Chapter 2960

"Boss, anesthesia is a big problem." Su Yun said, "the cardiopulmonary bypass group can only find Lao he to do it first. We can't occupy a group for so long."

"Well, it's hard at that time. Lao he has to watch back and forth. If there is any problem between ECMO and cardiopulmonary bypass, Lao he has to watch." Zheng Ren knows what Su Yun means.

"Yes, because Lao he can't stare, do you want to call big Chu and small Chu?" Su Yun asked.

"Is home convenient?"

"If you say you can, I'll ask again, or big Chu and small Chu will come. If you say no, it's so embarrassing."

"Come on, I'll talk to Director Xu. After all, we have to do surgical training for about one week. It's hard to find other people in the anesthesia department to accompany us all the time." Zheng Ren nodded and settled the matter.

Lin Yuan and Gu Xiaoran are rubbing hands. As long as people who have worked in the clinic for a period of time know, this operation is bound to go down in history.

Autologous stem cell cloning, 3D printing and lung transplantation are bound to write a great deal in the history of medicine, and may become an invisible hand to turn the pages of modern medical history.

Wait for Yi and Lao he to go to the community hospital to prepare for operation training.

The last time I had such exaggerated preoperative training was when I performed heart conjoined infant separation in the women's and children's hospital.

On the whole, the operation is less difficult than separating the conjoined heart, but Zheng Ren is still ready to go all out without leaving any spare force.

Even did not hesitate to gather the whole class of the medical group again.

Watching Su Yun bring Gu Xiaoran and Lin Yuan to move the 3D printing simulator to the operating table in the classroom for preoperative preparation, Zheng Ren took the opportunity to come to the system space and click to buy the operation training time.

With the rise of the system operating room, Zheng Ren prayed silently in his heart, and then drilled in.

Fortunately, as imagined, 3D printed cloned lung tissue is placed in the operating room, so you don't have to pay a high price to buy it in the system mall.

Zheng Ren expressed great satisfaction with this.

Surgery starts with anesthesia. Zheng Ren didn't throw this piece to Lao he. After all, 3D printed simulants are essentially different from real people.

Zheng Ren began to try anesthesia and ECMO.

First, give the experimental mask to absorb pure oxygen, with a volume fraction of 100%, and monitor ECG and blood oxygen saturation. Then Zheng Renxing punctured and catheterized the right radial artery to monitor the invasive blood pressure and analyze the blood gas.

Anesthesia was induced by midazolam 1 ~ 2 mg and etomidate 0.2 ~ O.4 mg / kg. Sufentanil 0.2 ~ o.4mg/kg and atracurium CIS benzenesulfonate 0.15 ~ O.3 mg / kg.

After entering the muscle relaxation state, start endotracheal intubation and connect a ventilator to assist breathing.

Propofol 0.03 ~ 0.05 nag · kg was injected intravenously to maintain anesthesia. 1 · min, vecuronium 1 ~ 2ug / kg / · min. And indirect intravenous fentanyl was injected to maintain anesthesia.

Zheng Ren observed the state of the experimental body for a period of time and did blood gas analysis intermittently.

The blood gas value is not stable, because the ventilation mode adopts pressure control, so Zheng Ren adjusts the ventilation parameters according to the blood gas analysis indexes and vital signs, and decides to perform manual ventilation when necessary.

After anesthesia induction, the right femoral artery and vein were intubated. The femoral artery was intubated to the level of common iliac artery with 15 ~ 17 fr catheter; 19 ~ 21 fr catheter was used in femoral vein and intubated to the level of inferior vena cava. All heparin coated membrane lung and pipeline, thermostat, centrifugal pump head and oxygenator are selected. After the catheter is placed, the diversion begins.

The maximum flow of ECMO is usually determined by intubation. Each cannula has its own special flow pressure curve. The larger the intubation, the higher the flow. For example, arterial cannula No. 17 can only achieve a flow rate of 4 to 5 L per minute, while cannula No. 21 can achieve a flow rate of 6 L per minute without causing additional pressure on the tube wall.

Considering the age of Xiaoshi, Zheng Ren tried many times and finally chose the most appropriate intubation.

The initial flow rate was 50% of the intermittent cardiac output and remained above 30% during bypass. The rotational speed and flow rate were adjusted according to oxygenation and cardiac function.

Zheng Ren didn't buy an assistant to help him operate. This time, he just groped for experience. Although there is a lot of time left for surgical training, Zheng Ren is not ready to "waste".

In this operation, Zheng Ren does not think that 3D printed cloned lung tissue can be perfectly competent. If there is any abnormality, he is ready to take Su Yun away, and then "hide the truth" and replace the 3D printed lung tissue brought by Su Yun's familiar laboratory with the lung tissue in the system space.

It's risky, but Zheng Ren has made the worst preparation for the success of the operation.

The lung tissue that can be taken out for real transplantation can only be exchanged with hundreds of thousands of experience values, which is more expensive than that used in the system space before.

Come on a little. I hope the lung tissue provided by Su Yun can be more reliable.

When the operation began, Zheng Ren found an abnormality.

Before the ECMO flow decreased, he observed the phenomenon of "pipe tremor".

This is because when the intravascular volume is at a low level, the negative pressure in the ECMO pipeline causes the venous cannula to hit the venous wall.

Continuous tremor may cause ECMO alarm or "wall suction to flow decrease". Zheng Ren found that the tremor amplitude can be relieved quickly after reducing ECMO flow; Then he solved this problem by slowly increasing ECMO flow while expanding capacity.

Normally, pipeline tremor is not uncommon in the use of ECMO. I think Lao he should have encountered it many times. However, Zheng Ren is still very careful to solve the pipeline tremor a little. He knows how to expand the capacity and how much dose to avoid pipeline tremor.

Just a detail, it's a waste of 30 hours of surgical training time.

The operation is bigger and bigger, and the operation training time is consumed more and more. Fortunately, there are 3D printing simulators available for training. Otherwise, if you buy an assistant in the system operating room, it is estimated that you can't train a series of times.

However, Zheng Ren is pleased that the 3D printing cloned lung tissue brought by Su Yun is quite good. After the operation, the system even gives 88% of the operation completion.

This degree of completion is relatively low in Zheng Ren's operations, but Zheng Ren has proved that there is no essential difference between 3D printed tissue and tissue purchased in system space.

As long as it's all right, Zheng Ren doesn't want to change into lung tissue and organs like living people.

A laryngoscope, a blade, these are small things, no matter how to explain. Even if Su Yun or others have doubts, they will think Zheng Ren is OCD. It's just a coincidence.

But a lung

Reselling human organs? In that case, as long as it is noticed, the consequences will be unimaginable.

Cloned lungs should work. This is the best news Zheng Ren got.

After 62 hours of surgical training, Zheng Ren felt that his level was really good. Organ transplantation expertise, although the pig hoof did not give an explanation, Zheng Ren is convinced that this specialization skill has played a great role.