Chapter 2962 Go All Out

"Boss, anesthesia is a big problem." Su Yun said, "The extracorporeal circulation group can only be done by Lao He first, we can't occupy one group for so long."

"Well, when the time comes, Lao He will have to watch back and forth. If there is any problem between Ecmo and extracorporeal circulation, Lao He will watch over it." Zheng Ren knew what Su Yun meant.

"Yes, because Old He can't keep an eye on him, do you want to call Da Chu and Xiao Chu?" Su Yun asked.

"Is it convenient at home?"

"If you say yes, I'll ask again, or else Da Chu and Xiao Chu are here, and you say no, that would be embarrassing."

"Come on, let me talk to Director Xu. After all, I have to do surgical training for about a week, so it's not easy to find other people from the anesthesiology department to accompany me all the time." Zheng Ren nodded and finalized the matter.

Lin Yuan and Gu Xiaoran were gearing up, as anyone who had worked in the clinic for a period of time would know that this operation would definitely be recorded in the annals of history.

Autologous stem cell cloning and 3D-printed lung transplantation are bound to write a strong and colorful stroke in the history of medicine, and it may become an invisible hand that turns the page of modern medical history.

Wait for Yiren and Lao He to go to the community hospital to prepare for surgery training.

The last time such an exaggerated preoperative training was in the Women's and Children's Hospital for the separation of conjoined twins.

Overall speaking, the operation was less difficult than separating a conjoined heart, but Zheng Ren was still ready to go all out and spare no effort.

He even assembled the entire medical team without hesitation.

Watching Su Yun take Gu Xiaoran and Lin Yuan to move the 3D-printed manikin to the operating table in the demonstration classroom to prepare for the operation, Zheng Ren took the opportunity to come to the system space and click to purchase the operation training time.

As the operating room of the system rose from the ground, Zheng Ren silently prayed in his heart, and then got into it.

Fortunately, as imagined, the 3D-printed cloned lung tissue is placed in the operating room, and there is no need to go to the system mall to buy it at a high price.

Zheng Ren was very satisfied with this.

Surgery, starting with anesthesia. Zheng Ren didn't throw all this to Lao He, after all, the 3D-printed simulated human is fundamentally different from the real person.

Zheng Ren began to try anesthesia and ecmo.

First give the experimental question mask to inhale pure oxygen, the volume fraction is 100%, and monitor the electrocardiogram and blood oxygen saturation. Afterwards, Zheng Renxing punctured the right radial artery to monitor invasive blood pressure and performed blood gas analysis.

Anesthesia induction with midazolam 1 ~ 2 mg, etomidate 0.2 ~ o. 4mg/kg. Sufentanil 0.2～o. 4mg/kg and atracurium cis-besylate 0.15 ~ O. 3 mg/kg.

After entering the state of muscle relaxation, endotracheal intubation was started, and a ventilator was connected to assist breathing.

Anesthesia was maintained by intravenous infusion of propofol 0.03-0.05 nag·kg. 1·min, vecuronium bromide 1～2ug/kg/·min. And indirect intravenous injection of fentanyl to maintain anesthesia.

Zheng Ren observed the state of the experimental subject for a period of time, and performed blood gas analysis intermittently.

The blood gas value is not stable, because the ventilation methods are pressure-controlled, so Zheng Ren adjusts the ventilation parameters according to the blood gas analysis indicators and vital signs, and decides to perform manual ventilation when necessary.

After induction of anesthesia, the right femoral artery and vein were intubated. The femoral artery was intubated to the level of the common iliac artery with a 15-17 Fr catheter. The femoral vein was intubated to the level of the inferior vena cava with a 19-21 Fr catheter. Use whole heparin-coated membrane lungs and pipelines, thermostats, centrifugal pump heads and oxygenators. After the catheter is placed, the flow begins.

The maximum flow rate of ECMO is usually determined by intubation. Each cannula has its own specific flow-pressure curve. The larger the cannula, the higher the flow rate. For example, a 17-gauge arterial cannula can only achieve a flow rate of 4 to 5 L per minute, while a 21-gauge cannula can achieve a flow rate of 6 L/min without putting additional pressure on the cannula wall.

Considering Xiaoshi's age, Zheng Ren tried many times, and finally chose the most suitable type of cannula.

The initial flow rate was 50% of the intermittent cardiac output, and it was maintained at more than 30% during the bypass period. During the operation, the speed and flow rate were adjusted according to the oxygenation and cardiac function.

Zheng Ren also didn't buy an assistant to help him with the operation, this time he was just exploring the experience. Although there is a lot of time left for surgical training, Zheng Ren is not prepared to "waste".

Zheng Ren did not think that the 3D-printed cloned lung tissue could perform this operation perfectly. If there is an abnormality, he is going to take Su Yun away, and then "cross the sea" to replace the 3D printed lung tissue brought by Su Yun's familiar laboratory with the lung tissue in the system space.

Doing so is very risky, but Zheng Ren has already made the worst preparations for the success of the operation.

The lung tissue that can be taken out for real transplantation can only be exchanged for hundreds of thousands of experience points, which is more expensive than the one used in the system space before.

Come on a little bit, I hope the lung tissue provided by Su Yun can be more reliable.

When the operation started, Zheng Ren discovered something abnormal.

He observed a "pipe chatter" before the ECMO flow dropped.

This is a phenomenon caused by the negative pressure in the ECMO circuit causing the venous cannula to impinge on the venous wall when the intravascular volume state is at a low level.

Sustained tremors may cause ECMO alarms or "suction until the flow drops". Zheng Ren found that the tremors could be relieved quickly after reducing the ECMO flow; then he solved this problem by slowly increasing the ECMO flow while expanding the capacity.

Generally speaking, the phenomenon of pipeline chatter is not uncommon in the use of ecmo, and Lao He should have encountered it many times. However, Zheng Ren was still very careful to solve the pipe tremor situation little by little, until he knew exactly how to expand the capacity and how much dose to avoid the pipe tremor.

Just one detail wasted 30 hours of surgical training time.

Surgery is getting bigger and bigger, and surgical training time is consuming more and more. Fortunately, there are 3D-printed simulators available for training. Otherwise, if you buy assistants in the operating room of the system, you may not be able to train a few times after a series of training.

However, what made Zheng Ren more gratified was that the 3D printed cloned lung tissue brought by Su Yun was quite good. After the operation was completed, the system actually gave an 88% completion rate of the operation.

This degree of completion is relatively low in Zheng Ren's surgery, but what Zheng Ren has proved is that there is no essential difference between 3D printed tissue and tissue purchased in the system space.

As long as it's okay, Zheng Ren doesn't want to transform into lung tissue and organs like a living person.

A laryngoscope, a blade, these are trivial matters, you can explain them any way you want. Even if Su Yun or others had doubts, they would think that Zheng Ren had OCD and it was just a coincidence.

But conjure up a lung...

Reselling human organs? If that's the case, as long as people notice it, the consequences will be disastrous.

The cloned lung should work, this is the best news Zheng Ren has received.

After 62 hours of surgical training, Zheng Ren felt that his level was really good. Organ transplant specialization, although Big Pig's Trotter didn't give an explanation, but Zheng Ren is sure that this specialization skill has played a big role.