Doctor: I picked up attributes in the hospital

Chapter 158
operating room.

At this moment in the operating room, the atmosphere is very dignified. Everyone present is tense, as if they are facing an enemy.

On Zhao Heng's side, the preoperative anesthesia preparations have been completed.

But watching the patient's heart rate and blood pressure go up and down, Zhao Heng felt like he was on a roller coaster.

"The patient's vital signs are stable and surgery can begin."

Zhao Heng regained his composure, looked at the patient's heart rate and blood pressure again, and said to Liu Ziang and Jiang Rui, the chief surgeons.

"Okay, let's start."

Liu Ziang nodded, which means the operation has started.

The first thing to do is extracorporeal circulation. Performing extracorporeal circulation on such a critically ill patient is equivalent to dancing on the tip of a knife. If one is not careful, the patient's heart may not be able to recover.

"Doctor Zhao, the artificial heart-lung machine, variable temperature water tank and oxygenator are all ready."

Here, Tian Zhen also reported to Zhao Heng.

She and Sun Li have already prepared all the equipment for extracorporeal circulation.

"it is good."

Zhao Heng nodded.

Next, Zhao Heng and Cardiac Surgery Chief Doctor Jiang Rui completed extracorporeal circulation, while Liu Ziang was preparing for the craniotomy.

These tasks are all carried out in an orderly manner. The entire operating room is like a large and complex battlefield. Everyone is responsible for charging forward at different times.

This is a very common multi-threaded working mode in the operating room. As a surgeon, you must be very proficient in mastering this working mode.

Under normal circumstances, direct intracardiac surgery with extracorporeal circulation uses a sternal median split incision, most of which are inserted into the supply vessel through the ascending aorta, and a vena cava drainage tube is inserted through the right atrium.

Sternocentral incision, in layman's terms, is to cut the patient's chest completely open from the center, and then directly expose the heart.

This is the same type of operation as craniotomy.

Zhao Heng was holding sternum forceps, and Jiang Rui was holding an electric knife. With the cooperation of the two, the patient's chest was soon opened.

Once the chest cavity was opened, the heart could be seen directly.

Seeing the beating of the human heart directly at close range, this vivid and vivid experience is still very shocking.

No matter how many times he watched it, every time he saw this scene, Zhao Heng would always feel a shudder in his heart.

This is a very vivid life, and life and death are in the hands of the chief surgeon. This feeling cannot be experienced without being a surgeon.

hiss!
Zhao Heng gasped when he saw the patient's heart.

Because, on the surface of the heart, he saw the scars caused by the electric shock. These scars were radial on the surface of the heart, which was a typical electric shock-like appearance.

Seeing the scene in front of him, Zhao Heng once again felt that it was a miracle that this patient survived to be on the operating table.

Next, let's see if the miracle will happen again.

"Proceed with ascending aorta cannulation."

Zhao Heng said in a deep voice.

He is an anesthesiologist, so the series of operations of extracorporeal circulation are naturally dominated by him.

"it is good."

Jiang Rui nodded.

At this moment, he already recognized Zhao Heng very much, but now his recognition has deepened.

Even at Hopkins, extracorporeal circulation for such critically ill patients is enough to write a paper and publish it in the main journal of SCI.

This is a race against death.

To use a popular metaphor, heart surgery is equivalent to a problem with the car engine, and the engine must be repaired without turning off the engine.

This is heart surgery, extracorporeal circulation, that's the kind of surgery.

Extracorporeal circulation, in fact, is to temporarily establish a circulatory system outside the heart to replace the heart, and the heart is temporarily in a state of arrest.

After the operation on the heart is completed, the heart can be restored to beating.

The almost unbelievable operation of stopping the heart and then restarting it is only possible because of the development of modern medical technology.

During the intubation, Zhao Heng's heart was raised. If the patient suffered from cardiac arrest before the extracorporeal circulation was completed, it meant that all subsequent operations were unnecessary.

But fortunately, for this patient, Zhao Heng has made very thorough preparations, so arterial blood supply - ascending aorta cannulation, venous drainage cannulation - single right atrium cannulation and superior and inferior vena cava cannulation , left heart drainage tube, all of these were successfully completed.

Looking at the constantly changing numbers on the fluorescent digital continuous display, Zhao Heng breathed a sigh of relief.

The blood flow pressure, flow rate, and oxygen concentration are all normal, and the subsequent surgery can be carried out normally.

"Doctor Jiang, you can start now."

Zhao Heng nodded to Jiang Rui and said.

"it is good."

Jiang Rui, who had been waiting for a long time, took a resident doctor from the Department of Cardiac Surgery to start the repair of the heart valve.

At the same time, Liu Ziang was also performing a craniotomy to remove the hematoma in his brain.

Sitting next to a large number of monitors, Zhao Heng sat upright, paying attention to the real-time data displayed on the monitors all the time.

These data reflect the patient's physical condition at all times.

Time passed by minute by minute.

Three hours later, Liu Zi'ang was the first to complete the removal of the intracranial hematoma and performed a cranial closure.

After completing the removal of the intracranial hematoma, Liu Ziang looked at Zhao Heng who had been in a state of high tension and did not dare to relax for a moment, and he was very appreciative in his heart.

There are not many young doctors today who can do what Zhao Heng does.

At this moment, Jiang Rui suddenly frowned, as if he had encountered some problem.

"Doctor Jiang?"

Seeing Jiang Rui's frown, Zhao Heng stood up and asked.

"Doctor Zhao, Director Liu, come and see."

Jiang Rui said to Zhao Heng and Liu Ziang.

When Jiang Rui said this, Zhao Heng and Liu Ziang walked to the operating table and looked at the place Jiang Rui pointed at.

Seeing this, Zhao Heng's scalp went numb, and Liu Ziang was not much better.

Because they saw that the surface of the patient's heart was already in bad shape. The heart looked like a rotten peach.

I really don't know how the patient got on the operating table just now?
"This is the sequelae of electric shock, rhabdomyolysis, it must be because of the special constitution of the patient itself, and it didn't break out until now."

Jiang Rui explained to Zhao Heng and Liu Ziang.

Rhabdomyolysis is a syndrome caused by intracellular substances entering the extracellular fluid, mainly caused by trauma, strenuous exercise, high fever, electric shock, and electrolyte imbalance.

The biggest problem with rhabdomyolysis is that too many broken cell products enter the renal blood vessels, which may lead to serious complications such as acute renal failure and disseminated intravascular coagulation (DIC).

"The heart is just one place, there must be other places."

Zhao Heng said very solemnly.

"Let's complete the operation first, and strictly prevent the patient from developing acute renal failure and DIC after the operation."

Liu Ziang thought for a while and made a decision.

"it is good."

Jiang Rui nodded.

This patient was really troubled. Even if he survived the operation, he had to survive the acute renal failure and disseminated intravascular coagulation caused by rhabdomyolysis after the operation.

(End of this chapter)