Chapter 2962

Because he was in the system operating room, Zheng Ren was not particularly impatient. This is the incomparable advantage of others. Zheng Ren is used to it. He silently watched the state of the experimental body go from bad to worse and began to measure various values.

The laboratory data showed that the subjects had symptoms of metabolic acidosis and acute renal failure.

Zheng Ren knows that there may be gas embolism during the use of ECMO. It is estimated that the gas embolism tied the renal artery, resulting in the failure of the operation before it was completed.

Just find out. Zheng Ren is in a stable mood. The significance of systematic operating room is here. Find the problem in advance and study what to do to avoid this situation as far as possible.

When it was determined that there was a problem with the kidney, Zheng Ren ended the operation of lung transplantation, but did not leave the system operating room. Instead, he made a nephrography for the experimental body.

The final conclusion proves Zheng Ren's judgment - gas embolism.

After placement of ECMO, liver and kidney function should be improved because ECMO can improve the perfusion of peripheral organs.

Looking for similar materials in journals, there are few relevant materials. Zheng Ren can only judge by relying on limited materials and his own imagination.

The deterioration of renal function may be a sign of failure of ECMO or suggest that the patient has renal disease before. Zheng Ren tried several methods, then discussed with Lao he, and finally decided to take continuous renal replacement therapy as a pipeline independent of ECMO system to avoid air embolism.

The cause of persistent metabolic acidosis may be insufficient perfusion of any organ, tissue necrosis, or distal limb infarction. Oxygenator failure can be characterized by massive hemolysis. The difference between hematuria, disseminated intravascular coagulation and hemolysis requires emergency diagnosis and examination, continuous intraoperative measurement and timely treatment.

One problem after another was solved. Zheng Ren pulled Lao he tirelessly to study.

When confirming and solving problems, Zheng Ren found that in addition to the failure caused by renal gas embolism, there was a 15% possibility of acute liver failure when using ECMO.

Because Xiaoshi has just completed two liver cancer Interventional Embolization, the liver function is relatively poor. Liver failure is also a top priority for surgery. Zheng Ren doesn't want to show his skills and complete liver transplantation at the same time as lung transplantation.

An organ transplant is afraid that small stones can't stand it, let alone more organs.

Finally, he and Lao he decided to measure liver function every 10 minutes during the operation. If the small stone still progresses to the continuous increase of bilirubin or acute increase of liver enzymes when ECMO flow and blood pressure are appropriate, a molecular adsorbent recycling system must be used for liver dialysis.

"Lao he, do we have liver dialysis during operation?" Zheng Ren asked.

"No, only Xiehe and DIDU have courage." Lao he said, "we don't have as much liver surgery as they do. In addition, this situation is not common, so the equipment hasn't entered for the time being."

Zheng Ren did not hesitate to call Zhou Chunyong.

Borrow a piece of equipment and return it. Bao Longtao, the president of the capital, is not going to embarrass himself because of this.

Lao he was very helpless. In his opinion, even if there was a problem with liver function, it would be too late to do it again. But boss Zheng made a gesture that he must make the operation perfect, so he didn't say much.

After nearly 10 hours of discussion and brainstorming, Lao he has been completely squeezed out by boss Zheng.

Looking at boss Zheng's energetic operation training on the operating table, Lao he held 12 A4 paper records in his hand and slowly closed his eyes.

Anesthesia, ECMO and cardiopulmonary bypass alone have so many details to pay attention to. What about surgery? It is estimated that there are more points to pay attention to.

"Lao he, do you want to drink some red bull?" Ringer's voice came.

"Ah? Lin Chu, why are you here?" Lao he was stunned for a moment. What time is it? Why... Why do you need to ask? Lin Chu is also preparing to stay in the community hospital for a period of time and do a good job in logistics.

In the age of Director Mao, the science and education department was almost transparent to the clinic. It basically did nothing serious except for taking cards for refresher doctors. Filled with a stale smell, clinicians frown when it comes to science and education.

Lin Chu's job is his duty, but Lao he is still not used to it.

He wanted to say hello to ringer, but his eyelids seemed to stand together. It took a lot of effort to open them.

"No, just go back to sleep." Ringer advised, "I think you're wasting too much energy. It's estimated that you'll be wasted tonight. It's no use boiling here, but it's inefficient. It's not a day. I think boss Zheng means it's a marathon."

"Alas, boss Zheng is still young, in good health and energetic." Lao he glanced at Zheng Ren, who stood silent under the shadowless lamp, sighed and said, "my old arms and legs are really bad."

"What did you discuss just now?"

"Boss Zheng took me through the anesthesia work of the operation from beginning to end." Lao he said, "the model of intubation, the depth of intubation, the frequency of ventilator, tidal volume, end expiratory pressure... Then there are various matters needing attention during ECMO, as well as the dialysis preparation of kidney and liver."

"Usually..."

"Lin Chu, how demanding boss Zheng is." Lao he said, "the liver and gallbladder have applied for several times and want to enter the intraoperative liver dialysis equipment, but they haven't come in yet. Boss Zheng manages the emperor's liver and gallbladder to borrow the equipment to ensure everything is safe."

"I heard it. I just wanted to ask you, is it meaningful to borrow this thing?" Ringer asked in a low voice.

"Of course, it makes sense. Once bilirubin rises during operation, it is much better to go to liver dialysis immediately than symptomatic treatment after operation." Lao he said, "but that's the meaning... If it's someone else, it's estimated to deal with it like this. The operation won't take long. It's better to go back and do dialysis during the operation. Moreover, there are not many people who know that there are not many renal dialysis during the operation, which is a very cutting-edge treatment."

"Look at what you said." Ringer smiled.

"Lin Chu, I'm not kidding." Lao he said seriously, "if you don't believe it, ask the clinician that dialysis is kidney. There are really not many people who know liver dialysis during operation."

Ringer nodded, and he raised the event level again.

Boss Zheng must care about what he cares about. There's nothing to say. For a possible problem, I don't hesitate to go to the imperial capital to borrow equipment. It's useless to say how much effort boss Zheng spent.

If it weren't for the age difference between boss Zheng and the little patient, ringer even thought the little patient was the illegitimate son of boss Zheng. If it weren't for his son, who would be willing to make such efforts and brush his face to prepare for surgery and treatment.

Treat patients like relatives. Director Yan will say it every time at the weekly meeting of the hospital. But there are not many doctors who can treat patients like relatives.

Boss Zheng... Even ringer thinks he has gone too far.