The operation for moyamoya disease was successfully completed, but the moment Zheng Ren was about to leave, he noticed that the ECG monitoring of the experimental subject began to fluctuate violently, and the heart rate instantly reached 120... 130... 150... 180...
Before Zheng Ren could do anything, the subject's heart rate dropped like a cliff and returned to zero.
There was no chest opening, intrathoracic heart compression was performed under direct vision, and the system prompted the subject to die.
Well…
Zheng Ren looked at the experimental subject speechlessly, not disappointed, but a little excited.
Although the experimental subject died, the system space told him in this way that he should first put on the extracorporeal membrane lung, and then push the extracorporeal membrane lung machine to the operating room for surgery. Alternatively, the patient can be wheeled to the operating room for extracorporeal membrane lung.
Although troublesome, this is the only feasible way.
This also explains why the system gave Moyamoya disease bypass surgery a surgical completion rate of 50%.
Just find the reason! Improvements can be made during subsequent surgeries.
Zheng Ren immediately started the next operation.
First, the experimental subject was given extracorporeal membrane lung.
Extracorporeal membrane lung has two bypass modes to meet the needs of different conditions.
vv diversion, the venous blood is drawn out through the vein, oxygenated by the oxygenator, and carbon dioxide is removed, and then pumped into another vein.
This method is suitable for patients with pulmonary failure. The vv bypass method is a lung replacement method and is often used in patients with acceptable heart function and lung failure.
It is commonly used in the respiratory department and can be used for extracorporeal support for patients with acute respiratory distress syndrome, acute respiratory failure caused by acute lung injury, and other respiratory failure. It mainly uses the ecmo membrane lung system to provide adequate oxygenation for patients. Buy time for respiratory system function to recover.
VA diversion, the venous blood is drawn out through the veins, oxygenated by the oxygenator and carbon dioxide is removed, and then pumped into the arteries.
This method is a combined cardiopulmonary replacement method, which is commonly used in heart failure and cardiopulmonary failure.
If the patient may suffer from long-term heart pumping insufficiency, or the heart stops beating, the aa-v pathway can be used, that is, two cannulas are led from the left and right atrium respectively, oxygenated by the oxygenator, and carbon dioxide is removed before pumping into the artery. .
This method can not only ensure adequate blood flow auxiliary support, but also prevent thrombosis in the heart and lungs and prevent the occurrence of pulmonary edema.
If the patient is awake, use muscle relaxants such as pancuronium bromide or chlorosuccinylcholine, intravenous morphine, and topical lidocaine before intubation.
But in the system operating room, the experimental subject itself was under general anesthesia, so Zheng Ren skipped this step.
After administration of 100 u/kg heparin, cervical arterial and venous cannulation was performed.
The intubation tube Zheng Ren chose was not very thick and could provide a flow rate of 2-3l/min. Cut open and look directly at the cannula. The intubation is not deep and tilted at a certain angle to avoid collapse and blood spurting due to excessive vertical intubation pressure.
After insertion, it should be confirmed under X-ray. After the intubation is sutured, the pipeline should be fixed.
After connecting to the machine, Zheng Ren began to perform surgery for moyamoya disease again.
The operation went well and this was the 14th training session.
The Zeiss microscope is still very good, and Zheng Ren did not suffer from dizziness or other symptoms like the last surgical training for suturing the intestines.
The surgery completion rate is 98%!
Zheng Ren finally breathed a sigh of relief, it should be done!
But he didn't go back right away. He had already spent so much time training for surgery, so why not make the surgery perfect
Eight more surgical training sessions were conducted, and the completion rate increased by 1% to 99%. The operation time was shortened by about 30%, and Zheng Ren was quite satisfied with the result.
The next step is to convince the patient’s family to undergo surgery.
If the patient's family members have financial difficulties, they can choose to live broadcast the surgery.
Zheng Ren settled everything, calmly left the system space and returned to the EICU ward.
"Boss Zheng, please invite the whole hospital for a consultation." Zhao Yunlong suggested on the side, "The neurosurgery department will take a look. If you feel there is a problem, let them formulate a treatment plan."
"Okay." Zheng Ren nodded.
Organizing a hospital-wide consultation is also a normal procedure. This is not a hospital run by his own family. Zheng Ren cannot do whatever he wants like in a system operating room.
In fact, it cannot be said that you can do whatever you want and be reasonable outside. But Big Pig Hoof never reasoned with Zheng Ren, and the assignment of tasks was random, not based on the severity of the illness.
Perhaps in the system's judgment, the patient in front of him is extremely difficult to treat, and there may be no need to issue a task at all.
"Xiao Zhao." Just as he was talking, Professor Zhang walked in.
"Professor Zhang." Zhao Yunlong still replied respectfully.
"The patient's family refused to grab it..." Professor Zhang glanced at the patient and was startled when he saw that the iabp had already been inserted.
Is it that fast
When did Zhao Yunlong become so efficient in doing things? Well, it's usually pretty quick, but this iabp is too fast.
Professor Zhang then took a look inside the ward. When he saw Zheng Ren, he immediately understood what was happening.
"Refuse to rescue?" Zheng Ren frowned.
"Yes." Professor Zhang nodded and said: "I communicated with the patient's family. There was not much hope, the cost was still high, and the family could not afford it, so I decided to give up."
His impression of Zheng Ren was pretty good.
Although Professor Zhang was more or less disgraced during his last operation on a stuck fish bone and a mediastinal abscess, medical treatment is like this. If someone can perform the operation successfully, that is his skill.
Anyone who knows something has to admit this.
Professor Zhang has no objection to this.
Young people are young people, and they are really passionate about rescue. Professor Zhang looked at Zheng Ren, Su Yun and Zhao Yunlong and thought to himself.
Wasn't it the same when I was young? But now it has changed. For me, this is just a job.
Don't compete with yourself because of a patient who cannot be saved.
Everyone in the ward fell silent in unison.
Professor Zhang felt that the atmosphere was not right. He said that the patient’s family members agreed to give up the rescue. Shouldn’t everyone breathe a sigh of relief
Why is the atmosphere so depressing
"Professor Zhang, that's it." Zheng Ren said: "The patient's situation is quite special, but I think it can still be rescued."
"Can it still be done?" Professor Zhang said in surprise.
IABP was administered, but the patient's heart rate was still not stable, and the load on the heart was still too great to sustain.
Judging from experience, the patient will soon experience heart failure.
With the technical power of 912, we can do this even if we keep calm and continue rescuing people.
But does this make sense
Professor Zhang was a little angry.
Young people, in order to show off their skills, use the lives of patients as sacrifices, is there such a thing
He glared at Zheng Ren and said coldly: "Boss Zheng, please tell me about the patient's condition."