Chapter 1789

"What if there is no signature from the patient's family?" Su Yun asked.

"Find director Lin." Zheng Rendao.

"Well, the work of the medical department is for clinical escort." Su Yun said contemptuously, "but it doesn't include you!"

"Emergency first aid, is there any other way?" Zheng Ren said, "ask Zhao Yunlong if he has finished signing. After a long time of work, it is estimated that he should be able to sign this time."

"How do you know?"

"It takes a day to do a head MRI, let alone IABP." Zheng Ren said: "the state is not very good. Let's give a critical notice. If the patient is choking enough, he can come back."

"...." Su Yun frowned, "are you sure?"

Zheng Ren sighed and looked at the patient's red blood dripping system panel, which was helpless.

"May also need the support of extracorporeal membrane lung. Will you do it?"

"No problem." Su Yun said with certainty.

ECMO is an extracorporeal circulation technology out of the heart operating room.

The principle is that the venous blood in the body is led out of the body, oxygenated by a special artificial cardiopulmonary bypass and injected into the patient's artery or venous system, which plays a role of partial cardiopulmonary replacement and maintains the oxygenated blood supply of human organs and tissues.

There is no ECMO in Haicheng first hospital. Zheng Ren saw it for the first time after graduation from Dr. mehar.

Zheng Ren smiled bitterly and shook his head. "Did you see it?"

"The diagnosis of moyamoya disease is very clear." Su Yun said: "if the upper body outer membrane lung, a large amount of heparin will enter the circulatory system. Do you think it will aggravate moyamoya disease and lead to intracerebral hemorrhage?"

"Well, it's very possible." What Zheng Ren said was quite polite. Just entering the system operating room, he tried to operate the extracorporeal membrane lung.

But less than two hours later, the patient died of intracerebral hemorrhage.

This is a dilemma.

The contradiction between heparin anticoagulation and bleeding, hemolysis and poor histocompatibility of biomaterials. The road of exploration is long. On this road, there are countless dead people, but there are countless living people.

Su Yun's lower body adventitia lung, technically speaking, has no problem.

But when Zheng Ren judged that a large amount of heparin would lead to intracerebral hemorrhage, Su Yun hesitated. Using extracorporeal membrane lung, regardless of the cost, is technically very difficult.

"Neurosurgery?" Su Yun asked.

"Find ringer first, now!" Zheng Ren said, "the operation was performed under cardiac arrest. The blood is heparinized. It is likely that it has been... Why hasn't Zhao Yunlong come back?"

"I'll call to hurry up." Su yundao.

"Look, I'll take a look." Zheng Ren packed up IABP, took a look at the patient's vital signs, opened the door and strode into the corridor of EICU.

Zhao Yunlong walked back quickly with an A4 paper.

"Lao Zhao, I'm looking for you." Zheng Ren waved.

"Go back and finish IABP. I'm worried about cardiac arrest." Zhao Yunlong said in a hurry.

"It's done." Zheng Rendao.

"Done...?" Zhao Yunlong said in surprise, then lowered his voice and hurried to Zheng Ren. "Boss Zheng, what did you just do?"

"Well, it's a heart attack. You can't do it without it. Now it's a little relieved, but it's not much relieved." Zheng Ren said: "I consider using extracorporeal membrane lung support for a period of time, but there is a contraindication."

"Moyamoya disease? Can you diagnose it?" Zhao Yunlong made a mistake.

"Yes." Zheng Ren said, "how did you explain to the patient's family before you opened your chest?"

"At the beginning, the patient was sent to the operating room for surgery under the condition of extrathoracic heart compression." Zhao Yunlong said: "I later explained to the patient's family before cardiopulmonary bypass. I suspected moyamoya disease again. Heparinization of blood is likely to lead to intracerebral hemorrhage."

"What does the family say?" Zheng Ren is most concerned about this issue.

If family members cooperate, patients have at least 30% to half of the probability that they can be rescued.

But if the patient's family doesn't cooperate

It's better to give up the rescue directly. In that case, medical disputes and contradictions will be much less.

On the extracorporeal membrane lung, it's hard to say whether the patient will die or live. However, for the families of hesitant patients, the cost during hospitalization has risen sharply.

But without extracorporeal membrane lung, the patient will die. The only difference is that he can live a few more hours.

The heart is so tired that Zheng Ren doesn't want to face this situation.

But life is like this. It's impossible to let yourself do whatever you want as in the system operating room.

"The patient is a second marriage, and her current husband said he would give up treatment." Zhao Yunlong said, "but her daughter just came here, insisted on treatment, and signed happily."

As soon as Zheng Ren's heart sank, it rose again.

What a complex family environment. No wonder at first, even MRI had to wait a day to do.

Zhao Yunlong has taken a great risk to operate and survive.

"I'll have a look." Zheng Rendao.

"Boss Zheng, Professor Zhang is communicating with the patient's family outside." Zhao Yunlong said, "wait a minute."

"Communicate what?" Zheng Ren heard a trace of bad meaning in Zhao Yunlong's tone.

"To be honest, it is unlikely that the patient will live again." Zhao Yunlong said dejectedly.

No one can expect patients to live more than the chief surgeon and bed doctor. This expectation is very complex and difficult to say in a word.

Zheng Ren also knows that after Professor Zhang's explanation, the family members will probably give up treatment, and the patient is dead.

As long as the patient's family members give up rescue, withdraw IABP and wait for the next rapid ventricular beat and heart failure, the patient will die.

He sighed deeply.

"Is it an economic problem?" Zheng Ren asked.

"Well, the family is not very well-off." Zhao Yunlong said, "migrant workers have never paid their social security in their hometown."

"If I..." Zheng Ren said half and stopped.

Zhao Yunlong helplessly patted Zheng Ren on the shoulder. Without saying anything, he walked back to the ward in silence.

Live emergency rescue, upper body adventitia lung?

The success rate is a key factor in the live broadcast of Xinglin garden.

The patients themselves have various problems. What can they do with extracorporeal membrane lung? Moyamoya disease, because of heparinization of blood in the body, rupture and bleeding of a small aneurysm, the patient has to die.

For mature business operations, this is completely untenable.

The reputation accumulated by Zheng Ren all the way will also be fatally damaged by the death of the patient.

But... Zheng Ren is not thinking about the outer membrane lung of the upper body, but the surgical treatment of moyamoya disease.

Block the bleeding position first, and other things will be easier to solve.

Zheng Ren judged that if there was extracorporeal membrane lung support and bypass surgery was ok, the patient still had the probability to survive.