Zheng Ren felt the patient's heart.
The heart muscle was constantly beating irregularly, as if it was making a final struggle. But all its efforts were in vain.
Even heart compressions under direct vision can only provide a little momentum to the weak heart.
Looking up, Zheng Ren narrowed his eyes and looked at the electrocardiogram on the electrocardiogram monitor.
3 or more premature ventricular contractions occur continuously!
The shape of the qrs wave group is abnormal, the time limit exceeds 0.12s, and the direction of the st-t wave is opposite to the main wave direction of the qrs wave group!
The ventricular rate exceeds 220 beats/min and the heart rhythm is irregular!
The independent activity of the atrium has no fixed relationship with the qrs wave complex, forming ventricular-atrial separation. Occasionally, individual or all ventricular activations may reversely propagate to the atria!
What a deal! Zheng Ren cursed in his heart.
He was angry.
No one delayed the rescue, and all procedures were the fastest, but the best opportunity was still not available.
"Magnesium sulfate, 2g intravenously!" Zheng Ren shouted in a deep voice.
The nurse is running, and Su Yun and Zhao Yunlong are giving the patient extracorporeal membrane lung.
2g of magnesium sulfate was pushed in and Zheng Ren observed it for 10 seconds. The effect was not good.
"Isopropanol, 1 mg, intravenously!"
"Isopropanol, 1 mg, intravenously!"
"Isopropanol, 1 mg, intravenously!"
Even Su Yun was a little panicked due to the continuous injection of isopropyl kidney.
Isoproterenol was once the drug of choice for the treatment of ventricular arrhythmias, but it is rarely used now because excessive dosage can lead to ventricular fibrillation.
Is the boss crazy
But there was no problem. The chest was opened in the ward and heart compressions were performed under direct vision. I was not afraid of ventricular fibrillation at all... I shouldn't be afraid.
Su Yun was a little hesitant.
He had never experienced such a large-dose intravenous rescue of isoproterenol.
The key lies in the placement time of the extracorporeal membrane lung.
The sooner extracorporeal membrane lung is used, the greater the patient’s hope of survival.
"Isopropyl kidney, 1 mg, intravenous injection!" Zheng Ren continued to give medical orders, pinching the patient's heart to maintain the last beat.
He could feel the weak beating of the patient's heart.
If it weren't for my own hands holding it, I'm afraid it would have stopped beating.
After pushing the isopropyl kidney for the sixth time, Zheng Ren finally heard the voice he wanted to hear most. The extracorporeal membrane lung machine was started, and Su Yun had already inserted an ECMO arterial and venous cannula from the femoral artery and vein, and the ECMO assisted circulation.
On the electrocardiogram, the ventricular tachycardia was slightly relieved under the action of large doses of isopyrax and magnesium sulfate.
"Su Yun, prepare for chest electric defibrillation!" Zheng Ren said.
"Okay." Su Yun didn't have time to take a breath before he started looking for electrodes and called Zheng Ren directly.
Two electrodes are placed on the front and back walls of the patient's heart.
"Boss, how old are you?" Su Yun asked.
Su Yun means how much energy. Generally speaking, intrathoracic defibrillation starts from 10j and slowly increases to 30j.
However, repeated defibrillation will consume a large amount of ATP, causing the patient's condition to be unstable after resuscitation. Even after a short period of sinus rhythm, the patient will soon experience cardiac arrest again.
Because last time in Sweden, Zheng Ren used extreme energy to resuscitate Dr. Mehar's heart, which left a deep impression on Su Yun. He asked directly without thinking.
"22j!" Zheng Ren paused and then said.
After Professor Zhang heard it later, he immediately said: "10j! It can't be too big, and the energy must be gradually increased!"
Su Yun didn't even look at him. He completely regarded him as air. He adjusted his energy to 22j and glanced at Zheng Ren.
Looking at each other, Su Yun pressed the button.
There was a soft sound, and the harsh cry from the heart monitor stopped.
Heart rate returns to sinus!
"I'll go..." Su Yun let out a long breath.
Professor Zhang was dumbfounded. Everything in front of him was beyond his cognitive scope.
Zheng Ren calmed down a little and said, "Tell the operating room and push the patient up directly."
"Don't wait?" Su Yun asked.
"We can't wait. If heparinization occurs again, cerebral hemorrhage may occur at any time." Zheng Ren said.
"Okay." Su Yun took off his sterile gloves and took out the phone.
"Boss, let's open the two stations together. We need to sew the chest wall." Su Yun said.
"Uh... Santai, ask Fu Gui'er and Lao Liu to come right away." Zheng Ren said, "I'm on extracorporeal membrane lung. He may bleed at any time. I need an arteriogram."
"..." Su Yun finally couldn't help but cursed in his heart.
Opening all three stations at the same time... The boss really dares to think about it.
But who makes him the boss? He has a big mouth and gets whatever he says. Su Yun cursed in his heart and started calling people.
Zheng Ren performed compression on the chest to stop the bleeding. He observed the patient's electrocardiogram and saw that the sinus condition had returned. He was relieved.
But there was only time to breathe a sigh of relief.
The chest is open, not to mention infection, just a pneumothorax is unbearable.
Everyone was busy as they took the time to send the patient to the operating room.
Soon, with beds, ventilators, ECG monitoring, and extracorporeal membrane lung machines, a bunch of people left the ward and headed to the operating room.
Professor Zhang stood alone in the empty ward, minding his own business.
What just happened
The chest is opened at the bedside, the heart is compressed under direct vision, a bunch of isopropyl kidneys are pushed in, and 22j of energy is directly applied to the chest for electric defibrillation...
These are things that Professor Zhang knows, but does not dare to do easily.
Nothing will happen
Professor Zhang still wonders if he is dreaming.
Can the patient be saved? What did Boss Zheng say in the end? It seems like three stations are open in a row.
Does he want to perform bypass treatment for moyamoya disease on the head, disinfect and suture the chest, and perform interventional imaging at the same time
This is not courageous, this is simply audacious.
It is important to know that the patient has heart failure and has continuous ventricular arrhythmias with the support of iabp.
Three operations are performed at the same time. Can the patient withstand such a big blow
Professor Zhang didn’t believe it.
Although he hoped that the patient could survive, Boss Zheng's approach went against the medical common sense he was familiar with.
Impossible, absolutely impossible!
After a few minutes, Professor Zhang thought about it several times in his mind and felt that there was no such possibility at all and the patient would definitely die.
He hesitated for a moment, but finally decided to go up and see what was going on.
In his heart, he had no intention of seeing Boss Zheng make a fool of himself. After all, he and Zhao Yunlong did it in the coronary artery bypass surgery room, and now he and Boss Zheng are like grasshoppers on the same rope.
It's true... young people know how to cause trouble!
How about giving up treatment and taking the person away from home
There are too many people in the world who cannot be cured, and three stations are opened in succession... When he thought of this, Professor Zhang's heart sank.
It's terrible, absolutely terrible.
You must follow them, otherwise they will not know how to write disease course records and operation records after the operation.
Don't blame your mistakes on yourself.
After working for decades, Professor Zhang had seen too many such dark things, and he knew that he would definitely not be able to leave.
With a sigh, Professor Zhang turned around and walked out of EICU, preparing to go on stage to take a look.