Chapter 2719 If You Go Back To The Past

Time is no longer counted in days, nor in hours, but in seconds.

Second by second, the patient's invasive arterial blood pressure drops steadily, and the heart rate does not change drastically when it exceeds 150 beats per minute.

But this kind of tachycardia is already very scary. I don't know when it will be a cliff-like fall, and the patient can be declared dead.

The blood oxygen saturation has dropped to about 66%, and the oxygen supply is not enough. The anesthetist has started to switch to a 100% pure oxygen ventilator for ventilation.

Under the action of pure oxygen, the blood oxygen saturation rises briefly and then drops unswervingly.

"Director Liu, it must be a gas embolism." The anesthetist was a little flustered, and all the possibilities he could think of were ruled out, leaving only this diagnosis with a huge mortality rate.

If it's a gas embolism, fuck it, the anesthetist's voice trembled when he said that.

Director Liu took a look and found that the Hem-o-lock was placed at the bifurcation of the renal vein to completely clamp the renal vein, and there was no possibility that a large amount of carbon dioxide would flow along the vein and enter the blood circulation through the pressure difference when pneumoperitoneum was established.

He denied the anesthetist's statement, but still cautiously stopped the carbon dioxide intraperitoneal inflation immediately, and pulled out the troroca to relieve the pneumoperitoneum

However, the patient's condition remained unchanged. The rescue medication had already been administered, and the vital signs displayed on the monitor were still declining.

"Call Director Miao." Director Liu said in a deep voice.

The itinerant nurse was stunned for a moment, and the time seemed to go back to half a year ago. No matter what happened, just call Director Miao and it would be resolved.

But she didn't hesitate, and didn't care that Director Miao had retired now, but immediately called Director Miao.

...

...

Director Miao was sitting at home, chatting and gossiping with Zheng Ren and Su Yun.

They chatted all over the place, but they didn't talk about medical treatment. I have been working for my whole life, and I have already returned to the field at this time, so let all that go away from me.

"Director Miao, my mother also dances square dance at home, so I don't know what's so good about it. Tell me about the benefits." Su Yun said, "Why is it raining or not? The old man and the old lady are so proud This thing."

"Let's join in the fun together." Director Miao said with a smile, his voice was full of vitality, and he had basically recovered completely. Except for a small problem when walking due to broken ends, everything else is fine.

"There is nothing to do at home all day, and being idle is idle."

"I have a dog at home, why don't you walk it for me if you have nothing to do? Take it by the way. Heizi's leg was broken during the earthquake relief work, so he can't run fast. Don't worry, it's comparable to your legs." Su Yun smiled. asked.

Just as Director Miao was about to curse with a smile, the phone rang.

He leaned back on the sofa and picked up his phone leisurely. After a glance, it was the call from the operating room. He sat up straight suddenly, the smile on his face was hidden, only majesty and solemnity remained.

"What's wrong, Director Miao?" Su Yun asked.

Director Miao waved his hand, and instead of answering Su Yun's words, he connected directly to the phone.

"What's wrong?" Director Miao asked in a deep voice.

The voice of wah wah wah came from the other side of the phone. It was very urgent and loud, and both Zheng Ren and Su Yun heard some fragments.

Uh... the patient was not doing well during the operation? !

The two looked at each other. If they were in 912, they would have rushed to the operating room by this time.

But now at Director Miao's house, waiting for a car to come, and then rushing to the hospital, the cucumber dishes are cold.

Department of Urology, laparoscopic nephrectomy in the afternoon, did you touch a blood vessel that shouldn't be touched?

"Video, let me check the patient's condition." Director Miao said seriously after listening to the brief introduction.

After hanging up the phone, Director Miao saw that Zheng Ren and Su Yun were staring at him, and explained: "The nephrectomy was performed under laparoscopy, and the blood pressure and heart rate suddenly became unstable, and the blood oxygen saturation dropped rapidly."

That's right!

"Have you touched a blood vessel?" Su Yun asked.

"No, it's over if it touches a blood vessel to stop the bleeding." Zheng Ren said, "It probably happened out of nowhere. Is it caused by a vagal nerve reflex?"

Director Miao shook his head slightly, "Cardiac arrest caused by vagus nerve during nephrectomy is rare, and medication is usually enough."

As soon as I said this, the voice of the WeChat video sounded, and Director Miao connected the video request.

"Director, patient..." Director Liu's voice came from the video. He held his mobile phone and pointed the screen at the laparoscopic TV screen. "There is no bleeding, the patient's blood pressure and heart rate..."

"Heart stopped! Cardiopulmonary resuscitation!" The anesthetist shouted loudly.

Zheng Ren and Su Yun quickly surrounded Director Miao and looked at the screen.

The heart rate dropped precipitously, the blood oxygen saturation was 52%, and the alarms on the ventilator and monitor continued. Even when they saw this scene at home, the three people naturally secreted a large amount of dopamine, adrenaline, and glucocorticoids in their bodies.

"The anesthesiologist adjusts the operating table so that the head is lowered and the feet are higher." Director Miao said.

But the screen was in a mess, the anesthesiologist was pushing the medicine, and Mr. Yu was doing the heart compressions. Because the problem was not found yet, everyone panicked.

"Anaesthetist! Xiao Liu, adjust the bed position, head down and feet up!" Director Miao said incredulously, raising his voice.

Soon the bed was adjusted at an angle, and the position was changed as Director Miao said.

Adrenaline, isoproterenol, cedilan, the instructions for intravenous injections came out from Director Miao's mouth one by one, and the doctor's orders were carried out on the video side.

It was as if an invisible hand turned back the time and went back to the past again. At this time, Director Miao was standing in the operating room and presiding over the rescue.

"Director Miao, what do you think is..."

"Establishing pneumoperitoneum, leading to gas embolism." Director Miao said with certainty.

If Zheng Ren was present, he could use the system panel to make a judgment; if Director Miao wasn't there, Zheng Ren would probably have to think about it for a while to be sure.

After all, gas embolism caused by the establishment of pneumoperitoneum is so rare, at least Zheng Ren has never encountered a similar situation when he performed laparoscopic surgery in general surgery.

Laparoscopic nephrectomy, Zheng Ren quickly searched for similar information in his mind.

For patients with kidney disease, laparoscopic nephrectomy is a minimally invasive, safe and effective surgical treatment, but there is an inevitable risk of air embolism due to the need to establish a pneumoperitoneum

The incidence of gas embolism is very low, about 0.002%~0.02%, once it occurs, the fatality rate can be as high as 50%

Reviewing the literature, so far only 5 cases of gas embolism in laparoscopic renal surgery have been reported

Jiang, still old and spicy, probably Director Miao has encountered a similar situation, and he can tell what happened at a glance.

After all, Director Miao was one of the first batch of surgeons in China to use laparoscopic surgery, and he has never encountered any situation.