Chapter 2756

The operation of the built-in floating catheter is very simple. Zheng Ren wears sterile gloves and completes the operation within 1 minute.

A floating catheter was implanted into the right internal jugular vein. At this time, the measured cardiac output was 6.1l/min and SvO2 was 51%.

The anesthesiologist picked up the pen and paper to start the calculation. Zheng Ren said in a deep voice, "don't worry. The systemic circulation resistance is 760 / CM5."

"..." the anesthesiologist and Zhao Yunlong were stunned. Not only them, but also su Yun was stunned.

The cardiac displacement measured by floating catheter can only be calculated by more complex formula to obtain the systemic circulation resistance. Boss Zheng calculated it by heart?

Let's hang up. Su Yun was 5 or 6 seconds late, and the figure was the same. He said something silently in his heart.

"Boss Zheng, is your heart rate so low?" Zhao Yunlong asked.

"Ready to open your chest." Zheng Rendao, "it is estimated that there is something wrong with the myocardium."

Myocardium... This judgment is far from pericardial tamponade. Zhao Yunlong can also think of the truth, but it is rare after all.

"Boss Zheng, is the blood filled with pericardium seeping into the myocardium?" Director Zhang Lin asked.

"Think about it. Just open it and have a look." Zheng Ren glanced and asked, "is the Iraqi coming?"

"Boss Zheng, Xiao Xie has gone to get your surgical equipment. It will arrive soon." The itinerant nurse said, "she just contacted me."

Zheng Ren nodded. He began to hold his arm and look at the image data of the patient's last echocardiography.

Su Yun and Zhao Yunlong put the patient in a good position and began to brush their hands for disinfection. Xie Yi also came with the instrument box in the sterile package.

"Lao Zhao." Zheng Ren suddenly said in a deep voice.

"Hmm? Boss Zheng." Zhao Yunlong signaled that he heard it.

"Call the ICU and prepare the isolation room." Zheng Rendao.

Isolation room? Zhao Yunlong was stunned for a moment, but did not ask why. He had finished brushing his hands, so he asked the anesthesiologist's assistant to call. He put his head out and contacted the ICU about the isolation room.

"Do you want to do delayed chest closure?" Su Yun frowned and asked, "is it so serious?"

"It is considered that it may be caused by more severe myocardial injury after IABP." Zheng Ren turned to brush his hands and expressed his views on the patient.

Director Lang was stunned when he heard what boss Zheng said. After IABP, the myocardial injury was more serious... Is this talking about his own mistake?

He was a little angry and confused.

If someone says so in Nanshan City, it must be throwing the pot, but this is 912, it shouldn't. Director Zhang Lin was very friendly. She came from home in the middle of the night and waited for herself in the office.

Even this is not enough. Director Zhang Lin also contacted Nobel laureate boss Zheng for thoracotomy.

People are Nobel laureates. Is it necessary to throw a pot to themselves? There's no need, okay. In his opinion, it is a big thing. In his opinion, it should be just an ordinary case.

However, IABP is of great benefit to patients with myocardial ischemia in clinical practice. Director Lang launched this technology ten years ago. It can be said that there are countless living people.

During diastolic period, balloon inflation, aortic diastolic pressure and coronary artery pressure increased, which increased myocardial blood and oxygen supply; Before cardiac contraction, balloon exhaust, aortic pressure, cardiac afterload, cardiac ejection resistance and myocardial oxygen consumption decreased.

IABP can effectively increase myocardial blood supply and reduce oxygen consumption, so that patients with coronary heart disease benefit the most.

Why did boss Zheng say it was IABP's pot? And what is he going to do? Delayed chest closure? Is the patient bleeding back to the ward with his chest open?

Is boss Zheng not afraid of postoperative infection? Seriously, Professor Su just said that he didn't know what the operation was, but it just sounded unreliable.

Director Lang's thoughts intertwined and collided with each other, and he was stunned. By this time, the operation had begun.

The surgical instrument box full of metal texture is so boring, and the cooperation between instrument nurses and operators is exquisite, even without language communication.

Under the shadowless lamp, no one spoke, only tacit cooperation.

Even there is no eye contact between the operator, assistant and instrument nurse. It seems that this kind of operation needs to be done every day. We have no interest in communication at all.

Director Lang gathered behind boss Zheng and saw that the sternum saw opened the sternum and the pericardium was exposed.

"It's not pericardial tamponade." Su Yun said, "echocardiography is no problem."

"Yes." Zheng Ren said the first sentence at this time, only one word.

When the pericardial wall was lifted and the pericardium was cut open, the attractor was inserted. Director Lang carefully observed the pipeline of the attractor, and only a small amount of blood was drawn out.

It's not pericardial tamponade, but why is the patient's myocardial pulsation so weak, and the blood pressure still can't rise under the action of norepinephrine and dopamine? Director Lang was puzzled.

As the pericardium was cut open by a delicate small scissors, a swollen heart appeared in the operation field. The heart showed overall dilation and swelling like changes, and the left ventricular activity was poor.

"Ho!" Su Yun said in surprise, "are they swollen like this?"

Zheng Ren did not speak, but continued to look. It was soon found that the single spear drainage hose for pericardiocentesis pierced into the surface of the left ventricle of the heart, local rupture, and new bleeding was still seen on the surface of the heart wound.

Sure enough, it was his own pot. There was a secondary injury in pericardiocentesis... When director Lang saw this scene, his hands and feet were numb and cold.

Can it be said that it is the pericardiocentesis that leads to the damage of left ventricular myocardium, which leads to similar symptoms?

I can't. he defended himself in his heart. This is an instinctive reaction of human self-defense, just seeking advantages and avoiding disadvantages, which is the same for anyone.

Why do you want to do pericardiocentesis? It's not because the symptoms of chest tightness and chest pain have not been relieved after the stent.

Director Lang defends weakly in his heart, while under the shadowless lamp, Zheng Ren has cut off his pericardium with scissors and used 3 × 3cm autologous pericardial patch was sutured continuously along the periphery of the wound, and the damaged part of the puncture point on the surface of the heart was repaired to stop bleeding.

"Boss Zheng, I'm late." Lao he came in wearing a mask belt.

"Oh, it's not late." Zheng Ren said, "the operation is almost finished."

"...." Lao he was stunned. Is it not too late? Boss Zheng doesn't usually talk like that. While saying it was not too late, he told himself that the operation was almost finished

"Prepare for transesophageal ultrasound." Zheng Rendao.

"OK." Lao he didn't have time to think about it. He began to get busy immediately.

"Zheng... Boss Zheng, what are you going to do?" Director Lang stammered and whispered.

"I can't close my chest. Let's have a B-ultrasound." Zheng Ren said, his hands gently closing his chest.

The chest was not completely closed, but with Zheng Ren's hand, the sternum wanted to gather together, and the alarm of the monitor rang wildly.