้องทำhyperventilation โดยเร็ว และเริ่มหายใจใหม่ จนกว่าอาการจะบรรเทาลง เมื่อเกิดอาการชัก จำเป็นต้องหยุดทันที และป้องกันการหยุดหายใจ และการหายใจเข้าสู่ท้อง โดยการกลืนอากาศและป้องกันการกัด "ลิ้น" หลังจากอาการหยุดแล้ว ผู้ป่วยอาจหมดสติ โดยการดูแลระบบหายใจควบคู่กันไป
แต่ถ้าอยู่ในภาวะต้องทำการรักษาต่อ ขึ้นอยู่กับความจำเป็นอย่างไรก็ตามผลของการ Toxic จะเกิดขึ้นอย่างช้าๆ โดยการให้ Heliox แต่ต้องอยู่ในดุลพินิจของแพทย์ ซึ่งจะทำให้เกิดการ oxygen toxic ได้ช้าลง ในระหว่างเข้ารับการรักษา

จากคุณ : Mr.T - [ 27 ส.ค. 45 21:51:39 A:202.183.228.67 X:203.170.155.201 ]

--------------------------------------------------------------------------------

ความคิดเห็นที่ 1

ขอบคุณสำหรับบทความดีๆ มีประโยชน์ครับ เดี๋ยวจะตามไปอ่านในเรื่องไนโตรเจนต่อ

ความกดดันที่จะทำให้เกิดออกซิเจนเป็นพิษนี่ เห็นในตำราเขียนไว้ว่าประมาณตั้งแต่ 1.4 ata คุณ Mr T เขียนไว้ว่า 0.4 ata นี่ผมเลยสงสัย เดี๋ยวต้องกลับไปค้นตำราดูครับ หากคุณ Mr T มีบทความอ้างอิงช่วยบอกด้วยนะครับ

จากคุณ : Marlin - [ 28 ส.ค. 45 15:30:58 ]

ความคิดเห็นที่ 2

ขอบคุณที่postความรู้เหล่านี้ไว้ให้อ่านนะครับ มีประโยชน์มากเลยครับ ใช่คุณMr Tในmtcdiveclubหรือเปล่าครับ

ถ้าพี่จะช่วยquoteบทความหรือหนังสือที่พี่แปลมาก้อจะเป็นพระคุณอย่างยิ่งเลยครับ
เผื่อจะได้ไปหาอ่านได้เพิ่มเติมครับ

จากคุณ : มอย - [ 28 ส.ค. 45 23:48:18 A:128.243.220.22 X:10.3.226.95 ]

ความคิดเห็นที่ 3

อ๊อกซิเจนเป็นพิษเริ่มที่ 1.6 ATA ครับแน่นอน
จากตำราของ NOAA
และUS Navy อนุญาตให้ผู้ปฏิบัติการใต้น้ำ ขณะปฏิบัติงาน ไม่เกิน 1.45 ATA
แต่อนุญาตให้พักน้ำโดยใช้ อ๊อกซิเจน เข้นข้น 1.6 ATA
ในขณะที่ เครื่องดำน้ำแบบ Rebreather จะเปิดระยะปลอดภัยอีกเป็น Set Point ที่ 1.3 ATA
ผู้ปฏิบัติการใต้น้ำ ของกองทัพเรือไทย
นักดำน้ำสำรวจสภาพเขื่อนของการไฟฟ้าฝ่ายผลิต
โบราณคดีใต้น้ำกรมศิลปากร
มีกำหนดต้องเข้าทดสอบความทนทาน อ๊อกซิเจน ทุก ๖ เดือน หรือ ๑๒ เดือน แล้วแต่หน่วยงาน
โดยการหายใจ อ๊อกซิเจน ๑๐๐ เปอร์เซนต์ที่ ๖๐ ฟุต เป็นเวลาครึ่งชั่วโมง
ซึ่งหมายถึง ความเข้มข้น 2.8 ATA ทั้งนี้ต้องอยู่ในการควบคุมของแพทย์

จากคุณ : Homo aquaticus - [ 29 ส.ค. 45 00:10:01 A:203.113.34.239 X: ]

ความคิดเห็นที่ 4

ขอบคุณพี่ Homo Aquaticus ครับ เมื่อไรจะได้ไปนั่งคุยกันนักทีหนอ คิดถึงครับ

จากคุณ : Marlin - [ 29 ส.ค. 45 00:53:01 ]

ความคิดเห็นที่ 5

ขอบคุณสำหรับบทความดี ๆ ขอให้มีกระทู้แบบนี้ใน blueplanet เยอะ ๆ ทีเถอะ เพี้ยง !

จากคุณ : พะยูน - [ 29 ส.ค. 45 10:44:57 A:202.44.135.35 X:unknown ]

ความคิดเห็นที่ 6

ขอถามแบบคนไม่รู้ประสาเกี่ยวกับ Nitrox เลยนะคะว่า การดำน้ำแบบ Nitrox หรือ Tri-mix นี้จะเสี่ยงต่อการเกิด Oxygen Toxic มากกว่าการใช้อากาศธรรมดาหรือไม่ อย่างไรคะ?

จากคุณ : juv - [ 29 ส.ค. 45 21:19:23 ]

ความคิดเห็นที่ 7

Nitrox จะเสี่ยงมากกว่าครับ เพราะเอาอ๊อกซิเจนเพิ่มเข้าไปสูงขึ้น
ถ้าหากเกินขีดความลึกก็เป็นอันตราย
ส่วน TriMix อาจเรียกได้ว่าเสี่ยงน้อยกว่า
เพราะเลือกผสมอ๊อกซิเจนให้เหมาะกับความลึก
แต่ก็เสี่ยงอยู่ดี ถ้าดำลึกกว่าส่วนผสมที่ตั้งไว้

จากคุณ : Homo aquticus - [ 29 ส.ค. 45 23:45:32 A:203.113.34.239 X: ]

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