Chapter 1997 Possible Withdrawal Symptoms

"High caffeine consumption has been linked to a range of psychiatric problems, from anxiety and dysthymia to manic and psychotic episodes. In addition, excessive consumption of energy drinks may induce certain medical problems, including acute renal failure."

"Well, it's quite pleasant to say that." Su Yun nodded.

"What's the matter?" Zheng Ren was surprised.

"It's too pretentious for you to talk about 116 individual case reports and whatnot. They are all from our own people, so it's better to speak simply." Su Yunshun spouted.

"I'm too lazy to talk about it." Zheng Ren said plainly, "However, there are only three reports in the world about functional drinks + coffee causing mental symptoms and acute renal failure at the same time, and they are from the UK..."

Zheng Ren didn't know if he was inspired by Su Yun, and immediately began to discuss it in detail.

Zhou Litao listened silently, he was dumbfounded. The detailed data provided by Boss Zheng is one thing, but the more important thing is that energy drinks + coffee can actually cause kidney failure.

"It's so serious." Zhou Litao said in a low voice.

"Well, of course." Zheng Ren said: "I talked to the nephrologist and diagnosed tubulointerstitial nephritis caused by toxin; the patient has elevated creatine kinase, which may be caused by physical restraint, psychomotor agitation, and impaired renal clearance. damage together.”

"Is there any test results to support it?" Lin Yuan asked.

"We're doing a biopsy and a series of related tests. Up to now... By the way, you didn't see the emergency kidney function check in the emergency department." Zheng Ren remembered, "Creatinine is 1205 μmol/L, blood urea nitrogen is 22 μmol/L. "

"Acute renal failure so severe?" Su Yun frowned.

The normal range of creatinine is 59-104 μmol/L, and the normal reference range of blood urea nitrogen is 2.9-6.4 μmol/L.

These two values ​​of the patient have increased several times to ten times, which is consistent with the performance of acute renal failure.

"I guess the blood gas analysis...should be acidosis. If Mr. Zhou is interested, he can consult a doctor in the nephrology department after the test results come back." Zheng Ren already knew it in his heart, and said with certainty.

Zhou Litao and Lin Yuan silently wrote down this point at the same time.

It's not that he doubted Boss Zheng, but he dared to say so meticulously, as if he had seen the test report with his own eyes, so there must be his reason.

"By the way, guess how many functional drinks the patient drank?" Zheng Ren asked.

"Quickly tell me, where do you guess this thing." Su Yun said contemptuously: "I don't believe you can guess before you go to the kidney to meet Lao Cui."

"It is said that from last night until the onset of the disease, I drank 12 bottles of functional drinks and more than 20 packets of coffee." Zheng Ren said.

The reason Zheng Ren didn't want to drink the potion given by the system frequently was because he was afraid of getting agitated by the drug.

"Tsk tsk, what kind of sleepiness is this?" Su Yun immediately looked at Zhou Litao.

Zhou Litao has a hair on his back, because he also often drinks coffee.

"President Zhou, you have to be careful."

"ah……"

"My boss and I will definitely not drink refreshing things like this." Su Yun said with a smile, "Caffeine poisoning has a lot of overlap with anxiety disorders on the physiological and psychological levels, and it mostly occurs when the daily intake of caffeine exceeds 1000 mg. Severe caffeine poisoning can be fatal, and the blood caffeine concentration can be ≥70mg/L at this time."

Zhou Litao breathed a sigh of relief, and said, "Don't worry, Brother Yun. I'm going to have a cup of coffee in the morning now, and I won't drink any more."

"Caffeine withdrawal symptoms will appear even if you only drink one cup of coffee a day for a long time." Su Yun threatened and threatened Zhou Litao with a smile.

"Don't listen to him, the amount of caffeine in a cup of coffee is very small." Zheng Ren didn't want to leave Zhou Litao with a psychological shadow, and immediately said: "Only about 10.2% of the patients will have mild withdrawal symptoms, it's fine. "

Zhou Litao was startled, 10.2% is also possible! Even the slightest withdrawal symptoms are withdrawal symptoms.

"Boss, you are so boring." Su Yun said contemptuously: "Just now I saw that the freckles on Mr. Zhou's face are all black, didn't you notice it?"

Zheng Ren didn't understand his bad taste, ignored Su Yun, and just smiled at Zhou Litao, "Mr. Zhou, then let's go first."

"Boss Zheng won't be chatting anymore?" Zhou Litao asked.

"No, I'm a little tired after the operation." Zheng Ren's smile was a little stiff.

Huh? Boss Zheng, who is like an iron man, is tired? Didn't it mean that Boss Zheng in Pengxi Township had surgery for three days and three nights?

But no matter what, Boss Zheng made it clear that he was tired, and Zhou Litao couldn't persuade him to stay, even though he had a lot to say to Su Yun.

Wechat is not very convenient after all, Zhou Litao is more used to looking at the other person's eyes and talking like asking a medical history.

Leaving the emergency department, Lin Yuan asked strangely: "Boss Zheng, are you sick?"

"No." Zheng Ren said expressionlessly.

"His father-in-law is coming back, and he feels depressed. You'd better not provoke him." Su Yun chuckled and told the truth.

This reason... Is the relationship between Boss Zheng and Xie Yi's family so bad? Lin Yuan expressed his incomprehension.

...

...

Imperial Tumor, Dean Lin is presiding over the emergency consultation in the operating room.

A male patient had an accident.

A few months ago, he was diagnosed with acute lymphoblastic leukemia by examination in the Imperial Tumor. Before the second course of chemotherapy, a professional nurse performed central venous catheterization under local anesthesia.

The catheter is a three-way valve type peripherally inserted central catheter (PICC) made in the United States, 4f, with a length of 60cm.

A PICC was inserted through the left median vein to reach the superior vena cava. 44cm was left in the body, the rest was left outside the body, and 5cm was cut off. Postoperative routine X-rays were taken to confirm the position.

There were no problems such as catheter blockage, difficulty in blood withdrawal, infection, and phlebitis during and between periods of treatment with PICC.

However, it was supposed to be the fifth chemotherapy. The patient was admitted to the hospital today. The nurse found that there was only a connector under the veil on the left forearm of the patient, but no external part of the PICC catheter. It was considered that the catheter had already slipped into the body.

As for when she fell off, the patient did not know the specific circumstances at that time.

The patient developed the triad of pulmonary embolism with chest pain, hemoptysis, and dyspnea in the past 1 week.

X-ray examination in the emergency department showed that the tip of the PICC catheter had reached the right pulmonary artery, and the end was left in the left subclavian vein inside the shoulder joint. Confirm that the PICC catheter fell out of the body, and immediately inform the patient and family members.

This alone is definitely not enough, this patient needs emergency surgery!

The cancer hospital does not have a circulatory department and is a specialized hospital.

Although it is very rare that the PICC tube fell off, it happened. The department urgently reported it to the medical department, and the medical department contacted the circulation specialist hospital and reported it to Dean Lin at the same time.

Intervention and access to PICC pipelines have been completed through this technical means in the past few times.

So a team of experts in circulatory interventional surgery was invited from the nearest circulatory hospital to start the operation urgently.

...

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Note 1: I drink 3 packs of coffee a day, and feel breathless as I write this...