Chapter 1796： audacious in the extreme
Zheng Ren touched the heart of the patient.
The constant and irregular vibration of the myocardium seems to be the last struggle. But all its efforts are in vain.
Even a direct heart press can only provide a little momentum to the weak heart.
Looking up, Zheng Ren’s eyes picked up and looked at the electrocardiogram on ECG monitoring.
Three or more ventricular premature contractions appear continuously!
The shape of the Q wave group is deformed, the time limit is more than 0.12 s, and the ST-T wave direction is opposite to the main wave direction of the Q wave group!
The ventricular rate is more than 220 beats per minute, and the heart rate is irregular!
The atrial independent activity has no fixed relationship with the Q wave group, forming a separation of the room. Occasionally individual or all ventricles are excited to recapture the atrium!
What a special thing! Zheng Ren’s heart sighed.
He is very angry.
No one delayed the rescue, all the processes were the fastest, but still did not grab the best time.
"Magnesium sulfate, 2g static push!" Zheng Ren screamed.
The nurse is running, Su Yun and Zhao Yunlong are giving the patient an extracorporeal membrane lung.
2g of magnesium sulfate was pushed in, and Zheng Ren observed for 10 seconds, and the effect was not good.
"Isopropyl kidney, 1mg, intravenous!"
"Isopropyl kidney, 1mg, intravenous!"
"Isopropyl kidney, 1mg, intravenous!"
Continuous isoproterenol injection, even Su Yun was a little panicked.
Isoproterenol has been used as the drug of choice for the treatment of ventricular arrhythmias, but it is rarely used because it can cause ventricular fibrillation.
This is crazy for the boss!
However, there is no problem. They open their chests in the ward, do heart press under direct vision, and are not afraid of ventricular fibrillation... should not be afraid.
Su Yun is a little hesitant.
He has not experienced such a large dose of isoproterenol.
The key is the implantation time of the extracorporeal membrane lung.
The sooner you use the extracorporeal membrane lung, the greater the hope that the patient will survive.
"Isopropyl kidney, 1mg, intravenous injection!" Zheng Ren is still under the doctor's advice, holding the patient's heart and maintaining the final pulse.
He can feel the weakness of the patient's heartbeat.
If you don't have your own hand pinched, you are afraid that you have stopped jumping.
After the sixth push of isopropyl kidney, Zheng Ren finally heard the voice he most wanted to hear. The extracorporeal membrane lung machine was started. Suyun had already placed ECMO arteriovenous cannula from the femoral artery and vein, and the ECMO was used to assist the circulation.
On the electrocardiogram, ventricular tachycardia was slightly relieved by the action of large doses of isoproterenol and magnesium sulfate.
"Su Yun, prepare for chest defibrillation!" Zheng Rendao.
"Good." Su Yun didn't have time to catch his breath, he began to look for electrodes and directly called Zheng Ren.
The two electrodes are placed on the front and back walls of the patient's heart, respectively
"Boss, how old?" Su Yun asked.
Su Yun means how much energy. Generally speaking, the internal defibrillation of the chest starts from 10J and slowly increases to 30J.
However, repeated defibrillation consumes a large amount of ATP, which leads to a state of instability after resuscitation. Even after a short sinus rhythm, the patient will soon have a cardiac arrest again.
Because last time in Sweden, Zheng Ren used the ultimate energy to let Dr. Mehar recover, and left a deep impression on Su Yun, he did not think, asked directly.
"22J!" Zheng Ren paused, and then said.
Professor Zhang said after hearing it later: "10J! Not too big, you must gradually increase your energy!"
Su Yun did not look at him, completely regarded him as the air, transferred to the energy of 22J, and took a look at Zheng Ren.
Looking at each other, Su Yun presses the button.
A whisper, the harsh call from the ECG monitoring stopped.
Heart rate restores sinus!
"I am going..." Su Yun took a deep breath.
Professor Zhang looked silly and all of this was beyond his cognitive range.
Zheng Ren also calmed down a bit, said, "With the operating room, the patient was pushed directly."
"Don't wait?" Su Yun asked.
"I can't wait, heparinization again, cerebral hemorrhage at any time." Zheng Rendao.
"Good." Su Yun took off the sterile gloves and touched the phone.
"Boss, open the two together, you have to sew the chest wall." Su Yundao.
"Hey... three sets, called Fuguier and Laoliu will come right away." Zheng Rendao, "On the extracorporeal membrane lung, bleeding at any time, I have an angiography."
"..." Su Yun finally couldn't help but sighed.
The three units are open together... The boss really dared to think.
But who makes him a boss, has a big mouth and says what it is. Su Yun’s heart groaned and began to call people.
Zheng Ren gave pressure to the chest to stop bleeding, observe the patient's electrocardiogram, see that the sinus has been restored, this is relieved.
It’s only a breath of time.
The chest is open, not to mention the infection, just a pneumothorax can not stand.
Take time to send the patient to the operating room, everyone is busy.
Soon, pushing the bed, ventilator, ECG monitoring, extracorporeal membrane lung machine, a bunch of people left the ward, and went to the operating room.
Professor Zhang stood alone in the empty ward and was self-conscious.
What happened just now?
Open the chest next to the bed, direct heart press, a branch of isopropyl kidneys to advance, chest electric defibrillation directly on the energy of 22J...
These are the things that Professor Zhang will do, but he dare not do it easily.
Will it not happen?
Professor Zhang is still wondering if he is dreaming.
The patient still has a save? Finally, what did Zheng boss say? It seems that three are connected.
He wants to do the moyamom treatment of the head at the same time, chest disinfection, suture, plus interventional angiography?
This is not a lot of courage, it is simply daring.
To understand patients with heart failure, ventricular arrhythmias continue to appear with the support of IABP.
Three operations are open at the same time. Can the patient withstand such a big blow?
Professor Zhang does not believe.
Although he hopes that the patient can survive, Zheng’s practice violates the medical knowledge he is familiar with.
Impossible, absolutely impossible!
A few minutes later, Professor Zhang thought about it several times in his heart. He felt that there was no such possibility at all, and the patient would die.
He hesitated, and finally decided to go and see the situation.
In his heart did not want to see the idea of Zheng boss ugly. After all, the heart coronary artery bypass surgery room and Zhao Yunlong did it, and now he and Zheng boss are counted as a grasshopper on the rope.
Really... young people know that they are getting into trouble!
Give up treatment well, how good is the family to take people away?
There are more people in the world who can't heal, and three of them are open... When I think of it, Professor Zhang's heart sinks.
It’s terrible, it’s terrible.
You must follow them, or they don't know how to write a history record and a surgical record after surgery.
Don't push your mistakes to your head.
After working for decades, Professor Zhang has seen more of this dark thing. He knows that he must not leave.
Sighing, Professor Zhang turned and walked out of the EICU, ready to take a look.
Website:
The constant and irregular vibration of the myocardium seems to be the last struggle. But all its efforts are in vain.
Even a direct heart press can only provide a little momentum to the weak heart.
Looking up, Zheng Ren’s eyes picked up and looked at the electrocardiogram on ECG monitoring.
Three or more ventricular premature contractions appear continuously!
The shape of the Q wave group is deformed, the time limit is more than 0.12 s, and the ST-T wave direction is opposite to the main wave direction of the Q wave group!
The ventricular rate is more than 220 beats per minute, and the heart rate is irregular!
The atrial independent activity has no fixed relationship with the Q wave group, forming a separation of the room. Occasionally individual or all ventricles are excited to recapture the atrium!
What a special thing! Zheng Ren’s heart sighed.
He is very angry.
No one delayed the rescue, all the processes were the fastest, but still did not grab the best time.
"Magnesium sulfate, 2g static push!" Zheng Ren screamed.
The nurse is running, Su Yun and Zhao Yunlong are giving the patient an extracorporeal membrane lung.
2g of magnesium sulfate was pushed in, and Zheng Ren observed for 10 seconds, and the effect was not good.
"Isopropyl kidney, 1mg, intravenous!"
"Isopropyl kidney, 1mg, intravenous!"
"Isopropyl kidney, 1mg, intravenous!"
Continuous isoproterenol injection, even Su Yun was a little panicked.
Isoproterenol has been used as the drug of choice for the treatment of ventricular arrhythmias, but it is rarely used because it can cause ventricular fibrillation.
This is crazy for the boss!
However, there is no problem. They open their chests in the ward, do heart press under direct vision, and are not afraid of ventricular fibrillation... should not be afraid.
Su Yun is a little hesitant.
He has not experienced such a large dose of isoproterenol.
The key is the implantation time of the extracorporeal membrane lung.
The sooner you use the extracorporeal membrane lung, the greater the hope that the patient will survive.
"Isopropyl kidney, 1mg, intravenous injection!" Zheng Ren is still under the doctor's advice, holding the patient's heart and maintaining the final pulse.
He can feel the weakness of the patient's heartbeat.
If you don't have your own hand pinched, you are afraid that you have stopped jumping.
After the sixth push of isopropyl kidney, Zheng Ren finally heard the voice he most wanted to hear. The extracorporeal membrane lung machine was started. Suyun had already placed ECMO arteriovenous cannula from the femoral artery and vein, and the ECMO was used to assist the circulation.
On the electrocardiogram, ventricular tachycardia was slightly relieved by the action of large doses of isoproterenol and magnesium sulfate.
"Su Yun, prepare for chest defibrillation!" Zheng Rendao.
"Good." Su Yun didn't have time to catch his breath, he began to look for electrodes and directly called Zheng Ren.
The two electrodes are placed on the front and back walls of the patient's heart, respectively
"Boss, how old?" Su Yun asked.
Su Yun means how much energy. Generally speaking, the internal defibrillation of the chest starts from 10J and slowly increases to 30J.
However, repeated defibrillation consumes a large amount of ATP, which leads to a state of instability after resuscitation. Even after a short sinus rhythm, the patient will soon have a cardiac arrest again.
Because last time in Sweden, Zheng Ren used the ultimate energy to let Dr. Mehar recover, and left a deep impression on Su Yun, he did not think, asked directly.
"22J!" Zheng Ren paused, and then said.
Professor Zhang said after hearing it later: "10J! Not too big, you must gradually increase your energy!"
Su Yun did not look at him, completely regarded him as the air, transferred to the energy of 22J, and took a look at Zheng Ren.
Looking at each other, Su Yun presses the button.
A whisper, the harsh call from the ECG monitoring stopped.
Heart rate restores sinus!
"I am going..." Su Yun took a deep breath.
Professor Zhang looked silly and all of this was beyond his cognitive range.
Zheng Ren also calmed down a bit, said, "With the operating room, the patient was pushed directly."
"Don't wait?" Su Yun asked.
"I can't wait, heparinization again, cerebral hemorrhage at any time." Zheng Rendao.
"Good." Su Yun took off the sterile gloves and touched the phone.
"Boss, open the two together, you have to sew the chest wall." Su Yundao.
"Hey... three sets, called Fuguier and Laoliu will come right away." Zheng Rendao, "On the extracorporeal membrane lung, bleeding at any time, I have an angiography."
"..." Su Yun finally couldn't help but sighed.
The three units are open together... The boss really dared to think.
But who makes him a boss, has a big mouth and says what it is. Su Yun’s heart groaned and began to call people.
Zheng Ren gave pressure to the chest to stop bleeding, observe the patient's electrocardiogram, see that the sinus has been restored, this is relieved.
It’s only a breath of time.
The chest is open, not to mention the infection, just a pneumothorax can not stand.
Take time to send the patient to the operating room, everyone is busy.
Soon, pushing the bed, ventilator, ECG monitoring, extracorporeal membrane lung machine, a bunch of people left the ward, and went to the operating room.
Professor Zhang stood alone in the empty ward and was self-conscious.
What happened just now?
Open the chest next to the bed, direct heart press, a branch of isopropyl kidneys to advance, chest electric defibrillation directly on the energy of 22J...
These are the things that Professor Zhang will do, but he dare not do it easily.
Will it not happen?
Professor Zhang is still wondering if he is dreaming.
The patient still has a save? Finally, what did Zheng boss say? It seems that three are connected.
He wants to do the moyamom treatment of the head at the same time, chest disinfection, suture, plus interventional angiography?
This is not a lot of courage, it is simply daring.
To understand patients with heart failure, ventricular arrhythmias continue to appear with the support of IABP.
Three operations are open at the same time. Can the patient withstand such a big blow?
Professor Zhang does not believe.
Although he hopes that the patient can survive, Zheng’s practice violates the medical knowledge he is familiar with.
Impossible, absolutely impossible!
A few minutes later, Professor Zhang thought about it several times in his heart. He felt that there was no such possibility at all, and the patient would die.
He hesitated, and finally decided to go and see the situation.
In his heart did not want to see the idea of Zheng boss ugly. After all, the heart coronary artery bypass surgery room and Zhao Yunlong did it, and now he and Zheng boss are counted as a grasshopper on the rope.
Really... young people know that they are getting into trouble!
Give up treatment well, how good is the family to take people away?
There are more people in the world who can't heal, and three of them are open... When I think of it, Professor Zhang's heart sinks.
It’s terrible, it’s terrible.
You must follow them, or they don't know how to write a history record and a surgical record after surgery.
Don't push your mistakes to your head.
After working for decades, Professor Zhang has seen more of this dark thing. He knows that he must not leave.
Sighing, Professor Zhang turned and walked out of the EICU, ready to take a look.
Website:
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