{"id":25032,"date":"2023-04-19T22:24:00","date_gmt":"2023-04-19T15:24:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25032"},"modified":"2023-04-20T11:44:35","modified_gmt":"2023-04-20T04:44:35","slug":"lam-sang-va-chan-doan-suy-ho-hap-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/lam-sang-va-chan-doan-suy-ho-hap-tre-em\/","title":{"rendered":"L\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n suy h\u00f4 h\u1ea5p tr\u1ebb em"},"content":{"rendered":"

Suy h\u00f4 h\u1ea5p (SHH) l\u00e0 t\u00ecnh tr\u1ea1ng b\u1ed9 m\u00e1y h\u00f4 h\u1ea5p kh\u00f4ng \u0111\u1ee7 kh\u1ea3 n\u0103ng duy tr\u00ec s\u1ef1 trao \u0111\u1ed5i kh\u00ed theo nhu c\u1ea7u c\u01a1 th\u1ec3, g\u00e2y gi\u1ea3m O2<\/sub> v\u00e0\/ho\u1eb7c t\u0103ng CO2<\/sub> m\u00e1u. H\u1eadu qu\u1ea3 c\u1ee7a suy h\u00f4 h\u1ea5p l\u00e0 thi\u1ebfu oxy cho nhu c\u1ea7u bi\u1ebfn d\u01b0\u1ee1ng c\u1ee7a c\u00e1c c\u01a1 quan, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u00e3o, tim v\u00e0 \u1ee9 \u0111\u1ecdng CO2<\/sub> g\u00e2y toan h\u00f4 h\u1ea5p.<\/strong><\/p>\n

1.\u0110\u1ea1i c\u01b0\u01a1ng<\/h2>\n

H\u00f4 h\u1ea5p l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh g\u1ed3m 4 giai \u0111o\u1ea1n:<\/p>\n

– Th\u00f4ng kh\u00ed hay h\u00f4 h\u1ea5p b\u00ean ngo\u00e0i: l\u00e0 giai \u0111o\u1ea1n kh\u00f4ng kh\u00ed \u0111i t\u1eeb ngo\u00e0i v\u00e0o \u0111\u1ebfn ph\u1ebf nang v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n

– Khu\u1ebfch t\u00e1n: l\u00e0 qu\u00e1 tr\u00ecnh oxy t\u1eeb ph\u1ebf b\u00e0o \u0111\u1ebfn mao m\u1ea1ch qua m\u00e0ng ph\u1ebf nang mao m\u1ea1ch v\u00e0 CO2<\/sub> th\u00ec ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n

– V\u1eadn chuy\u1ec3n: l\u00e0 qu\u00e1 tr\u00ecnh \u0111\u01b0a oxy t\u1eeb mao m\u1ea1ch ph\u1ebf nang \u0111\u1ebfn t\u1ed5 ch\u1ee9c nh\u1edd h\u1ed3ng c\u1ea7u v\u00e0 huy\u1ebft t\u01b0\u01a1ng.<\/p>\n

– H\u00f4 h\u1ea5p t\u1ed5 ch\u1ee9c: l\u00e0 giai \u0111o\u1ea1n cu\u1ed1i c\u00f9ng m\u00e0 oxy t\u1eeb m\u00e0ng t\u1ebf b\u00e0o v\u00e0o trong t\u1ebf b\u00e0o nh\u1edd c\u00e1c enzym h\u00f4 h\u1ea5p.<\/p>\n

C\u00e1c giai \u0111o\u1ea1n tr\u00ean li\u00ean quan m\u1eadt thi\u1ebft v\u00e0 \u1ea3nh h\u01b0\u1edfng l\u1eabn nhau. M\u1ed9t giai \u0111o\u1ea1n b\u1ecb r\u1ed1i lo\u1ea1n \u0111\u1ec1u \u0111\u01b0a \u0111\u1ebfn s\u1ef1 r\u1ed1i lo\u1ea1n h\u00f4 h\u1ea5p l\u00e0m thi\u1ebfu oxy cho c\u01a1 th\u1ec3.<\/p>\n

Ng\u01b0\u1eddi ta chia suy h\u00f4 h\u1ea5p l\u00e0m 3 giai \u0111o\u1ea1n:<\/p>\n

– Ch\u01b0a c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/p>\n

– C\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng: t\u00edm t\u00e1i, kh\u00f3 th\u1edf.<\/p>\n

– C\u00f3 r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a.<\/p>\n

2. C\u00e1c nguy\u00ean nh\u00e2n suy h\u00f4 h\u1ea5p \u1edf tr\u1ebb em<\/a><\/strong><\/h2>\n

Suy h\u00f4 h\u1ea5p c\u00f3 th\u1ec3 do b\u1ec7nh l\u00fd c\u1ee7a \u0111\u01b0\u1eddng th\u1edf, t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i ho\u1eb7c b\u1ec7nh l\u00fd n\u00e3o, th\u1ea7n kinh \u2013 c\u01a1. Nguy\u00ean nh\u00e2n suy h\u00f4 h\u1ea5p \u0111\u01b0\u1ee3c ph\u00e2n chia:<\/p>\n

    \n
  1. Nguy\u00ean nh\u00e2n t\u1ea1i h\u1ec7 h\u00f4 h\u1ea5p <\/em>(chi\u1ebfm \u0111a s\u1ed1: 80 \u2013 90% c\u00e1c cas)<\/li>\n<\/ol>\n

    – \u0110\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean: d\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf, vi\u00eam thanh thi\u1ec7t c\u1ea5p, ph\u00f9 n\u1ec1 thanh m\u00f4n, u nh\u00fa ch\u00e8n \u00e9p\u2026<\/p>\n

    – \u0110\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi: vi\u00eam ph\u1ed5i, hen ph\u1ebf qu\u1ea3n, vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p, vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i, ph\u00f9 ph\u1ed5i, x\u1eb9p ph\u1ed5i, tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i \u2026<\/p>\n

      \n
    1. Nguy\u00ean nh\u00e2n ngo\u00e0i h\u1ec7 h\u00f4 h\u1ea5p<\/em><\/li>\n<\/ol>\n

      – Tim m\u1ea1ch: suy tim, tim b\u1ea9m sinh t\u00edm, tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim\u2026<\/p>\n

      – Th\u1ea7n kinh trung \u01b0\u01a1ng: vi\u00eam n\u00e3o, vi\u00eam m\u00e0ng n\u00e3o, xu\u1ea5t huy\u1ebft, ch\u1ea5n th\u01b0\u01a1ng.<\/p>\n

      – L\u1ed3ng ng\u1ef1c: ch\u1ea5n th\u01b0\u01a1ng, b\u1ea1i li\u1ec7t\u2026<\/p>\n

      – Ng\u1ed9 \u0111\u1ed9c, chuy\u1ec3n h\u00f3a (ng\u1ed9 \u0111\u1ed9c CO, methemoglobine), thi\u1ebfu m\u00e1u n\u1eb7ng\u2026<\/p>\n

      3. Nguy\u00ean nh\u00e2n suy h\u00f4 h\u1ea5p \u1edf tr\u1ebb s\u01a1 sinh<\/p>\n

        \n
      • B\u1ec7nh m\u00e0ng trong, h\u1ed9i ch\u1ee9ng h\u00edt, vi\u00eam ph\u1ed5i trong t\u1eed cung, ch\u1eadm ti\u00eau d\u1ecbch ph\u1ed5i, t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/li>\n
      • Ngo\u00e0i ph\u1ed5i:<\/li>\n<\/ul>\n

        + D\u1ecb t\u1eadt: d\u1ecb d\u1ea1ng l\u1ed3ng ng\u1ef1c, tim b\u1ea9m sinh, tho\u00e1t v\u1ecb c\u01a1 ho\u00e0nh<\/p>\n

        + R\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a: h\u1ea1 \u0111\u01b0\u1eddng m\u00e1u, h\u1ea1 th\u00e2n nhi\u1ec7t, toan m\u00e1u<\/p>\n

        + B\u1ec7nh h\u1ec7 th\u1ea7n kinh: xu\u1ea5t huy\u1ebft trong s\u1ecd, vi\u00eam m\u00e0ng n\u00e3o, ng\u1ed9 \u0111\u1ed9c morphin\u2026<\/p>\n

        3. L\u00e2m s\u00e0ng suy h\u00f4 h\u1ea5p c\u1ea5p<\/strong><\/h2>\n

        Suy h\u00f4 h\u1ea5p bi\u1ec3u l\u00e2m s\u00e0ng b\u1edfi kh\u00f3 th\u1edf, m\u1ec7t m\u00f5i, ki\u1ec7t s\u1ee9c, t\u00edm t\u00e1i, k\u00e8m theo c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a nguy\u00ean nh\u00e2n g\u00e2y suy h\u00f4 h\u1ea5p. C\u00e1c d\u1ea5u hi\u1ec7u ch\u00ednh y\u1ebfu l\u00e0:<\/p>\n

        – Th\u1edf nhanh: t\u00f9y theo l\u1ee9a tu\u1ed5i.<\/p>\n

        D\u01b0\u1edbi 2 th\u00e1ng tu\u1ed5i khi nh\u1ecbp th\u1edf 60 l\u1ea7n\/ph\u00fat.<\/p>\n

        T\u1eeb 2 th\u00e1ng \u0111\u1ebfn 12 th\u00e1ng khi nh\u1ecbp th\u1edf 50 l\u1ea7n\/ ph\u00fat.<\/p>\n

        T\u1eeb 12 th\u00e1ng \u0111\u1ebfn 5 tu\u1ed5i khi nh\u1ecbp th\u1edf 40 l\u1ea7n\/ph\u00fat.<\/p>\n

        Tr\u00ean 5 tu\u1ed5i khi nh\u1ecbp th\u1edf > 30 l\u1ea7n\/ph\u00fat.<\/p>\n

        – Co l\u00f5m ng\u1ef1c: co l\u00f5m c\u00e1c c\u01a1 li\u00ean s\u01b0\u1eddn, tr\u00ean d\u01b0\u1edbi \u1ee9c, h\u1ed1 th\u01b0\u1ee3ng \u0111\u00f2n. D\u1ea5u hi\u1ec7u co l\u00f5m ng\u1ef1c k\u00e8m theo c\u00e1nh m\u0169i ph\u1eadp ph\u1ed3ng: d\u1ea5u hi\u1ec7u ch\u1ed1ng ng\u1ea1t.<\/p>\n

        – Th\u01b0\u1eddng g\u1eb7p c\u00e1c ki\u1ec3u kh\u00f3 th\u1edf:<\/p>\n

        + Th\u1edf nhanh \u2013 n\u00f4ng \u2013 \u0111\u1ec1u.<\/p>\n

        + Th\u1edf ch\u1eadm \u2013 s\u00e2u \u2013 \u0111\u1ec1u.<\/p>\n

        + Th\u1edf nhanh \u2013 s\u00e2u \u2013 \u0111\u1ec1u.<\/p>\n

        + R\u1ed1i lo\u1ea1n nh\u1ecbp th\u1edf.<\/p>\n

        – D\u1ea5u hi\u1ec7u ch\u1ed1ng ng\u1ea1t: t\u0103ng nh\u1ecbp th\u1edf, co k\u00e9o c\u00e1c c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5, c\u00e1nh m\u0169i ph\u1eadp ph\u1ed3ng.<\/p>\n

        – T\u00edm t\u00e1i: t\u00f9y theo m\u1ee9c \u0111\u1ed9 SHH, t\u00edm t\u00e1i k\u00edn \u0111\u00e1o ho\u1eb7c xu\u1ea5t hi\u1ec7n r\u00f5. T\u00edm t\u00e1i khi Methemoglobin > 5 g%.<\/p>\n

        + T\u00edm t\u00e1i k\u00edn \u0111\u00e1o: t\u00edm t\u00e1i xu\u1ea5t hi\u1ec7n khi g\u1eafng s\u1ee9c. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p t\u00edm t\u00e1i xu\u1ea5t hi\u1ec7n mu\u1ed9n nh\u01b0: tr\u1ebb thi\u1ebfu m\u00e1u, tr\u1ebb s\u01a1 sinh.<\/p>\n

        + T\u00edm t\u00e1i \u0111\u01b0\u1ee3c xem nh\u01b0 l\u00e0 t\u00edm c\u1ea3 ngo\u1ea1i bi\u00ean v\u00e0 trung \u01b0\u01a1ng.<\/p>\n

        + T\u00edm t\u00e1i ngo\u1ea1i bi\u00ean (hay \u0111\u1ea7u chi) khi mao m\u1ea1ch m\u00f3ng tay v\u00e0 \u0111\u1ea7u chi xanh xao nh\u01b0ng ni\u00eam m\u1ea1c v\u00e0 l\u01b0\u1ee1i c\u00f2n h\u1ed3ng.<\/p>\n

        + T\u00edm t\u00e1i trung \u01b0\u01a1ng: t\u00edm t\u00e1i c\u1ea3 \u0111\u1ea7u chi, ni\u00eam m\u1ea1c, l\u01b0\u1ee1i.<\/p>\n

        4. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h2>\n

        – C\u00f4ng th\u1ee9c m\u00e1u.<\/p>\n

        – \u0110\u01b0\u1eddng huy\u1ebft<\/p>\n

        – SaO2<\/sub> < 90%.<\/p>\n

        – Kh\u00ed trong m\u00e1u:tr\u1ebb em, PaO2 <\/sub>\u00a0b\u00ecnh th\u01b0\u1eddng 90 \u00b1 5 mmHg, gi\u1edbi h\u1ea1n d\u01b0\u1edbi l\u00e0 80 mmHg. Tr\u1ebb s\u01a1 sinh do HbF chi\u1ebfm \u0111a s\u1ed1, m\u1ee9c gi\u1edbi h\u1ea1n cho ph\u00e9p t\u1eeb 40 \u2013 70 mmHg.<\/p>\n

        – \u0110o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p.<\/p>\n

        – M\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m h\u1ed7 tr\u1ee3 kh\u00e1c nh\u01b0: Hct, pH m\u00e1u, Ion \u0111\u1ed3\u2026<\/p>\n

        – X quang ng\u1ef1c: c\u00e1c t\u1ed5n th\u01b0\u01a1ng t\u1ea1i ph\u1ed5i, m\u00e0ng ph\u1ed5i, trung th\u1ea5t..<\/p>\n

        – CT ng\u1ef1c.<\/p>\n

        5. Ph\u00e2n \u0111\u1ed9 suy h\u00f4 h\u1ea5p<\/strong><\/h2>\n

        5.1. Tr\u1ebb s\u01a1 sinh<\/em><\/strong>: ch\u1ec9 s\u1ed1 Silverman<\/p>\n\n\n\n\n\n\n\n
        Di \u0111\u1ed9ng ng\u1ef1c b\u1ee5ng<\/td>\n0 (Nh\u1eb9)<\/td>\n1<\/td>\n2 (n\u1eb7ng)<\/td>\n<\/tr>\n
        Co k\u00e9o li\u00ean s\u01b0\u1eddn<\/td>\nC\u00f9ng chi\u1ec1u<\/td>\nNg\u1ef1c < b\u1ee5ng<\/td>\nNg\u01b0\u1ee3c chi\u1ec1u<\/td>\n<\/tr>\n
        L\u00f5m m\u0169i \u1ee9c<\/td>\n0<\/td>\n+<\/td>\n++<\/td>\n<\/tr>\n
        C\u00e1nh m\u0169i ph\u1eadp ph\u1ed3ng<\/td>\n0<\/td>\n+<\/td>\n++<\/td>\n<\/tr>\n
        Ti\u1ebfng r\u00ean<\/td>\n0<\/td>\n+<\/td>\n++<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        K\u1ebft qu\u1ea3: < 3: b\u00ecnh th\u01b0\u1eddng, t\u1eeb 3 \u2013 5: SHH nh\u1eb9, > 5: SHH n\u1eb7ng.<\/p>\n

        5.2.Tr\u1ebb l\u1edbn<\/em><\/strong>: chia l\u00e0m 3 \u0111\u1ed9<\/p>\n

        Tri\u1ec7u ch\u1ee9ng<\/p>\n\n\n\n\n\n\n\n\n\n
        <\/td>\n\u0110\u1ed9 1<\/td>\n\u0110\u1ed9 2<\/td>\n\u0110\u1ed9 3<\/td>\n<\/tr>\n
        Tri gi\u00e1c<\/em><\/strong><\/td>\nT\u1ec9nh<\/td>\nB\u1ee9t r\u1ee9t, l\u1eabn l\u1ed9n<\/td>\nL\u01a1 m\u01a1, h\u00f4n m\u00ea<\/td>\n<\/tr>\n
        H\u00f4 h\u1ea5p<\/em><\/strong><\/td>\nNh\u1ecbp th\u1edf t\u0103ng <30%\u00a0 b\u00ecnh th\u01b0\u1eddng<\/td>\nNh\u1ecbp th\u1edf t\u0103ng 30-50%\u00a0 b\u00ecnh th\u01b0\u1eddng, co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5<\/td>\nNh\u1ecbp th\u1edf t\u0103ng >50%\u00a0 b\u00ecnh th\u01b0\u1eddng, ch\u1eadm, kh\u00f4ng \u0111\u1ec1u, ng\u01b0ng th\u1edf<\/td>\n<\/tr>\n
        Nh\u1ecbp tim<\/em><\/strong><\/td>\nB\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng nh\u1eb9<\/p>\n

        Huy\u1ebft \u00e1p t\u0103ng<\/td>\n

        		\n
          \n
        • T\u0103ng<\/li>\n<\/ul>\n

          – huy\u1ebft \u00e1p t\u0103ng<\/td>\n

        		Nhanh ho\u1eb7c ch\u1eadm<\/p>\n

        – Huy\u1ebft \u00e1p t\u0103ng ho\u1eb7c c\u00f3 th\u1ec3 gi\u1ea3m<\/td>\n<\/tr>\n

        PaO2<\/sub><\/em><\/strong><\/td>\n60- 80mmHg<\/td>\n40- 60 mmHg<\/td>\n< 40 mmHg<\/td>\n<\/tr>\n
        <\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
        <\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

         <\/p>\n

        5.3. Ph\u00e2n lo\u1ea1i SHH theo v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu<\/em><\/strong><\/p>\n

        – SHH do nguy\u00ean nh\u00e2n t\u1ea1i ph\u1ed5i<\/p>\n

        + Do r\u1ed1i lo\u1ea1n khu\u1ebfch t\u00e1n.<\/p>\n

        + Do shunt trong ph\u1ed5i.<\/p>\n

        + Do r\u1ed1i lo\u1ea1n ph\u00e2n b\u1ed1.<\/p>\n

        – SHH do nguy\u00ean nh\u00e2n ngo\u00e0i ph\u1ed5i<\/p>\n

        + T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh trung \u01b0\u01a1ng.<\/p>\n

        + T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh t\u1ee7y.<\/p>\n

        + T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh ngo\u1ea1i bi\u00ean.<\/p>\n

        + Do t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh \u2013 c\u01a1.<\/p>\n

        + Do t\u1eafc kh\u00ed \u0111\u1ea1o.<\/p>\n

        5.4. Ph\u00e2n lo\u1ea1i theo kh\u00ed trong m\u00e1u<\/em><\/strong><\/p>\n

        – Suy h\u00f4 h\u1ea5p m\u1ed9t ph\u1ea7n: \u00a0PaO2 <\/sub>d\u01b0\u1edbi 60 mmHg, SaO2 <\/sub>< 96%.<\/p>\n

        – Suy h\u00f4 h\u1ea5p to\u00e0n ph\u1ea7n: \u00a0PaO2 <\/sub>d\u01b0\u1edbi 60 mmHg, PaCO2 <\/sub>tr\u00ean 49 mmHg.<\/p>\n

         <\/p>\n

        T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/strong><\/p>\n

          \n
        1. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb nhi khoa (2009) \u201cSuy h\u00f4 h\u1ea5p c\u1ea5p\u201d .B\u1ec7nh vi\u1ec7n Nhi \u0111\u1ed3ng 1 Tp H\u1ed3 Ch\u00ed Minh, Nh\u00e0 xu\u1ea5t b\u1ea3n Y h\u1ecdc, tr. 39 \u2013 44.<\/li>\n
        2. V\u00f5 C\u00f4ng \u0110\u1ed3ng ( 1997) \u201c R\u1ed1i lo\u1ea1n trao \u0111\u1ed5i kh\u00ed trong suy h\u00f4 h\u1ea5p\u201d. Nhi khoa sau \u0111\u1ea1i h\u1ecdc t\u1eadp 3, Nh\u00e0 xu\u1ea5t b\u1ea3n \u0110\u00e0 N\u1eb5ng, tr. 746 \u2013 758.<\/li>\n<\/ol>\n

           <\/p>\n","protected":false},"excerpt":{"rendered":"

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H\u1eadu qu\u1ea3 c\u1ee7a suy h\u00f4 h\u1ea5p l\u00e0 thi\u1ebfu oxy cho nhu c\u1ea7u bi\u1ebfn d\u01b0\u1ee1ng c\u1ee7a c\u00e1c c\u01a1 quan, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u00e3o, […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[3],"yoast_head":"\nL\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n suy h\u00f4 h\u1ea5p tr\u1ebb em - Vinmec<\/title>\n<meta name=\"description\" content=\"Suy h\u00f4 h\u1ea5p (SHH) l\u00e0 t\u00ecnh tr\u1ea1ng b\u1ed9 m\u00e1y h\u00f4 h\u1ea5p kh\u00f4ng \u0111\u1ee7 kh\u1ea3 n\u0103ng duy tr\u00ec s\u1ef1 trao \u0111\u1ed5i kh\u00ed theo nhu c\u1ea7u c\u01a1 th\u1ec3, g\u00e2y gi\u1ea3m O2 v\u00e0\/ho\u1eb7c t\u0103ng CO2 m\u00e1u.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"L\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n suy h\u00f4 h\u1ea5p tr\u1ebb em - 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