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¡¾2636¡¿Secret investigation

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    Patients may be delayed into renal ischemia and kidney injury, but acute kidney injury usually presents with non-bright red urine.  The urinary manifestations of acute kidney injury are usually dark urine and cloudy urine.

    Clinically, there are generally two indicators to distinguish acute kidney injury. One is urine output. Low urine output is the most typical clinical symptom of acute kidney injury.  The other is the serum creatinine value.  Acute kidney injury can be divided into three grades based on urine output and serum creatinine value.  Clinical classification has always been used to guide clinical treatment plans.  When it is classified into level three, it is time to consider starting a hemodialysis plan.

    Now this patient¡¯s urine has become darker after returning to the ICU.  The icu doctor hurriedly sent urine and blood samples to the laboratory for testing.  At this time, can we easily say that this patient may have acute kidney injury due to previous diseases?  Obviously it can't be done.

    Doctors must be realistic and cannot blame the patient's previous illness. This will be very detrimental to the patient's subsequent treatment.

    Xie Wanying mentioned this to Brother Xia: "It is estimated that the proportion of acute kidney injury caused by surgery is larger. The rate of acute kidney injury after cardiothoracic surgery is very high."

    This is an inevitable surgical complication.  As long as patients use extracorporeal circulation during surgery, many harmful factors in extracorporeal circulation, such as myoglobin inflammatory mediators, can easily cause acute kidney injury.  At this time, the possibility of acute kidney injury caused by so-called renal hypoperfusion is lower.

    Xia Dongxian listened to her methodical analysis and nodded in his mind: I have heard before that this little junior sister learned very well about surgery and internal medicine.  Now it seems that it is more than that, the junior sister has the potential to become a big boss.  Dai Ronghong recommended it.

    As an ICU doctor, Xia Dongxian has dealt with big bosses in various disciplines too many times. It can be said that he knows what the qualifications of a big boss are better than other doctors.

    The perioperative management of critically ill patients is not only a key and difficult point in the ICU, but also a test of a surgical master¡¯s true ability.

    Some hospital surgeons leave such patient problems to ICU doctors, but some do not.  In the Department of Surgery, the older the boss, the less likely he is to be a blame-shifter. Especially when it comes to key patients that are related to other important matters, the boss personally keeps an eye on them.

    Not surprisingly, Xia Dongxian didn¡¯t need to notify him and quickly met Fu Xinheng who came over after taking a rest after the operation.

    Wearing slippers and standing at the door of their ICU office, Fu Xinheng took his hand out of his white coat pocket and waved it, hinting to Xia Dongxian that he didn't need to speak.

    ¡° Seeing this robot sneaking around, it must have evil intentions and a purpose.  Xia Dongxian's eyes rolled: Could it be that he wanted to inspect his junior sister in all aspects and be particularly picky?

    This possibility is very high.  Robots are called robots. One of the reasons is that they don't know how to adapt and are too harsh.

    Xie Wanying was immersed in studying the patient's medical records. She didn't raise her head and didn't notice the person coming. She said: "Analysis of acute kidney injury from serum creatinine and urine output alone is not enough. Biological markers usually need to be added. Now the patient's urine is brown, and acute kidney injury must be considered."  The possibility of tubular necrosis. The influencing factors during the operation will no longer be discussed after the operation. Judging from other indicators of today¡¯s patients, I personally think the most critical point is still-blood transfusion.¡±

    "Blood transfusion?" Xia Dongxian was surprised.

    When you have a kidney problem, you don¡¯t need medicine and just think about blood transfusion?

    ¡°To recover after surgery, the kidneys must return to adequate renal perfusion, allowing the patient¡¯s kidneys to have the conditions to repair themselves.¡±

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