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Chapter 3526 [3526] Just in case

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    After hanging up the caller, talk on the phone again.

    It turns out that while she was away from Guozhi, everyone followed the consensus of the doctors after the morning meeting and started to try the lung recruitment operation during a series of preparations before the patient recovered and was weaned off the machine, but something seemed to go wrong.

    The call came from Director Wang himself. He asked her in confusion: "Didn't you say that the patient is almost ready to be weaned off the machine?"

    "You can't eat hot tofu in a hurry. This is also very applicable clinically."  Originally, after there was another patient, it was Xie Wanying who should be the most anxious, but now it seems that she is not at all.  It shows that whether a doctor is in a hurry or not actually depends on how much technical control the doctor has over the patient's condition.

    gas.

    Listening to Director Wang¡¯s extremely anxious words, Xie Wanying only remembered that she had not said that the patient could be weaned from the machine in the morning.

    ECMO weaning itself is a very complicated matter.

    Doctors cannot just wean the patient off the machine and wait until the patient is no longer able to intubate the patient.  You should know that after the femoral artery is pulled out, the blood vessel wall needs to be repaired. This shows how much the operation of the machine can damage the patient's blood vessels.

    There are only so many blood vessels in the patient's own body, and it is impossible for doctors to have unlimited important blood vessels for doctors to make multiple attempts.  Protecting blood vessels has always been one of the key considerations for clinicians.  Moreover, this patient was put on a ventilator and a hemofiltration machine in addition to the ecmo machine.  Which machine should be withdrawn first and then all is a question that requires careful consideration by the doctor.  Even if it is prudent, the doctor will try to stop the machine without extubating it before weaning it off.

    The machine will make a decision after 24 hours of observation.  She previously suggested adjusting the ventilator parameters to perform lung recruitment training for patients, which was to inflate the patient's collapsed lungs and promote the early recovery of the patient's lung function.  This is actually just the first step in the pulmonary function rehabilitation process before the patient is weaned from the machine

    Don¡¯t forget that Mr. Zhang uses vaecmo mode for patients, which includes support for the patient¡¯s cardiac function.  If you want to withdraw membrane lung, in addition to observing the patient's lung function, heart function is also essential.

    of.  To sum up, the patient¡¯s cardiopulmonary function must be restored to the threshold before membrane oxygenation can be withdrawn.  The calculation of cardiopulmonary function indicators requires very complex verification work. It is not just about looking at a blood report or other documents.

    A report can be concluded.  For example, cardiac function indicators, in addition to daily observation of membrane lung machine parameters and electrocardiogram and other routine items, doctors must conduct special cardiac function examinations before weaning off the membrane lung machine. As mentioned many times before, the examination can better clarify the heart function.

    ??????????????? Echocardiography.  Not only instrument examination, but also the patient's medication status is a very important reference value for doctors.  For example, after the machine is weaned, if you do not want to intubate, the ideal situation is of course to have a means that can replace the machine, and blood vessels are the first choice.

    Active and inotropic drugs.  Whether medicine can be used to replace the effect of the machine just in case requires clinical judgment and experiments before weaning the machine off.

    Generally speaking, when trying to reduce the membrane pulmonary flow rate before weaning the machine, injecting a certain amount of the above drugs while trying to wean the machine can make a rough assessment.  After listening to the series of lectures given by Mr. Xie on the phone, Director Wang from Guozhi ICU once again deeply felt the importance of listening to Mr.  Want again

    Go to Mr. Zhang and ask Mr. Zhang to retain talents.  Without Teacher Xie's guidance, they would have inevitably tormented the patient as a guinea pig when they were groping at this moment, and they might even have tormented the patient to death.  (Remember the website address: www.hlnovel.com
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