Chapter 1853: with translation of chapter title

"What are you thinking about at home?" Su Yun crouched, fiddling with the patient's chest tube.

He cleared the fresh blood that had drained from the chest tube, timing it while bending a segment of the tube to observe the drainage speed.

The chest tube is patent, drainage is not much; this can be confirmed.

What Su Yun is doing seems unnecessary, but Zheng Ren knows he is eliminating possible problems from minor details.

Many seemingly serious conditions actually stem from the accumulation of tiny problems.

"Old Zhao, what about the second line?" Su Yun asked while fiddling with the chest tube in his hand.

"Professor Zhang..." Zhao Yunlong said.

Su Yun was also helpless.

It's not that Professor Zhang is like that; everyone's level differs, as does their ability to bear risk and their thoughts.

Some lean toward being aggressive, some toward being conservative.

Each has its own advantages, and each has its own disadvantages.

As for Professor Zhang, if he were teaching at school, he would be a very good teacher. But placed in such an extremely complex situation, he may not necessarily be a good choice for emergency rescue.

"Where is the person?" Zheng Ren asked.

"He'll be here soon." Zhao Yunlong said: "Zheng... Boss, could you keep an eye on things? I'll go urge the patient's family."

"Go ahead." Zheng Ren said: "Is the catheter lab ready for IABP?"

"It's ready; Director Zhang Lin is rushing over from home." Zhao Yunlong said.

Zheng Ren nodded, didn't continue speaking, but opened the computer and began to look at the patient's chart.

Zhao Yunlong's account was too brief, only mentioning the main points, with no time left to elaborate in detail.

Regarding the patient's condition, Zheng Ren still thought it better to examine it himself carefully.

The patient is 52 years old, with a family history of hypertension; his father died of cerebral hemorrhage. Previously asymptomatic, as Zhao Yunlong said, he came to the hospital two days ago due to worsening chest tightness and shortness of breath.

In the medical record, the patient reported no history of dizziness.

Regarding this, Zheng Ren expressed doubt. If there were dizziness, a covert onset would be most reasonable.

The patient's history is just as stated; it cannot represent everything, only serving as a reference, especially for a patient with such a complex condition as now.

Upon admission, head CT showed abnormality; the cranial nuclear magnetic resonance was done a day later.

Zheng Ren could sense that the patient's family might not sign consent for IABP; there may have been early signs—family or financial factors could be involved.

Zheng Ren looked over the lab slips and various examination reports one by one.

He quickly gained a certain understanding of the patient's condition evolution. Su Yun, beside him, glanced at the chart, then back at the patient's condition, almost twisting his neck.

"Boss, the smog disease shown on the MRI is quite serious." Su Yun commented as he saw Zheng Ren insert the MRI film into the viewer.

"Hmm, I was considering..." Zheng Ren had just said that when the monitor alarm blared.

The beeping sound echoed through the room.

Zheng Ren and Su Yun sprang up; Zheng Ren's chair overturned to the floor with a bang.

"Prepare IABP!" Zheng Ren shouted lowly.

Su Yun stared for a moment, instinctively wanting to refuse. Doing IABP without the patient's family signature—is that a death wish?

But he heard from Zheng Ren's tone an unyielding determination not to be refused.

To hell with it! Su Yun gritted his teeth; anyway, if the sky falls, the boss will bear it. At worst, quitting and working at Massachusetts General Hospital seems like a decent option.

"IABP machine and its helium supply are ready!"

"IABP catheter and puncture kit are ready!"

"0.9% NaCl 500ml + heparin 5000U, ready!"

"Pressure bag, maintain pressure at 300mmHg?"

Su Yun asked.

"Okay." Zheng Ren pulled back the patient's blanket, then opened the IABP puncture kit and prepared povidone-iodine.

"Lidocaine." Zheng Ren said in a low voice while putting on gloves.

Su Yun had already turned on the machine, pushed it to the bedside, unscrewed a plastic bottle of lidocaine, and placed the syringe into the sterile pack.

Zheng Ren picked up the syringe, inserted the needle into the bottle's opening, and drew out lidocaine.

Without dilution, he grabbed a handful of povidone-iodine with his right hand, disinfected the patient's femoral artery, then administered local anesthesia.

Puncture succeeded; the balloon catheter was advanced into the patient's femoral artery. Zheng Ren moved quickly, while Su Yun just placed the electrode pads on the patient's chest, and both ECG monitoring systems ran simultaneously.

By then Zheng Ren had completed the maneuver, sending the IABP tube to the descending aorta position.

He turned on the counterpulsation pump and handed the sensor for monitoring aortic pressure to Su Yun.

Su Yun connected the sensor to the main unit.

Flush system, connected to the sensor, central lumen connected to the pressure line.

Zheng Ren's required tasks were basically done; Su Yun's side was buzzing with activity.

Connecting the helium tubing, Su Yun checked several times, confirming the helium working pressure met specifications.

"Suture it." Su Yun said firmly.

Zheng Ren nodded and began securing the helium tubing.

Meanwhile Su Yun adjusted the various parameters on the main unit.

Su Yun is more professional at this than I am, and Zheng Ren knows it. Letting him handle it is the most hassle-free approach.

I myself have no need to participate.

As the IABP system started working, Zheng Ren exhaled in relief; the patient would be fine for the short term.

The machine feeds the patient's ECG or blood pressure signal into the counterpulsation control unit, causing the balloon pump to act in synchrony but opposite to the patient's heartbeat.

Just before ventricular contraction, when the aorta opens, the balloon deflates, lowering end-diastolic aortic pressure, reducing left ventricular work. Afterload is reduced, decreasing myocardial oxygen consumption.

Just before cardiac diastole, the balloon inflates, increasing diastolic coronary perfusion pressure and myocardial oxygen supply.

Doing this reduces left ventricular preload and afterload, easing the heart's burden. The balloon rapidly deflates just before ventricular contraction and aortic valve opening, causing an instantaneous drop in aortic pressure, simultaneously lowering left ventricular ejection resistance and increasing cardiac output.

For perioperative Shou Bing support and Stability of hemodynamic status, the intra-aortic balloon pump has unparalleled significance.

With the initiation of the intra-aortic balloon pump, the frantic ECG Monitor gradually calms.

«Boss, the patient's family hasn't signed. » Su Yun finished adjusting the machine's various parameters, seeing Zheng Ren packing up the intra-aortic balloon pump equipment, she said helplessly.

«No time. » Zheng Ren said, «By the time the family signs, the person will be dead. »

«Why hasn't Lao Zhao come back yet? » Su Yun muttered, her eyes fixed on the monitor.

This emergency 120 Emergency was considered a success, but various values and indicators remain less than ideal. The patient remains in a critical state, and whether it will hold depends on fate.

«Boss…» Su Yun frowned and said, «I don't think this looks good; the patient's condition is too severe, worse than imagined. »

Zheng Renye also noticed this, mentally calculating what to do next.