Chapter 2965 Treat the enemy as family
Since they were in the operating theater, Zheng Ren was not particularly anxious. This was an advantage that no one else had, and Zheng Ren was already used to it. He silently watched as the condition of the experimentals deteriorated and began to measure various values.
The test results showed that the test subjects had symptoms of metabolic sourness and acute kidney failure.
Zheng Ren knew that there might be air embolism during the use of ECMO. It was estimated that the gas embolism had sealed the kidney artery had caused the surgery to fail before it was even completed.
It’s good that you found out. Zheng Ren’s emotions were calm. This was the significance of the system’s operating theater. It was to discover the problem in advance and study how to avoid this situation as much as possible.
After confirming that there was a problem with the kidney, Zheng Ren ended the lung transplant surgery. However, he did not leave the operating theater. Instead, he performed a kidney angiography for the experimental body.
The final conclusion proved Zheng Ren’s judgment on air embolism.
After the placement of the ECMO, liver and kidney function should be improved because ECMO could improve the perfusion of peripheral organs.
There was very little relevant information in the journal, so Zheng Ren could only make a judgment based on the limited information and his own imagination.
The deterioration of kidney function could be a sign of ECMO’s failure, or it could be a hint that the patient had a kidney disease before. Zheng Ren tried a few methods and discussed it with Mr. He. In the end, they decided to use continuous kidney replacement therapy as a separate tube from the ECMO system to avoid a gas block.
The cause of chronic metabolic sourness might be insufficient infusion of any organ, tissue necrosis, or remote limb blockage. The failure of an oxygen clutch could be seen as large amounts of hemolysis. The difference between hemorrhaging, diffused endocardium coagulation, and hemolysis was that they needed to be diagnosed and examined in an emergency. The values were constantly measured during the operation, and timely treatment was very important.
One by one, the problems were solved. Zheng Ren pulled old he along to study them tirelessly.
Every time he verified and solved a problem, Zheng Ren found that in addition to the failure caused by gas embolism in the kidney, there was a 15% chance of acute liver failure when using ECMO.
Since little stone had just completed two interventional heart surgery for liver cancer, his liver function was relatively poor. Liver failure was also the most important thing for surgery. Zheng Ren did not want to show off his hand skills and complete the liver transplant at the same time as the lung transplant.
Little stone might not even be able to handle one organ transplant, let alone more.
In the end, he decided with old he that liver function would be measured every ten minutes during the surgery. If little stone still progressed to a continuous increase in levels of Ruby or an acute increase in liver enzymes under the condition that the ECMO flow and blood pressure were appropriate, he would need to use a molecular ago-type shifter, a circulatory system, to perform liver dialysis.
“Old he, do we have any intraoperative liver dialysis?” Zheng Ren asked.
“No, only Peking Union Medical College Hospital and Beijing’s Hepatobiliary and Pancreatic Surgery have it in the capital.” Old he said,”we don’t perform as many liver surgeries as they do. Besides, this kind of situation is not common, so we haven’t brought in any equipment for the time being.”
Zheng Ren did not hesitate and gave Zhou chunyong a call.
He wanted to borrow a piece of equipment so that he could return it easily. President Bao longtao, the president of the hospital of Hepatobiliary and Pancreatic Surgery in Beijing, would not make things difficult for him over such a small matter.
Old he felt particularly helpless. In his opinion, even if there was a problem with his liver function, it would still be in time to get him treated again. However, since boss Zheng was determined to perform the surgery perfectly, he did not say anything.
After nearly 10 hours of discussion and brainstorms, old he had been completely squeezed dry by boss Zheng.
Seeing boss Zheng go to the operating table to do surgery training in high spirits, old he held the record on 12 A4 papers in his hand and slowly closed his eyes.
There were already so many details to pay attention to in anesthesia, ECMO, and cardiopulmonary bypa.s.s. What about surgery? There were probably more things to pay attention to.
“Old he, do you want to drink some Red Bull?” Lin GE’s voice came.
“Ah? Chief Lin, what are you doing here?” Old he was taken aback. What time was it already? why did Lin Ge … Was there a need to ask? chief Lin was also preparing to stay in the community Hospital for a while to do the logistics work.
The science and education Division was almost transparent to clinical medicine during Division Chief Mao’s time. They basically did nothing serious other than giving in-service training doctors what they needed to eat and take care of. It was filled with a stale smell, and when it came to science and education, the clinicians would frown.
This was part of his job, but old he was still not used to it.
He wanted to say h.e.l.lo to Lin Ge, but their eyelids seemed to be standing together, and it took him a lot of effort to open them.
“If you can ‘t, go back and sleep.” Lin Ge advised,”I see that you’ve used up too much of your mental energy. I think you’ll be crippled tonight.” There was no point in staying here, and the efficiency would be low. It’s not like it happened in a day. From what I see, boss Zheng is saying that this is a marathon. “
“Sigh, boss Zheng is still young, healthy, and full of energy.” Old he glanced at Zheng Ren, who was silently performing the surgery under the shadowless lamp. He sighed and said,”my old arms and legs are really not going to make it.”
“What were you guys discussing just now?”
“Boss Zheng brought me through the anesthesia for the surgery from start to finish.” Old he said,”the type of tube, the depth of the tube, the frequency of the ventilator, the amount of tide, the end-exhaling pressure … Then, there are the various things that need to be paid attention to during ECMO, and the preparation for dialysis of the kidney and liver.”
“Usually …”
“Chief Lin, boss Zheng has high expectations.” Old he said,”the Hepatobiliary and Pancreatic Surgery has made several applications to be used for intraoperative liver dialysis equipment, but he has not been able to get in until now. Boss Zheng will borrow the equipment from the liver and guts department in the capital to ensure that everything is foolproof. “
“I heard it. I was just about to ask you, what’s the point of borrowing this thing?” Lin Ge asked in a low voice.
“Of course it’s meaningful. Once there’s an increase in his or her blood levels during the surgery, he should immediately go for liver dialysis. It’s much more effective than postoperative treatment.” Old he said,”but the meaning … Is just that. If it were someone else, they would probably just deal with it this way. The surgery would not take long, so it was better to do dialysis during the surgery. Moreover, there are not many people who know about kidney dialysis during an operation. This is considered a very advanced treatment. “
“Look at what you’re saying.” Lin Ge laughed.
“Chief Lin, I’m not joking.” Old he said very seriously,”if you don’t believe me, you can ask the clinician. Dialysis is about the kidney. Not many people know about dialysis of the liver during an operation.”
Lin Ge nodded and raised the level of the event.
He had to care about what boss Zheng cared about. There was nothing to say. For a possible problem, boss Zheng had gone to the capital to borrow equipment. It was needless to say how much effort he had put in.
If it weren’t for the fact that boss Zheng and the patient were about the same age, Lin Ge would have thought that the patient was boss Zheng’s illegitimate son. If it were not for her son, who would be willing to put in so much effort and even put in so much effort to prepare for the surgery and treatment?
He treated his patients as if they were his family, and hospital director Yan would always talk about it during every weekly hospital meeting. However, there were not many doctors who could really treat their patients as if they were their own family.
Boss Zheng … Even Lin Ge felt that he had gone too far.