"What if there's no signature from the patient's family?" Su Yun asked.
"Look for Chief Lin," Zheng Ren said.
"Yes, the work of the medical administration division is to protect the clinic," Su Yun said disdainfully. "But it doesn't include people like you!"
"Emergency treatment. Is there any other way?" Zheng Ren said. "Ask Zhao Yunlong if he's done signing. I've been working for a long time. I think he should be able to sign it this time. "
"How do you know?"
"It takes a whole day to do an MRI of the head, let alone IABP," Zheng Ren said. "His condition isn't very good either. Give a critical notice. The patient will come back if he can't handle it."
Su Yun frowned. "Are you sure?"
Zheng Ren sighed. He looked at the patient's red System panel and felt a little helpless.
"He might still need the support of an extracorporeal membrane lung. Do you know how to do it?"
"No problem," Su Yun said with certainty.
ECMO was a cardiopulmonary bypass technique that came out of the cardiac operating theater.
Its principle was to draw venous blood out of the body and inject it into the patient's arteries or venous system through a special artificial cardiopulmonary bypass oxygenation. It played a partial role in replacing the heart and lungs and maintaining the oxygenated blood supply of the human organs and tissues.
Sea City General Hospital did not have ECMO. The first time Zheng Ren saw it after graduation was with Dr. Mehar.
Zheng Ren smiled bitterly and shook his head. "Have you seen the nuclear MRI?"
"The diagnosis of moyamoya disease is very clear," Su Yun said. "If it's an extracorporeal membrane lung, a large amount of heparin will enter the circulatory system. Do you think it will aggravate moyamoya disease and cause cerebral hemorrhage? "
"Yes, the possibility is very high." Zheng Ren's words were relatively polite. As soon as he entered the System's operating theater, he tried to perform an extracorporeal membrane lung.
However, less than two hours after he finished, the patient died due to cerebral hemorrhage.
This was a dilemma.
The conflict between heparin anticoagulation and hemorrhage, hemolysis, and poor compatibility of biomaterials. The road of exploration was long. On this road, countless people died, but there were also countless people who survived.
Technically speaking, there was no problem with Su Yun's ECMO lung.
However, Zheng Ren judged that a large amount of heparin would cause cerebral hemorrhage, so Su Yun hesitated. Using an ECMO lung, not to mention the cost, was an extremely difficult task from a technical point of view.
"Find the neurosurgery department?" Su Yun asked.
"Find Lin Ge first, now!" Zheng Ren said, "The surgery was done under cardiac arrest. The blood was heparinized, so it's very likely that … Why isn't Zhao Yunlong back yet?"
"I'll make a call to urge them," Su Yun said.
"You watch, I'll go take a look." After packing up the IABP, Zheng Ren checked the patient's vital signs, opened the door, and strode into the corridor of the EICU.
Zhao Yunlong quickly walked back with a piece of A4 paper in his hand.
"Old Zhao, I need to talk to you." Zheng Ren waved.
"Go back and do the IABP. I'm worried that I'll have another cardiac arrest," Zhao Yunlong said in a hurry.
"It's done," Zheng Ren said.
"You … finished?" Zhao Yunlong said in surprise. He then lowered his voice and hurried to Zheng Ren's side. "Boss Zheng, did you just make it?"
"Yes, it's a sudden heart attack. I have to do it. My condition is slightly better now, but not by much, "Zheng Ren said." I'm considering using the extracorporeal membrane lung for a while, but there's a contraindication. "
"Moyamoya disease? Can you diagnose it? "Zhao Yunlong was in a dilemma.
"Yes," Zheng Ren said. "What did you tell the patient's family before the thoracotomy?"
"I didn't have time to tell them at the beginning. The patient was sent to the operating theater with external chest compressions for surgery," Zhao Yunlong said. "Before I started the extracorporeal circulation, I told the patient's family that it was suspected to be moyamoya disease. Heparinization of the blood is likely to cause cerebral hemorrhage."
"What did the family say?" Zheng Ren was most concerned about this problem.
If the family cooperated, there was at least a 30% to 50% chance of saving the patient.
However, if the family did not cooperate …
It would be better to give up on resuscitation. That way, there would be fewer medical disputes and conflicts.
If the extracorporeal membrane lung was used, it was hard to say whether the patient would survive or not. However, for the patient's hesitant family, the hospitalization period would increase dramatically.
However, if the patient did not undergo extracorporeal membrane lung, the patient would undoubtedly die. The only difference was that they could live for a few more hours.
His heart was tired, and Zheng Ren did not want to face such a situation.
However, life was like this. It was impossible to do whatever he wanted like in the System's operating theater.
"The patient is married for the second time. Her current husband said he wanted to give up treatment," Zhao Yunlong said. Zhao Yunlong said, "But her daughter just rushed over and insisted on treatment. She even signed the papers happily."
Zheng Ren's heart had just sunk, but it rose again.
What a complicated family environment. No wonder they had to wait a day for the MRI to be done at the beginning.
Zhao Yunlong had already taken a huge risk to be able to undergo surgery and survive.
"I'll go take a look," Zheng Ren said.
"Boss Zheng, Professor Zhang is outside communicating with the patient's family," Zhao Yunlong said. "Wait a moment."
"Communicate what?" Zheng Ren heard a hint of unease in Zhao Yunlong's tone.
"To be honest, the possibility of the patient surviving again is not high," Zhao Yunlong said dejectedly.
No one wanted the patient to be alive more than the chief surgeon and the doctor in charge. This kind of expectation was very complicated and difficult to express in a few words.
Zheng Ren also knew that after Professor Zhang finished explaining, the family would most likely give up on treatment, and the patient would die.
As long as the patient's family gave up on resuscitation and withdrew the IABP, the next rapid ventricular beat would cause heart failure and the patient would die.
He sighed deeply.
"Is it a financial problem?" Zheng Ren asked.
"Yes, the family is not very well-off," Zhao Yunlong said. "They're migrant workers and have never paid social security in their hometown."
"If it were me …" Zheng Ren stopped mid-sentence.
Zhao Yunlong patted Zheng Ren's shoulder helplessly and did not say anything else, walking back to the ward in silence.
Live broadcast of emergency treatment, ECMO?
The success rate was a very important factor in Xinglin Garden's live broadcast.
What would happen if the patient had ECMO due to various problems? Due to the heparinization of the body's blood, a microaneurysm would rupture and bleed, and the patient would die during the live broadcast.
For a mature business operation, this was completely untenable.
The reputation that Zheng Ren had painstakingly built up would also be fatally damaged by the patient's death.
However … Zheng Ren was not thinking about the ECMO, but the surgical treatment for Moyamoya Disease.
First, the bleeding point was blocked, and the rest would be easier to solve.
Zheng Ren judged that with the support of the ECMO, the bypass surgery would not be a problem, and the patient would still have a chance of survival.
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