Chapter 1791： Treatment disagreement

The operation of moyamoya disease was successfully completed, but Zheng Ren noticed that the electrocardiogram monitoring of the experimental body began to fluctuate drastically at the moment of leaving, and the heart rate instantly reached 120...130......150......180......

Before I did what Zheng Ren did, the heart rate of the experimental body fell like a cliff and returned to zero.

Without opening the chest, chest compressions were performed under direct vision, and the system prompted the death of the experimental body.

Uh……

Zheng Ren looked at the experimental body without words, but there was no loss, but there was a hint of excitement.

Although the experimental body died, the system space told him in this way that the extracorporeal membrane lung should be applied first, and then the machine that pushes the extracorporeal membrane lung to the operating room for surgery. Alternatively, the patient can be pushed to the operating room for extracorporeal membrane lungs.

Although troublesome, this is the only viable option.

This also explains why the system provides 50% of the degree of surgical completion for moyamoya bypass surgery.

Just find the reason! Improvements can be made in subsequent operations.

Zheng Ren immediately started the next operation.

First, begin to give the experimental body the extracorporeal membrane lung.

There are two ways of transfusion in the extracorporeal membrane lung to meet the needs of different conditions.

V-V is diverted, and the venous blood is taken out through the oxygenator to remove oxygen dioxide and then pumped into another vein.

This approach accommodates patients with pulmonary failure. The V-V bypass method is a lung replacement method and is commonly used in patients with impaired heart function and pulmonary failure.

Respiratory medicine is more commonly used in some patients with acute respiratory distress syndrome, acute respiratory failure caused by acute lung injury and other patients with respiratory failure. It mainly uses ECMO's membrane lung system to provide adequate oxygenation for patients. Get time for recovery of respiratory function.

V-A is diverted, and the venous blood is taken out through the oxygenator to remove the carbon dioxide and then pumped into the artery.

This approach is a common alternative to cardiopulmonary bypass, heart failure and cardiopulmonary failure.

If the patient may have a long-term cardiac pump dysfunction or the heart stops beating, the AA-v pathway can be used, that is, the two cannulas are separately drawn from the left and right atrium, oxygenated by the oxygenator, and the carbon dioxide is removed and pumped into the artery. .

This method can ensure adequate blood flow support, prevent cardiopulmonary thrombosis and prevent pulmonary edema.

If the patient is awake, apply a muscle relaxant such as guancuronium bromide or chlorosuccinylcholine before intubation, intravenous morphine, and local lidocaine.

However, in the operating room of the system, the experimental body itself was in an anesthesia state, and Zheng Ren saved this step.

After heparin was given 100 u/kg, the arteriovenous catheter was performed in the neck.

Zheng Ren's choice of intubation is not very thick, can provide 2-3L / min flow can be. Cut open and look straight into the cannula. The cannula is not deep, and is inclined at a certain angle to avoid collapse and spurt of the vertical cannula pressure.

After inserting it, confirm it under the X-ray. After the cannula is sutured, fix the tube.

Connecting the machine, Zheng Ren began to do the operation of moyamoya disease again.

The operation was very smooth, this is the 14th training.

Zeiss's microscope is still very good. Zheng Ren did not have dizziness and other symptoms like the surgical training of the last suture of the intestine.

The degree of surgery is 98%!

Zheng Ren finally breathed a sigh of relief, it should be!

But he didn't go back right away. He has spent so much surgery training time. Why not make the surgery perfect?

Eight additional surgical trainings were performed, with a 1% increase in completion, reaching 99%. The operation time was shortened by about 30%, and Zheng Ren was satisfied with the result.

The next step is to convince the patient's family to perform the operation.

If the patient's family is financially difficult, they can choose to have a live surgery.

Zheng Ren settled everything and calmly left the system space and returned to the EICU ward.

"Zheng Boss, please have a consultation at the hospital." Zhao Yunlong suggested on the side, "Nervous surgery to take a look, if you feel that there is a problem, let them set a treatment plan."

"Good." Zheng Ren nodded.

Organizing a hospital consultation is also a normal procedure. This is not a hospital opened by her own family. Zheng Ren can't do as he wants in the operating room of the system.

In fact, you can't say that you are doing what you want, and you can reason outside. However, the big pig's hooves never reasoned with Zheng Ren, and the task of enacting is also random, not according to the severity of the illness.

Perhaps in the system judgment, the patients in front of the eye belong to the kind of extremely difficult to treat, and there is no need to issue a task at all.

"Xiao Zhao." Just saying, Professor Zhang came in.

"Professor Zhang." Zhao Yunlong still answered with respect.

"The patient's family refused to grab..." Professor Zhang glanced at the patient and saw that the IABP had already entered, and could not help but stunned.

Is the speed so fast?

When was Zhao Yunlong doing something so arrogant? Well, it’s usually very good, but it’s too fast under this IABP.

Professor Zhang immediately glanced at the ward. When he saw Zheng Ren, he immediately understood what happened.

"Refused to rescue?" Zheng Ren's brow wrinkled.

"Yeah." Professor Zhang nodded and said: "I have communicated with the patient's family. I hope that it is not big, the cost is still too big, and the family can't afford it. I decided to give up."

His impression of Zheng Ren is still good.

Although the last time the card squid, mediastinal abscess surgery, Professor Zhang is more or less lost face, but medical treatment is like this, people can do the surgery, that is the ability.

As long as there are a few people in your heart, you have to admit it.

Professor Zhang has no objection to this.

Young people are young people, and it’s really a **** one to rescue them. Professor Zhang looked at Zheng Ren, Su Yun and Zhao Yunlong and thought of it.

When I am young, isn’t it the same? It has changed since now, and for yourself, this is just a job.

Not because of a patient who can't be saved, he is competing with himself.

Everyone in the ward was silent about it.

Professor Zhang feels that the atmosphere is wrong. He said that the family members of the patients agreed to give up the rescue. Shouldn’t everyone be relieved?

How is the atmosphere so depressed?

"Professor Zhang is like this." Zheng Rendao: "The patient's situation is quite special, but I think it can still be rescued."

“Can you?” Professor Zhang said strangely.

The IABP is on, but the patient's heart rate is still not stable, and the load on the heart is still too large to be maintained.

According to experience, patients will soon have heart failure.

With the technical strength of 912, I can hang my breath and continue to rescue. This can also be done.

But does this make sense?

Professor Zhang is somewhat angry.

Young people, in order to show their skills, take the life of the patient as a sacrifice, do you do this!

He glared at Zheng Ren and said coldly: "Zheng boss, you tell me what the patient is."