Chapter 1787 IABP

"What are you thinking at home?" Su Yun squatted and fiddled with the patient's chest tube.

He emptied the fresh blood drained from the chest tube, and while timing, he bent a section of the chest tube to observe the speed of the drainage.

The chest tube is unobstructed and the drainage is not much, which can be confirmed.

What Su Yun did seemed unnecessary, but Zheng Ren knew that he was ruling out possible problems with some small details.

Many seemingly serious illnesses are actually caused by the accumulation of a little problem.

"Old Zhao, what about the second line?" Su Yun asked while fiddling with the chest tube.

"Professor Zhang..." Zhao Yunlong said.

Su Yun was also helpless.

It's not like Professor Zhang is the same. Everyone's level is different, and their ability to bear risks and ideas are also different.

Some are more radical, some are more conservative.

Each has advantages and disadvantages.

As for Professor Zhang, if he goes to school, he will be a very good teacher. But in such an extremely complicated situation, he may not be a good emergency emergency candidate.

"Where are the people?" Zheng Ren asked.

"It's coming soon." Zhao Yunlong said: "Zheng... Boss, give me a look, and I'll urge the patient's family."

"Go." Zheng Ren said, "Is the catheterization laboratory ready for IABP?"

"Ready, Director Zhang Lin is rushing over from home." Zhao Yunlong said.

Zheng Ren nodded, did not continue talking, but turned on the computer and began to look at the patient's medical records.

Zhao Yunlong's description is too brief, only the most important points are mentioned, and there is no time to elaborate the rest.

Regarding the patient's situation, Zheng Ren still wanted to take a closer look at it.

The patient is 52 years old and has a family history of hypertension. His father died of cerebral hemorrhage. He had no symptoms before, just like Zhao Yunlong said, he came to the hospital two days ago because of aggravation of chest tightness and shortness of breath.

In the medical records, the patient reported no history of vertigo.

On this point, Zheng Ren expressed doubts. If vertigo is present, it is most reasonable to accompany an insidious onset.

The patient's medical history is just like this, and it does not represent everything, but can only be used as a reference, especially for patients with such a complex situation in front of them.

On admission, the CT of the head was abnormal, and the MRI of the head was done every other day.

Zheng Ren could feel that the patient's family members did not sign and agree to IABP, and there may have been signs early in the morning - both family and economic factors are possible.

The laboratory test sheets and various inspection reports all looked the same to Zheng Ren.

He quickly gained a certain understanding and cognition of the evolution of the patient's condition. Su Yun looked at the medical records beside him and looked back at the patient's condition, his neck was about to break.

"Boss, the moyamoya disease shown on the MRI is quite serious." Su Yun commented when Zheng Ren inserted the MRI film into the reader.

"Well, I think about..." Zheng Rengang said here, the sound of the monitor alarming loudly.

The beeping sound resounded through the room.

Zheng Ren and Su Yun stood up abruptly, and the chair Zheng Ren was sitting on flipped to the ground with a "bang" sound.

"Prepare for IABP!" Zheng Ren roared in a low voice.

Su Yun was startled for a moment, and he subconsciously wanted to refuse. Do IABP directly without the signature of the patient's family members, do you want to die?

But he could hear the determination in Zheng Ren's voice that he couldn't refuse.

Leave him alone! Su Yun's heart was stunned, anyway, the sky fell and the boss was holding it. Great resignation and going to work at Massachusetts General Hospital seems like a good choice too.

"IABP machines and machines ready with helium!"

"IABP catheter and puncture kit are ready!"

"0.9% NaCl 500ml + heparin sodium 5000U, ready!"

"Pressurized bag, keep the pressure at 300mmHg?"

Su Yun asked.

"Yes." Zheng Ren lifted the quilt on the patient's body, then opened the IABP puncture bag and prepared iodophor.

"Lidocaine." Zheng Ren said in a deep voice while wearing gloves.

Su Yun had already turned on the machine, pushed it to the bedside, unscrewed a plastic bottle of lidocaine, and put the syringe into the sterile bag.

Zheng Ren picked up the syringe, inserted the tip of the needle into the opening of the plastic bottle, and pulled out lidocaine.

Without diluting it, I grabbed a handful of iodophor with my right hand, sterilized the patient's femoral artery, and then performed local anesthesia.

The puncture was successful, and the balloon catheter was delivered into the patient's femoral artery. Zheng Ren moved quickly. Su Yun had just put the electrodes on the patient's chest, and the two ECG monitoring systems were running at the same time.

At this time, Zheng Ren had completed the operation and sent the IABP tube to the descending aorta.

Turning on the counterpulsation pump, Zheng Ren handed the sensor for monitoring the aortic pressure to Su Yun.

Su Yun connected the sensor to the host.

The flushing system is connected to the sensor and the central lumen is connected to the pressure catheter.

The work that Zheng Ren needs to do has basically been completed, and Su Yun's side is busy flying.

After connecting the helium pipeline, Su Yun read it several times to make sure that the working pressure of helium meets the requirements.

"Sew it." Su Yun said with certainty.

Zheng Ren nodded and started fixing the helium pipeline.

And Su Yun debugs various parameters on the host.

This point Su Yun is more professional than himself, Zheng Ren knows it. Letting him do it is the most worry-free way.

You don't need to be involved at all.

As the IABP system started to work, Zheng Ren let out a sigh of relief, and the patient would be fine in a short time.

The machine feeds the patient's ECG or blood pressure signal into the counterpulsation control device, causing the balloon pump to act in the opposite direction in synchronization with the patient's heart beat.

Immediately before systole, that is, when the aorta opens, the balloon is deflated, reducing end-diastolic pressure in the aorta and reducing left ventricular work. Reduce afterload and reduce myocardial oxygen consumption.

Immediately before diastole, the balloon is inflated to increase coronary perfusion pressure during diastole and increase myocardial oxygen supply.

Doing so can reduce left ventricular pre-load and post-load, reducing the load on the heart. The balloon quickly completes the exhaust immediately before the heart contracts and the aortic valve opens, which instantly decompresses the aorta, reduces the left ventricular ejection resistance at the same time, and increases the cardiac output.

IABP is unparalleled for perioperative support and stabilization of hemodynamic status.

With the activation of IABP, the frantic ECG monitoring began to calm down gradually.

"Boss, the patient's family didn't sign it." Su Yun said helplessly after adjusting the various parameters of the machine and seeing Zheng Ren packing up the IABP's things.

"I don't have time." Zheng Ren said, "When the patient's family members sign, everyone will be dead."

"Why hasn't Lao Zhao come back?" Su Yun muttered, but his eyes were fixed on the monitor.

This emergency emergency was considered a success, but the various values ​​and indicators were still not ideal. The patient is still on the verge of death, and as for when it fails, it depends on his life.

"Boss..." Su Yun said with a frown. "I don't see it right. The patient is too sick, heavier than expected."

Zheng Ren also noticed this, thinking about what to do next.