v3 Chapter 2756： Delayed chest closure
The operation of the built-in floating catheter is very simple. Zheng Ren put on sterile gloves and completed the operation within 1 minute.
A floating catheter was implanted into the right internal jugular vein of the iliac crest, and cardiac output was measured at this time,%.
The anesthesiologist picks up the pen and paper to start the calculation. Zheng Ren Shensheng said, "No need to count, the systemic circulation resistance is."
"..." Both the anesthesiologist and Zhao Yunlong stunned. Not only them, but even Su Yun stunned.
心 Floating catheter measurement of cardiac output needs to be calculated by a more complicated formula to obtain the systemic circulation resistance. Boss Zheng calculated it?
Kai Hang, Su Yun's figure 5 or 6 seconds later is the same, he said in a silent voice.
"Boss Zheng, my heart output is so low?" Zhao Yunlong asked.
"Ready to open the chest." Zheng Rendao, "It is estimated that myocardial problems."
Myocardium ... This judgment is too far from pericardial tamponade. The reason is that Zhao Yunlong can figure it out, but that is a rare situation after all.
"Boss Zheng, did the pericardial stuffing blood leak into the heart muscle?" Director Zhang Lin asked.
"Considering, just open it and see." Zheng Ren glanced and asked, "Is the Yiren here?"
"Boss Zheng, Xiao Xie went to get your surgical equipment and will be there soon." The itinerant nurse said, "She just contacted me."
Zheng Ren nodded, and he began to hold his arm and watch the patient's last echocardiographic image.
Wu Suyun and Zhao Yunlong set the patient's posture and began to brush their hands for disinfection. The Xie Yi people also came by carrying the instrument box in the sterile package.
"Old Zhao." Zheng Ren suddenly said in a deep voice.
"Huh? Boss Zheng." Zhao Yunlong motioned to hear it.
"Call icu and prepare for isolation." Zheng Ren said.
Isolated room? Zhao Yunlong froze for a moment, but didn't ask why. After he finished brushing his hands, he asked the anesthesiologist's assistant to make a call.
"Do you want to delay closing the chest?" Su Yun asked with a frown, "So serious?"
"Consideration is probably caused by the more severe myocardial damage after IABP." Zheng Ren turned to brush his hands and expressed his views on the patient.
Director Jilang hesitated when he heard what Boss Zheng said. After IABP, myocardial damage was more severe ... Is this a mistake?
He was a little angry and dazed.
有人 If someone said this in Nanshan City, it would be a dumping pan, but here is 912, it should not. Director Zhang Lin was very enthusiastic. She rushed home from the middle of the night and waited for herself in the office.
Even this is not enough. Director Zhang Lin also contacted Nobel Prize winner Boss Zheng for a thoracotomy.
People are the Nobel Prize winners. Is it necessary to throw a pot at yourself? There is no need for this at all. He seems to be a big thing, and in his opinion it should be just a common case.
But IABP has great benefits for patients with myocardial ischemia in clinical practice. Director Lang has already carried out this technology ten years ago, and it can be said that there are countless living people.
Diastolic balloon inflation, elevated aortic diastolic blood pressure, increased coronary arterial pressure, increased myocardial blood supply and oxygen supply; before systole, airbag venting, aortic pressure decreases, heart load decreases, and cardiac ejection resistance decreases Myocardial oxygen consumption decreases.
IABP can effectively increase myocardial blood supply and reduce oxygen consumption, so that patients with coronary heart disease benefit the most.
Why did Boss Zheng say it was the pot of IABP? And what is he going to do? Delayed chest closure? Does the patient go back to the ward with the blood on his chest?
老板 Isn't Boss Xiao Zheng afraid of postoperative infection? To be honest, the delay in closing the chest that Professor Su just said did not understand what the operation was, but it sounded very unreliable.
The ideas of Director Jilang were intertwined and collided with each other, he pondered. By this time, surgery had already begun.
金属 The surgical instrument box full of metal texture is so eye-catching, the cooperation between the instrument nurse and the surgeon is exquisite, and even the language is not used.
下 Under the shadowless lamp, no one spoke, only tacit cooperation.
Even the eye contact between the surgeon and the assistant and the equipment nurse is not there. As if this operation is done ten or eight times a day, everyone has no interest in communication.
Director Jilang got behind Boss Zheng and saw the sternum saw open the sternum and the pericardium was exposed.
"It wasn't stuffed with pericardium," Su Yun said. "Echocardiography is fine."
"Um." Zheng Ren said the first sentence at this time, only one word.
Lifted the wall of the pericardium and cut the pericardium the moment the suction device was inserted. Director Lang carefully observed the pipeline of the attractor, only a small amount of blood was drawn out.
It is not pericardial tamponade, but why is my patient's heart muscle beating so weakly that blood pressure still cannot rise under the action of noradrenaline and dopamine? Director Lang was puzzled.
As the pericardium was cut open by a delicate little scissors, a swollen heart appeared in the surgical field. The heart was dilated, swelling-like, and left ventricular activity was poor.
"Oh!" Su Yun was surprised, "It's swollen like this?"
Zheng Ren did not speak, but continued to search. It was soon discovered that a single spear drainage hose for pericardial puncture penetrated the surface of the left ventricle of the heart, partially ruptured, and new blood was still seen on the surface of the heart wound.
I was really my own pot, and the pericardial puncture had a secondary injury ... When Director Lang saw this scene, his hands and feet were numb and cold.
说 Do you say that you have performed pericardial puncture yourself ~ www.novelhall.com ~, which caused damage to the left ventricle myocardium?
He couldn't do it, he justified himself in his heart. This is a human instinct reaction to self-defense.
为什么 Why do you have a pericardial puncture? Is it because the symptoms of chest tightness and chest pain have not been alleviated after the stent is removed?
Director Jilang explained that he was weak and weak. Under the shadowless lamp, Zheng Ren had cut off the pericardium with scissors, and used 3 × 3cm pericardial patch to sew along the periphery of the wound, and repaired the puncture point on the surface of the heart to stop bleeding.
"Boss Zheng, I'm late." Lao He came in while wearing a mask strap.
"Oh, it's not too late." Zheng Rendao, "The operation is almost done."
"..." Lao He froze, isn't it too late? Boss Zheng doesn't usually say that. While talking late, tell yourself that the operation is almost complete ...
"Preparing for transesophageal ultrasound." Zheng Rendao.
"Okay." Lao He was too late to think about it and immediately began to get busy.
"Zheng ... Boss Zheng, what are you going to do?" Director Lang stammered in a low voice.
"There is no way to close the chest, to have a B-ultrasound." Zheng Ren said, gently closing his chest with both hands.
The chest cavity was not completely closed, but with Zheng Ren's hands hard, the sternum wanted to gather together, and the alarm of the monitor rang loudly.
Vertex
A floating catheter was implanted into the right internal jugular vein of the iliac crest, and cardiac output was measured at this time,%.
The anesthesiologist picks up the pen and paper to start the calculation. Zheng Ren Shensheng said, "No need to count, the systemic circulation resistance is."
"..." Both the anesthesiologist and Zhao Yunlong stunned. Not only them, but even Su Yun stunned.
心 Floating catheter measurement of cardiac output needs to be calculated by a more complicated formula to obtain the systemic circulation resistance. Boss Zheng calculated it?
Kai Hang, Su Yun's figure 5 or 6 seconds later is the same, he said in a silent voice.
"Boss Zheng, my heart output is so low?" Zhao Yunlong asked.
"Ready to open the chest." Zheng Rendao, "It is estimated that myocardial problems."
Myocardium ... This judgment is too far from pericardial tamponade. The reason is that Zhao Yunlong can figure it out, but that is a rare situation after all.
"Boss Zheng, did the pericardial stuffing blood leak into the heart muscle?" Director Zhang Lin asked.
"Considering, just open it and see." Zheng Ren glanced and asked, "Is the Yiren here?"
"Boss Zheng, Xiao Xie went to get your surgical equipment and will be there soon." The itinerant nurse said, "She just contacted me."
Zheng Ren nodded, and he began to hold his arm and watch the patient's last echocardiographic image.
Wu Suyun and Zhao Yunlong set the patient's posture and began to brush their hands for disinfection. The Xie Yi people also came by carrying the instrument box in the sterile package.
"Old Zhao." Zheng Ren suddenly said in a deep voice.
"Huh? Boss Zheng." Zhao Yunlong motioned to hear it.
"Call icu and prepare for isolation." Zheng Ren said.
Isolated room? Zhao Yunlong froze for a moment, but didn't ask why. After he finished brushing his hands, he asked the anesthesiologist's assistant to make a call.
"Do you want to delay closing the chest?" Su Yun asked with a frown, "So serious?"
"Consideration is probably caused by the more severe myocardial damage after IABP." Zheng Ren turned to brush his hands and expressed his views on the patient.
Director Jilang hesitated when he heard what Boss Zheng said. After IABP, myocardial damage was more severe ... Is this a mistake?
He was a little angry and dazed.
有人 If someone said this in Nanshan City, it would be a dumping pan, but here is 912, it should not. Director Zhang Lin was very enthusiastic. She rushed home from the middle of the night and waited for herself in the office.
Even this is not enough. Director Zhang Lin also contacted Nobel Prize winner Boss Zheng for a thoracotomy.
People are the Nobel Prize winners. Is it necessary to throw a pot at yourself? There is no need for this at all. He seems to be a big thing, and in his opinion it should be just a common case.
But IABP has great benefits for patients with myocardial ischemia in clinical practice. Director Lang has already carried out this technology ten years ago, and it can be said that there are countless living people.
Diastolic balloon inflation, elevated aortic diastolic blood pressure, increased coronary arterial pressure, increased myocardial blood supply and oxygen supply; before systole, airbag venting, aortic pressure decreases, heart load decreases, and cardiac ejection resistance decreases Myocardial oxygen consumption decreases.
IABP can effectively increase myocardial blood supply and reduce oxygen consumption, so that patients with coronary heart disease benefit the most.
Why did Boss Zheng say it was the pot of IABP? And what is he going to do? Delayed chest closure? Does the patient go back to the ward with the blood on his chest?
老板 Isn't Boss Xiao Zheng afraid of postoperative infection? To be honest, the delay in closing the chest that Professor Su just said did not understand what the operation was, but it sounded very unreliable.
The ideas of Director Jilang were intertwined and collided with each other, he pondered. By this time, surgery had already begun.
金属 The surgical instrument box full of metal texture is so eye-catching, the cooperation between the instrument nurse and the surgeon is exquisite, and even the language is not used.
下 Under the shadowless lamp, no one spoke, only tacit cooperation.
Even the eye contact between the surgeon and the assistant and the equipment nurse is not there. As if this operation is done ten or eight times a day, everyone has no interest in communication.
Director Jilang got behind Boss Zheng and saw the sternum saw open the sternum and the pericardium was exposed.
"It wasn't stuffed with pericardium," Su Yun said. "Echocardiography is fine."
"Um." Zheng Ren said the first sentence at this time, only one word.
Lifted the wall of the pericardium and cut the pericardium the moment the suction device was inserted. Director Lang carefully observed the pipeline of the attractor, only a small amount of blood was drawn out.
It is not pericardial tamponade, but why is my patient's heart muscle beating so weakly that blood pressure still cannot rise under the action of noradrenaline and dopamine? Director Lang was puzzled.
As the pericardium was cut open by a delicate little scissors, a swollen heart appeared in the surgical field. The heart was dilated, swelling-like, and left ventricular activity was poor.
"Oh!" Su Yun was surprised, "It's swollen like this?"
Zheng Ren did not speak, but continued to search. It was soon discovered that a single spear drainage hose for pericardial puncture penetrated the surface of the left ventricle of the heart, partially ruptured, and new blood was still seen on the surface of the heart wound.
I was really my own pot, and the pericardial puncture had a secondary injury ... When Director Lang saw this scene, his hands and feet were numb and cold.
说 Do you say that you have performed pericardial puncture yourself ~ www.novelhall.com ~, which caused damage to the left ventricle myocardium?
He couldn't do it, he justified himself in his heart. This is a human instinct reaction to self-defense.
为什么 Why do you have a pericardial puncture? Is it because the symptoms of chest tightness and chest pain have not been alleviated after the stent is removed?
Director Jilang explained that he was weak and weak. Under the shadowless lamp, Zheng Ren had cut off the pericardium with scissors, and used 3 × 3cm pericardial patch to sew along the periphery of the wound, and repaired the puncture point on the surface of the heart to stop bleeding.
"Boss Zheng, I'm late." Lao He came in while wearing a mask strap.
"Oh, it's not too late." Zheng Rendao, "The operation is almost done."
"..." Lao He froze, isn't it too late? Boss Zheng doesn't usually say that. While talking late, tell yourself that the operation is almost complete ...
"Preparing for transesophageal ultrasound." Zheng Rendao.
"Okay." Lao He was too late to think about it and immediately began to get busy.
"Zheng ... Boss Zheng, what are you going to do?" Director Lang stammered in a low voice.
"There is no way to close the chest, to have a B-ultrasound." Zheng Ren said, gently closing his chest with both hands.
The chest cavity was not completely closed, but with Zheng Ren's hands hard, the sternum wanted to gather together, and the alarm of the monitor rang loudly.
Vertex
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