Chapter 2971

"Not for the time being. Wait a minute." Zheng Ren has cut off his right lung and put it into the pathological basin. At this time, Lao he was holding the report in his hand and Hui reported, "the blood sample 10 minutes ago had a total bilirubin of 876 μ Mol / L, blood gas... "

He only said the items with problems and did not involve other items. It was simple and clear.

Liver damage is so serious?! Dr. Charles was stunned.

The liver function is seriously damaged and the renal function is OK. If Dr. Charles stands on the operating table, he must have intraoperative liver dialysis at the moment. As for the machine, Mayo Clinic has nothing, how can it put together a mottled dialysis machine.

Look at that machine, the parts of at least four manufacturers are pieced together, like a beggar.

But Dr. Charles did not ridicule and ridicule. He was more surprised.

Dr. Zheng is like an experienced captain who has drifted on the sea for decades. With clues, he judges that a storm is coming.

Before that, he had led his assistants to drive the broken ship and escape from the place with the greatest wind and waves.

It's unimaginable. Dr. Charles recalled it again, but he could only sigh. If he had been on the operating table, he would not have expected acute liver failure in advance.

The previous unreasonable treatment has also become clear, although Dr. Charles still doesn't understand how Zheng "predicted" that the patient will have acute liver failure.

Is it because of the blow of interventional surgery? Dr. Charles was quietly looking for possibilities.

"40mg heparin, 5000ML normal saline, pre flushing pipeline and plasma perfusion device, blood flow rate 75ml / min and replacement fluid rate 25ml / min." Zheng Ren commanded in a deep voice.

ICU's doctor began to operate the machine for bilirubin adsorption.

At the same time, Zheng Ren excised the whole cardiopulmonary tissue under the condition of semi inflated lung and put it into the pathological basin. After receiving the 3D printed lung tissue stored in perferdex solution handed by Xie, we began to take an ice bath.

Then, the 3D printed right lower lobe was placed in the chest and anastomosed in the order of trachea artery atrial sleeve.

"Rehydration, 500ml normal saline." Zheng Ren said, "dopamine, you can give it now."

Lao he immediately opened the micro pump already prepared, and the drugs immediately entered the body along the blood vessels.

"The ECMO flow was adjusted so that the mean pulmonary artery pressure was less than 40 mmHg."

"The blood flow rate of liver dialysis was accelerated, 100ml / min."

"Methylprednisolone 500mg impact."

After the doctor's orders were issued, the auxiliary doctors constantly adjusted the values of ECMO, liver dialysis instrument, micro pump and ventilator.

At the same time, Zheng Ren placed the lower lobe of the right donor lung in the right chest, continuously sutured the bronchial membrane with 4-0 absorbable monofilament suture, and intermittently sutured the cartilage with 4-0 Vicryl suture.

Suturing is done under a microscope, simple and straightforward. It seems that on-the-spot command and operation operate synchronously in the brain without interfering with each other.

Even if Dr. Charles once stood at the peak of surgery, he only stood at the peak of technique, and would never pay attention to the whole process of surgery and everyone's every detail.

It's not that the details are useless, but that he... Can't do it.

Dr. Charles would not be surprised at how delicate Zheng Ren's anastomosis was under a microscope. He just regrets that the passage of years not only takes away youth and vitality, but also stability and delicacy. He can't do what he used to do now.

However, while operating, he controls all the details on the operating table, including ventilator, micro pump, ECMO and liver dialysis, which is simply beyond human reach.

In the consternation of Dr. Charles, Zheng Ren clamped the proximal side of the right pulmonary artery, trimmed the blood vessel as appropriate to match the diameter of the donor pulmonary artery, and then sutured the pulmonary artery continuously with 5-0 Prolene suture.

His hands are steady and slow.

Then, a vascular clamp was clamped on the left atrium near the pulmonary vein, the ligation line of the residual end of the pulmonary vein was removed, and the openings of the upper and lower pulmonary veins were connected to form a left atrial sleeve of appropriate size, which was continuously sutured with the atrial sleeve on the right pulmonary vein of the 3D printed lung donor with 4-0 Prolene thread.

After the anastomosis, Zheng Ren covered all anastomotic stomas with 3D printed greater omentum, and performed the anastomosis patiently and carefully.

This... The lung transplantation on one side is finished!

Dr. Charles looked at the time in surprise. The cold ischemia time of the right lung was 58 minutes!

When I saw the operation, I didn't feel anything, but the moment the cold numbers appeared in my mind, Dr. Charles knew the difference.

This is the fastest lung transplant he has ever seen. It doesn't matter how fast the operation is done. The key is that the operator doesn't devote himself to the operation. He is still the soul of the whole field and controls all medical activities including the operation.

Is this the peak level after the peak? He has exceeded his understandable hand feeling and controlled the whole audience without any omission.

This is the real king in the operating room!

"Shh ~" Su Yun sighed and glanced at the values of the monitor and ECMO.

"Boss, there seems to be no problem." Su Yun said, "did the operation succeed?"

"Only half. Concentrate." Zheng Ren glanced at the values and began to give the doctor's order again.

"By adjusting ECMO flow, the mean pulmonary artery pressure increased by 5mmhg."

"The blood flow rate of liver dialysis was accelerated, 110ml / min."

"Methylprednisolone 500mg impact."

"The rate of dopamine and m-hydroxylamine decreases..."

In the song of good luck, the voice of Zheng Ren's medical advice became cheerful.

"Right lung ventilation, manual lung inflation." Zheng Ren said softly.

Lao he responded and began to adjust the position of the trachea, changing to single lung mode and right lung ventilation. As he began to pinch the ball, the gas entered the fresh lungs. The lungs bulged like balloons, and the sound of beeping could be heard faintly.

It's not noise, it's the sonata of life!

"Yes, next." Su Yun said with a little excitement.

"Don't worry, warm salt water." Zheng Rendao.

The chest cavity was filled with warm saline. Lao he held the ball to control the expansion of lung tissue. Finally, Zheng Ren reinforced the greater omentum at the anastomotic site of the main trachea, which completed the unilateral operation.

Then Zheng Ren withdrew the Swan Ganz catheter to the common pulmonary artery and placed it in the right pulmonary artery to start the left lung transplantation.

For Dr. Charles, the operation has actually been completed.

There are differences in the operation process between the left lung and the right lung, but for the operator with 58 minutes of cold ischemia on the right side, we can't doubt whether he can complete the operation.

In the operating room, under Haoyunlai's BGM, the sound of various machines running slightly sounded, as if they were playing an accompaniment to Haoyunlai.

Bright and clean.