THEammoniémieisivivinyo ukukala izingaammonia egazini.

I-Amoniya idlala indima ukugcinwa kwe-pH kodwa kuyisici esinobuthi okufanele siguqulwe ngokushesha futhi siqedwe. Uma kukhona ngokweqile (hyperammoniemie), inobuthi ikakhulukazi ebuchosheni futhi ingabangela ukudideka (izifo zengqondo), ukukhathala futhi ngezinye izikhathi ngisho ne-coma.

Ukuhlanganiswa kwayo kwenzeka ikakhulukazi ku-amathumbu, kodwa futhi ezingeni lezinso nemisipha. I-detoxification yayo yenzeka esibindini lapho iguqulwa ibe yi-urea, bese iqedwa ngaleli fomu emcinini.

Njengoba lokhu kuyinhlanganisela enobuthi, kubalulekile ukwenza ukuhlolwa kwe-ammonia uma usola ukwanda kokuhlushwa kwayo.

Udokotela angabeka umthamo wayo:

• uma esola a Ukungasebenzi kwe-hepatic

• ukuthola izimbangela zokuquleka noma ushintsho ekuziphatheni

• ukuhlonza izimbangela ze-coma (bese inqunywa kanye nezinye izivivinyo, njengoshukela wegazi, ukuhlolwa kokusebenza kwesibindi nezinso, ama-electrolyte)

• ukuqapha ukusebenza kahle kokwelashwa kwe-hepatic encephalopathy (ukuphazamiseka kokusebenza kwengqondo, ukusebenza kwe-neuromuscular kanye nokwazi okwenzeka ngenxa yokwehluleka kwesibindi okungapheli noma okunamandla),

Qaphela ukuthi udokotela angase acele i-ammonia kumntwana osanda kuzalwa uma ecasuka, ehlanza, noma ebonisa ukukhathala okukhulu ezinsukwini zokuqala zokuzalwa kwakhe. Lo mthamo wenziwa ikakhulukazi uma kwenzeka kulaliswa esibhedlela.

Ukunqunywa kwe-ammonia kungenziwa ngezindlela ezahlukene:

• by isampula yegazi le-arterial, eyenziwa emithanjeni yesifazane (esiqhemeni se-groin) noma i-radial artery (esihlakaleni)

• ngesampula legazi le-venous, ngokuvamile elithathwa ekugobeni kwendololwane, okungcono kakhulu esiswini esingenalutho

Amanani ajwayelekile e-ammonia kubantu abadala aphakathi kuka-10 no-50 µmoles / L (ama-micromoles ilitha) egazini le-arterial.

Lawa manani ayahluka kuye ngesampula kodwa naselabhorethri eyenza ukuhlaziya. Aphansi kancane egazini le-venous kunegazi le-arterial. Zingahluka futhi ngocansi futhi ziphakeme ezinganeni ezisanda kuzalwa.

Uma imiphumela ibonisa izinga eliphezulu le-ammonia (hyperammonemia), kusho ukuthi umzimba awukwazi ukuwudiliza ngokwanele futhi uwuqede. Izinga eliphezulu lingahlotshaniswa ikakhulukazi nalokhu:

• ukwehluleka kwesibindi

• ukulimala kwesibindi noma izinso

• hypokalemia (izinga eliphansi le-potassium egazini)

• yokumelwa yinhliziyo

• ukopha emathunjini

• isifo sofuzo esithinta izingxenye ezithile zomjikelezo we-urea

• ubunzima obukhulu bemisipha
• ubuthi (imithi ye-antiepileptic noma i-phalloid amanitis)

Ukudla okunamaprotheni aphansi (okuncane kwenyama namaprotheni) kanye nokwelashwa (i-arginine, i-citrulline) okusiza ukuqeda i-ammonia kungase kunqunywe.