2758 Delayed chest closure
The operation of the internal floating catheter was very simple. Zheng Ren put on sterile gloves and completed the operation within one minute.
A floating catheter was implanted into the right internal carotid vein, and the measured heart rate was 6.1L/min, and the SnO2 was 51%.
The anesthetist picked up a pen washi and was about to start calculating when Zheng Ren said in a deep voice,”there’s no need to calculate. The cardiopulmonary circulation resistance is 760/CM5.”
“…” The anesthetist and Zhao Yunlong were both stunned. Not only them, even Su Yun was stunned.
To measure the displacement of the heart with a floating duct, one had to calculate the internal circulation resistance through a more complicated formula, but boss Zheng could calculate it mentally?
He must be cheating. Su Yun calculated the same number five or six seconds later. He cursed in his heart.
“Boss Zheng, why are you so narrow-minded?” Zhao Yunlong asked.
“Prepare to open up the chest,” Zheng Ren said,”it’s probably a problem with her heart.”
Cardiac muscle … This judgment was far from cardiac tamponade. Zhao Yunlong could also understand the reasoning behind this, but it was a rare situation.
“Boss Zheng, did the blood from the cardiac tamponade seep into the heart muscle?” Director Zhang Lin asked.
“I’m thinking about it. We’ll know once we open it. ” “Is Yiren here?” Zheng Ren asked after taking a glance.
“Boss Zheng, young Xie has gone to get your surgical equipment. He’ll be here soon.” The circulating nurse said,”she just contacted me.”
Zheng Ren nodded. He crossed his arms and started to look at the patient’s last ultrasound scan.
Su Yun and Zhao Yunlong adjusted the patient’s position and began to disinfect his hands. Xie Yiren also rushed over with a sterile package and a box of equipment.
“Old Zhao.” Zheng Ren suddenly said in a deep voice.
“Eh? Boss Zheng. ” Zhao Yunlong indicated that he had heard.
“Call the icu and tell them to prepare the quarantine room.” Zheng Ren said.
Quarantine room? Zhao Yunlong was stunned for a moment, but he did not ask why. He had already finished washing his hands and asked the anesthetist’s assistant to make a call. He stretched his head over to contact the icu about the quarantine room.
“Do you want to perform delayed chest closure?” Su Yun frowned and asked,”it’s that serious?”
“It’s very likely that this is caused by the increased damage to the heart muscle after injecting IABP. ” Zheng Ren turned around to wash his hands and expressed his opinion on the patient.
Director lang was stunned when he heard boss Zheng’s words. After injecting IAB, the heart muscle was damaged more severely … Was he referring to his own mistake?
He was a little angry and confused.
If someone said this in Nanshan city, they would definitely be shirking responsibility. However, this was 912, so it shouldn’t be. Director Zhang Lin was very enthusiastic. She had rushed from home in the middle of the night and was waiting for him in the office.
Even that wasn’t enough. Director Zhang Lin even contacted the Nobel Prize winner, boss Zheng, to perform a thoracotomy.
He was a Nobel Prize winner, was there a need to push the blame to him? There was no need for that, alright? In his opinion, it was a serious case, but in his opinion, it should be an ordinary case.
However, IAB had great clinical benefits for patients with myocardial infarction. Department Director lang had developed this technology ten years ago, and it could be said that there were countless living people.
Inflation of the laparoscope during the dilaplosis period, increasing the aortic vasculaton pressure and coronary artery pressure, and increasing the blood supply and oxygen supply to the heart muscle; Before the heart contracted, the airbag would discharge, the aortic pressure would decrease, the aftereffect of the heart would decrease, the heart’s ejection resistance would decrease, and the amount of oxygen consumed by the heart would decrease.
IAPP could effectively increase the blood supply to the heart and reduce oxygen consumption, which would benefit patients with coronary heart disease the most.
Why did boss Zheng say that it was the IABP’s fault? And what was he trying to do? Delayed chest closure? Was the patient supposed to go back to the ward with her chest open while she was covered in blood?
Wasn’t little boss Zheng afraid that the patient would be infected after the surgery? To be honest, he didn’t know what delayed chest closure professor su was talking about, but it didn’t sound reliable.
Department Director Lang’s thoughts were intertwined and collided with each other as he mulled over it in a daze. Meanwhile, the surgery had already begun.
The metallic surgical equipment box was so eye-catching, and the scrub nurse and the surgeon cooperated so well that they did not even need to communicate with each other.
Under the shadowless light, no one spoke, only tacit cooperation.
There was not even any eye contact between the surgeon, assistants, and scrub nurses. It was as if they had to perform eight to ten such surgeries every day, and no one was interested in communicating at all.
Department Director lang moved behind boss Zheng and saw that the sternum saw had opened the sternum and the pericardium was exposed.
“It’s not cardiac tamponade. ” Su Yun said,”there’s no problem with the ultrasound.”
“Yes.” Zheng Ren only spoke his first sentence at this moment. It was only one word.
The moment he lifted the pericardium wall and cut open the pericardium, he inserted the aspirator into it. Department Director lang observed the catheter of the aspirator carefully, and only a small amount of blood was drawn out.
It was not cardiac tamponade, but why was the patient’s cardiac pulsation so weak? why was the blood pressure still unable to rise even under the effects of epinephrine and dopamine? Department Director lang was puzzled.
The pericardium was cut open with an exquisite pair of scissors, and a swollen heart appeared in the operating field. The heart was expanding and swelling, and the left chamber was less active.
“Swish!” Su Yun was surprised.”It’s swollen to this extent?”
Zheng Ren did not say anything and continued to search. Soon, they found that the single-spear drainage soft tube used for cardiac puncture had pierced into the surface of the left lobe of the heart and was partially ruptured. New bleeding could still be seen on the surface of the heart wound.
“As expected, it’s my fault. There’s a side injury after the pericardium was punctured …” Department Director Lang’s hands and feet were numb and cold when he saw this.
Could it be that he had performed a cardiac puncture, which caused the left ventricle to be damaged, resulting in similar symptoms?
‘I can’ t,’he thought to himself. This was a human’s self-defense instinctive reaction. It was just to seek advantages and avoid disadvantages, and it was the same for everyone.
Why did he need to perform a cardiac puncture? It was because the symptoms of chest tightness and chest pain did not alleviate at all after the stent was placed.
Department Director lang defended himself weakly in his heart. Under the shadowless lamp, Zheng Ren had already cut off the pericardium with scissors. He used a 3×3 cm autologous pericardium patch to suture continuously along the periphery of the wound, and locally repaired the damaged puncture point on the surface of the heart to stop the bleeding.
“Boss Zheng, I’m late.” Old he walked in while tying his mask.
“Oh, you’re not late.” “The surgery is almost done,” Zheng Ren said.
“…” Old he was stunned. It’s not too late? Boss Zheng usually didn’t talk like that. She told herself that it wasn’t too late, and at the same time, she told herself that the surgery was almost done …
“Prepare for transesophageal ultrasound.” Zheng Ren said.
“Alright,” he said. Old he didn’t have time to think and immediately got busy.
“Boss … Boss Zheng, what are you preparing to do?” Department Director lang stammered and asked in a low voice.
“There’s no way to close the chest. Let’s do an ultrasound. ” As Zheng Ren spoke, his hands gently closed his chest.
His chest was not completely closed, but as Zheng Ren exerted more force, his sternum tried to close up, and the monitor’s alarm rang wildly.