Chapter 3526        【3526】Just in case

After hanging up the phone call from the young master, come and talk to the phone again.

It turned out that during her departure from Guozhi, everyone began to try lung re-extraction operations as the doctors agreed after the meeting in the morning, and as a series of preparations before the patient recovered and evacuated the plane, it seemed that something went wrong.

Director Wang personally called her and asked her inexplicably: "Didn't you say that the patient can almost withdraw the plane?"

If you are anxious, you can't eat hot tofu, this is also very applicable in clinical practice.

After having another patient, the one who should be anxious about her is Xie Wanying, but now it seems that it is not. It means whether the doctor is anxious or not. In fact, it depends on the doctor's own proportion of the doctor's ability to control the patient's condition.

Listening to Director Wang's extremely anxious words, Xie Wanying only remembered that she had never said in the morning that the patient could withdraw the plane.

ECM is a very complicated matter.

Doctors cannot say that they can withdraw the patient's aircraft at will, and then intubate the patient after the patient is not able to do so. You should know that after the femoral artery is pulled out, the blood vessel wall repair surgery is required. It can be seen how much the machine is going to harm the patient's blood vessels.

There are a few blood vessels in the patient's own, and it is impossible to have infinite important blood vessels for the doctor to try many times. Protecting blood vessels has always been one of the key points that clinicians consider.

Besides, this patient has used a ventilator or a hemofiltration machine in addition to the ecmo machine. Which machine is first and then evacuated is all a problem that the doctor needs to think carefully. If you are even cautious, the doctor will try to shut down the machine without extruding the tube for 24 hours before evacuating the machine.

Make a decision after observation.

The adjustment of ventilator parameters before her suggests to provide patients with lung reextraction training is to boost the patient's collapsed lungs and promote early recovery of lung function. This is actually just the first step in the patient's lung function rehabilitation process before the patient withdraws the machine.

Don’t forget that Mr. Zhang used the vaecmo model for the patient, which contains support for the patient’s heart function. If you want to remove the membrane of the lungs, in addition to observing the patient’s lung function, heart function is also essential.

In summary, the patient's cardiopulmonary function must be restored to the threshold indicator before the patient can remove the membrane of the lungs. The calculation of cardiopulmonary function indexes is very complicated to do. It can be concluded that it is not simply a blood report or other single report.

.

For example, cardiac function indicators, doctors should not observe routine items such as membrane lung machine parameters and electrocardiograms on a daily basis, and have to undergo special cardiac function examinations before withdrawing the machine. For the transesophageal echocardiac movements that can more clearly determine the heart function after many times, they have been said before.

Figure check.

Not only instrument examination, the patient's medication situation is also a very important reference value for doctors. For example, after withdrawing the machine, if you do not want to intubate, the ideal state must of course be a means that can replace the machine, and the first choice is vasoactive and positive.

Intense medicine. Whether medicine can be used instead of the machine's effect is just in case, clinicians need to conduct research and analysis and pre-removal experiments.

Generally speaking, when reducing the membrane-pulmonary flow before evacuation, try to inject a certain amount of the above-mentioned drugs while evacuating the machine, which can make a rough assessment of the relevant results.

After listening to the series of lecture notes by Student Xie on the phone, Director Wang of Guozhi Ici once again deeply felt the importance of listening to Teacher Xie's lecture. It was a little too late to take out the pen to record it. I couldn't help but think about waiting in my heart.

We should go to find Mr. Zhang and ask Mr. Zhang to keep talents.
Chapter completed!