Chapter 1998

"High caffeine intake is associated with a range of mental problems, from anxiety and bad mood to mania and psychotic attacks. In addition, excessive intake of energy drinks may also induce some physical problems, including acute renal failure."

"Well, it's nice to talk like that." Su Yun nodded.

"Why?" Zheng Renqi is strange.

"If you want to say 116 case reports and what kind of things, it's still too pretend. They are all their own people. It's better to speak simply." Su Yun spouted.

"Too lazy to say." Zheng renpingdan said: "however, there are only three reports of mental symptoms and acute renal failure caused by functional drinks + coffee in the world, respectively in the UK..."

Zheng Ren didn't know if he was inspired by Su Yun and immediately began to discuss it in detail.

Zhou Litao listened silently, and the whole person was silly. The detailed data provided by boss Zheng is on the one hand, but more importantly, functional drinks + coffee can lead to renal failure.

"So serious." Zhou Litao whispered.

"Well, of course." Zheng Rendao: "I told the nephrologist that the diagnosis of tubulointerstitial nephritis caused by toxin; the patient has elevated creatine kinase, which may be caused by physical restraint, psychomotor agitation and impaired renal clearance."

"Are there any test results to support it?" Lin Yuan asked.

"Now we are doing puncture biopsy and a series of related examinations. So far... By the way, you haven't seen the emergency renal function checked by the emergency department." Zheng Ren remembered, "creatinine 1205 μ Mol / L, urea nitrogen 22 μ mol/L。”

"Acute renal failure is so serious?" Su Yun frowned.

The normal value of creatinine ranges from 59 to 104 μ Mol / L, the normal reference range of urea nitrogen is 2.9-6.4 μ mol/L。

These two values of patients are several times or even ten times higher, which is consistent with the performance of acute renal failure.

"I guess blood gas analysis... There should be acidosis. If President Zhou is interested, he can consult the nephrologist when the examination results come back." Zheng Ren already knew it and said it with certainty.

Zhou Litao and Lin Yuan wrote this down silently.

I don't doubt boss Zheng. He dares to say so carefully, as if he had seen the test sheet with his own eyes. There must be his reason.

"By the way, how many functional drinks did the patient drink?" Zheng Ren asked.

"Hurry up and guess where this thing is." Su Yun said contemptuously, "I don't believe you can guess before you go to the kidney to meet Lao Cui."

"It is said that from last night to the onset of the disease, I drank 12 bottles of functional drinks and more than 20 packs of coffee." Zheng Rendao.

Zheng Ren is unwilling to drink the medicine given by the system often because he is afraid of being provoked by this kind of medicine.

"Tut Tut, what's this like?" Su Yun then looked at Zhou Litao.

Zhou Litao's back is hairy because he often drinks coffee with him.

"President Zhou, you should be careful."

"Ah..."

"My boss and I certainly won't drink such refreshing things." Su Yun said with a smile, "caffeine poisoning overlaps with anxiety disorders at the physiological and psychological levels. It often occurs when the daily intake of caffeine exceeds 1000 mg. Severe caffeine poisoning can lead to death. At this time, the concentration of caffeine in blood can be ≥ 70 mg / L."

Zhou Litao sighed and said, "don't worry, Brother Yun. I'll get up in the morning and have a cup of coffee. I won't drink any more."

"Caffeine stage symptoms will also appear after a cup of coffee is used to it." Su Yun threatens and intimidates Zhou Litao with a smile.

"Don't listen to him. A cup of coffee contains very little caffeine." Zheng Ren didn't want Zhou Litao to leave a psychological shadow. He immediately said, "only about 10.2% of patients will have mild withdrawal symptoms. It's okay."

Zhou Litao was shocked. 10.2% is also possible! The slightest withdrawal symptoms are also withdrawal symptoms.

"Boss, you are so boring." Su Yun said contemptuously, "just now I saw that the freckles on President Zhou's face were black. Didn't you find them?"

Zheng Ren didn't understand his evil taste and ignored Su Yun. He just smiled at Zhou Litao, "President Zhou, let's go first."

"Boss Zheng won't talk much?" Zhou Litao asked.

"No, I'm a little tired after the operation." Zheng Ren's smile was a little stiff.

Eh? Is boss Zheng tired like an iron man? Didn't you say that boss Zheng had surgery for three days and nights in Pengxi Township?

But anyway, boss Zheng made it clear that he was tired and Zhou Litao was not easy to stay, although he had a lot to say to Su Yun.

After all, wechat is not very convenient. Zhou Litao is more used to looking into each other's eyes and talking like asking for medical history.

Leaving the emergency department, Lin Yuan asked strangely, "boss Zheng, are you sick?"

"No." Zheng Ren said expressionless.

"His father-in-law is coming back. He's depressed. You'd better not provoke him." Su Yun smiled and told the truth.

For this reason... Is the relationship between boss Zheng and Xie Yi's family so bad? Lin Yuan said he didn't understand.

……

……

President Lin is presiding over the emergency consultation in the operating room.

A male patient had an accident.

A few months ago, he was diagnosed as acute lymphoblastic leukemia after examination of tumor in DIDU. Before the second course of chemotherapy, professional nurses performed central venous catheter placement under local anesthesia.

The catheter is a three-way valve peripherally inserted central venous catheter (PICC) made in the United States, 4f, with a length of 60cm.

PICC was placed through the left median vein and delivered to the superior vena cava. 44cm was left in vivo, the rest was left in vitro, and 5 cm was cut off. The position was confirmed by routine X-ray film after operation.

There were no catheter blockage, difficult blood pumping, infection, phlebitis and other problems during and between PICC treatment.

However, it was supposed to be the fifth chemotherapy. Today, when the patient was admitted to the hospital, the nurse found that there was only a connector under the film of the patient's left forearm, but there was no external part of the PICC catheter. It was considered that the catheter had been removed into the body.

As for when it fell off and the specific situation at that time, the patient did not know.

The patient had a triple sign of pulmonary embolism of chest pain, hemoptysis and dyspnea in recent 1 week.

Emergency X-ray examination showed that the tip of PICC catheter had reached the right pulmonary artery and the end was left to the inner side of shoulder joint in the left subclavian vein. Confirm that the PICC catheter falls off into the body and inform the patient and family members immediately.

That's not enough. This patient needs emergency surgery!

The cancer hospital has no internal circulation department and belongs to a specialized hospital.

Although PICC tube falling off is rare, it has also happened. The Department urgently reported it to the medical department, which reported it to President Lin when contacting the circulation specialized hospital.

The intervention of PICC pipeline was completed through this technical means several times before.

Therefore, a set of expert team of circulatory interventional surgery was invited from the nearest circulatory specialized hospital to open the stage urgently.

……

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Note 1: I drink 3 packs of coffee every day. When I write this paragraph, I feel I have difficulty breathing