Chapter 1795 Boldness (Monthly Ticket 15500 Plus More × 31)

Zheng Ren felt the patient's heart.

The myocardium throbbed erratically, as if in a last struggle. But all its efforts were in vain.

Even direct-view cardiac compressions can only provide a small amount of momentum to the weak heart.

Looking up, Zheng Ren's eyes narrowed, looking at the ECG on the ECG monitor.

3 or more ventricular premature contractions in a row!

The shape of the QRS complex is deformed, the time limit exceeds 0.12s, and the direction of the ST-T wave is opposite to the direction of the main wave of the QRS complex!

The ventricular rate exceeds 220 beats/min, and the heart rhythm is irregular!

Atrial independent activity has no fixed relationship with the QRS complex, resulting in atrial separation. Occasionally individual or all ventricles are excited retrograde to capture atria!

What a surprise! Zheng Ren cursed in his heart.

He was angry.

No one delays the rescue, and all processes are the fastest, but the best time is still not seized.

"Magnesium sulfate, 2g static push!" Zheng Ren roared in a deep voice.

The nurse was running, and Su Yun and Zhao Yunlong were giving the patient a lower extracorporeal membrane lung.

2g of magnesium sulfate was pushed in, Zheng Ren observed it for 10 seconds, but the effect was not good.

"Isoproterenol, 1mg, IV!"

"Isoproterenol, 1mg, intravenous injection!"

"Isoproterenol, 1mg, intravenous injection!"

The continuous bolus injection of isoproterenol made even Su Yun panic.

Isoproterenol was once the drug of choice for the treatment of ventricular arrhythmias, but it is now rarely used because it can lead to ventricular fibrillation in excessive doses.

Boss is this crazy!

But there's nothing wrong with it. They've all had their chest opened in the ward, and they've done cardiac compressions under direct vision. I'm not afraid of ventricular fibrillation at all... I shouldn't be afraid.

Su Yun hesitated.

He has never experienced the rescue of this kind of high-dose isoproterenol intravenous push.

The key is the implantation time of the extracorporeal membrane lung.

The sooner extracorporeal membrane lungs are used, the better the patient's chances of survival.

"Isoproterenol, 1mg, intravenous injection!" Zheng Ren continued to give the doctor's orders, holding the patient's heart in his hand to maintain the last beat.

He could feel the weakness of the patient's heart beating.

If I didn't hold my hand, I'm afraid I would have stopped jumping.

After pushing isoproterenol for the sixth time, Zheng Ren finally heard the voice he wanted to hear the most. The extracorporeal membrane lung machine has been started, and Su Yun has placed ECMO arteriovenous cannula from the femoral artery and vein, and the ECMO runs the auxiliary circulation.

On the electrocardiogram, the ventricular tachycardia was slightly relieved by high doses of isoproterenol and magnesium sulfate.

"Su Yun, prepare to defibrillate the chest!" Zheng Ren said.

"Okay." Before Su Yun could catch his breath, he started looking for electrodes and called Zheng Ren directly.

Two electrodes are placed on the front and back walls of the patient's heart.

"Boss, how old is it?" Su Yun asked.

Su Yun means how much energy, generally speaking, the intrathoracic defibrillation starts from 10J and slowly increases to 30J.

However, repeated defibrillation will consume a large amount of ATP, resulting in the patient's state will not be very stable after resuscitation, and even after a brief sinus rhythm, the patient will soon experience cardiac arrest again.

Because last time in Sweden, Zheng Ren used extreme energy to resuscitate Dr. Mehar's heart, which left a deep impression on Su Yun. He didn't think about it and asked directly.

"22J!" Zheng Ren paused, then said.

After Professor Zhang heard it later, he immediately said: "10J! It can't be too big, and the energy must be gradually increased!"

Su Yun didn't even look at him, he completely regarded him as air, adjusted to 22J energy, and glanced at Zheng Ren.

Looking at each other, Su Yun pressed the button.

With a soft click, the harsh screams from the ECG monitor stopped.

Heart rate back to sinus!

"I'm going..." Su Yun let out a long breath.

Professor Zhang was dumbfounded, all the things in front of him were beyond his cognition.

Zheng Ren also calmed down a bit and said, "Tell the operating room to push the patient up directly."

"Don't wait?" Su Yun asked.

"I can't wait, heparinized again, there may be a cerebral hemorrhage at any time." Zheng Ren said.

"Okay." Su Yun took off the sterile gloves and took out the phone.

"Boss, let's drive the two together, we have to sew the chest wall." Su Yun said.

"Uh... Santai, call Fu Gui'er and Lao Liu to come right away." Zheng Ren said, "I have extracorporeal membrane lungs and bleeding at any time. I will have an arteriography."

"..." Su Yun finally couldn't help but cursed in his heart.

The three sets are driven together... The boss really dares to think about it.

But who made him the boss? He has a big mouth and says what he says. Su Yun sneered in his heart and began to call someone.

Zheng Ren applied compression to the chest to stop bleeding, observed the patient's electrocardiogram, and was relieved to see that the sinus had recovered.

But there is only time to breathe a sigh of relief.

Open chest, not to mention infection, just a pneumothorax can't stand it.

Take the time to send the patient to the operating room, and everyone is busy.

Soon, pushing the hospital bed, ventilator, ECG monitoring, extracorporeal membrane lung machine, a group of people left the ward and went to the operating room mightily.

Professor Zhang stood alone in the empty ward, stunned by himself.

What just happened?

The chest is opened at the bedside, the heart is pressed under direct vision, a branch of isoproterenol is pushed in like this, and the energy of 22J is directly applied to the chest electric defibrillation...

These are things that Professor Zhang knows, but dare not do lightly.

Will nothing happen?

Professor Zhang still wonders if he is dreaming.

Is there any help for the patient? Finally, what did Boss Zheng say? Seems to be three in a row.

Does he want to do a bypass treatment for moyamoya disease on the head, disinfection and suturing of the chest, and interventional angiography at the same time?

This is not boldness, it is simply boldness.

It should be known that patients with heart failure have continuous ventricular arrhythmias under the support of IABP.

With three surgeries performed at the same time, can the patient withstand such a big blow?

Professor Zhang does not believe it.

Although he hoped that the patient would survive, Boss Zheng's approach went against the common medical knowledge he was familiar with.

Impossible, absolutely impossible!

A few minutes later, Professor Zhang thought about it several times in his mind, and he felt that there was no such possibility at all, and the patient would surely die.

He hesitated for a moment, and finally decided to go up and check the situation.

In his heart, he didn't want to see Boss Zheng make a fool of himself. After all, the coronary artery bypass surgery room was done by himself and Zhao Yunlong, and now he and Boss Zheng are like grasshoppers on the same rope.

Really... young people know that they are in trouble!

If you give up treatment well, how good is it to take people away from your family?

There are too many people in this world who cannot be healed, and the three stations are connected... As soon as he thinks of this, Professor Zhang's heart sank.

Terrible, simply terrifying.

You must follow along, otherwise they don't know how to write the course record and surgery record after the operation.

Don't blame your mistakes on yourself.

After working for decades, Professor Zhang has seen many such shady things, and he knew that he would definitely not be able to leave.

With a sigh, Professor Zhang turned around and walked out of the EICU, ready to take a look.