Chapter 1856: 1791 Treatment Discrepancy (Monthly Ticket 13000 Bonus ×26)

The surgery for smog disease went smoothly, but at the moment Zheng Ren was about to leave, he noticed the experimental subject's ECG monitor began to fluctuate violently, the heart rate instantly reaching 120……130……150……180……

Before Zheng Ren could do anything, the experimental subject's heart rate plummeted like a cliff, dropping straight to zero.

Without opening the chest, performing direct cardiac compression, the system prompted that the experimental subject had died.

Uh……

Zheng Ren looked at the experimental subject speechlessly, not feeling disappointed but a hint of excitement.

Although the experimental subject died, the system space told him this way that he should first initiate extracorporeal membrane oxygenation, then push the ECMO machine into the operating room to perform surgery; or, he could push the patient into the operating room to do ECMO.

Although troublesome, this is the only feasible method.

This also explains why the system gave the smog disease bypass surgery a completion rate of 50%.

As long as we find the cause, we can improve it in subsequent surgeries.

Zheng Ren immediately began the next surgery.

First, initiate extracorporeal membrane oxygenation for the experimental subject.

Extracorporeal membrane oxygenation has two flow modes, adapting to different disease needs.

V-V flow: venous blood is drawn out via veins, oxygenated and carbon dioxide removed in the oxygenator, then pumped into another vein.

This mode suits patients with pulmonary failure. V-V flow is a lung replacement method, commonly used when cardiac function is adequate but pulmonary function fails.

Respiratory medicine frequently uses it for some acute respiratory distress syndrome, acute lung injury causing acute respiratory failure, and other respiratory failure patients' extracorporeal support, mainly using the ECMO membrane lung system to provide adequate oxygenation, buying time for respiratory system function recovery.

V-A flow: venous blood is drawn out via veins, oxygenated and carbon dioxide removed in the oxygenator, then pumped into arteries.

This mode is for combined cardiopulmonary replacement, commonly used for cardiac failure and cardiopulmonary failure.

If the patient may experience prolonged cardiac pumping failure or cardiac arrest, the AA-v route can be used, i. e., two cannulas respectively draw blood from the left and right atria, oxygenate and remove CO2 via the oxygenator, then pump into arteries.

This method ensures sufficient blood flow support while preventing intracardiac and pulmonary thrombosis and pulmonary edema.

If the patient is awake, before intubation administer pancuronium bromide or succinylcholine choline as muscle relaxants, give morphine intravenously, and give lidocaine locally.

But in the system operating room, the experimental subject is already under general anesthesia, so Zheng Ren skipped this step.

After administering heparin 100u/kg, perform cervical arterial and venous cannulation.

Zheng Ren chose a cannula not too thick, capable of providing 2-3 L/min flow. He cut open, performed direct visualization cannulation. The cannula is not inserted deeply, tilted at a certain angle to avoid excessive vertical pressure causing dislodgement or spraying blood.

After insertion, confirm under X-ray, suture the cannula site, then secure the tubing.

After connecting the machine, Zheng Ren once again began the smog disease surgery.

The surgery went smoothly; this was the 14th training session.

Zeiss's microscope is still excellent; Zheng Ren did not experience dizziness etc. as in the previous intestinal suturing surgery training.

Surgery completion rate 98%!

Zheng Ren finally exhaled, he should have succeeded!

But he didn't immediately return, having already spent so much surgical training time, why not make the surgery as perfect as possible?

He performed another 8 surgery trainings, completion rate increased by 1% to reach 99%. Surgery time shortened by about 30%, Zheng Ren was fairly satisfied with this result.

Next is to convince the patient's family and proceed with surgery.

If the patient's family is financially strained, they can opt for surgery live broadcast.

Zheng Ren had everything figured out, calmly left the system space, and returned to the EICU ward.

"Zheng Lao Ban, please call a hospital-wide consultation." Zhao Yunlong suggested from the side, "Let neurosurgery take a look; if you feel there's a problem, have them set a treatment plan."

"Okay." Zheng Ren nodded.

Organizing a hospital-wide consultation is also standard procedure. This isn't his own hospital; Zheng Ren cannot act as he pleases in the system operating room.

Actually, it can't be said he can do as he pleases; outside he can reason. But Big Pig Trotter never reasons with Zheng Ren, issuing tasks randomly, not based on condition severity.

Perhaps in the system's judgment, the patient before him belongs to the extremely difficult-to-treat type, possibly not needing a task assignment at all.

"Xiao Zhao." As he spoke, Professor Zhang entered.

"Professor Zhang." Zhao Yunlong still replied respectfully.

"The patient's family refuses rescue……" Professor Zhang glanced at the patient, seeing the IABP already inserted, he couldn't help but be stunned.

So fast?

When did Zhao Yunlong become so efficient? Well, he's usually efficient, but this IABP insertion was too quick.

Professor Zhang immediately glanced around the ward; upon seeing Zheng Ren, he instantly understood what had happened.

"Refusing rescue?" Zheng Ren's brows furrowed.

"Mm." Professor Zhang nodded, saying: "I communicated with the patient's family; hope is slim, costs are high, the family cannot afford it, so they decided to give up."

His impression of Zheng Ren is still decent.

Although during the previous fishbone and mediastinal abscess surgery, Professor Zhang somewhat lost face, but medicine is like that; if someone can perform the surgery, that's ability.

Anyone with a sense of proportion must acknowledge this.

Professor Zhang has no objection to this.

Young people are young people; when rescuing, they are full of fervor. Professor Zhang looked at Zheng Ren, Su Yun, and Zhao Yunlong, thinking to himself.

When I was young, wasn't it the same? Now I've changed; to me, this is just a job.

It's not worth competing with oneself over an unsalvageable patient.

Everyone in the ward fell silent in unison.

Professor Zhang felt the atmosphere off; he said the patient's family agreed to give up rescue, shouldn't everyone be relieved?

Why is the atmosphere so oppressive?

"Professor Zhang, it's like this." Zheng Ren said: "The patient's condition is special, but I still think we can attempt rescue."

"Still possible?" Professor Zhang exclaimed.

The IABP is in place, yet the patient's heart rate remains unstable; seeing the cardiac load still too high, difficult to sustain.

Based on experience, the patient's heart function will soon fail.

With 912's technical ability, keeping the patient alive and continuously rescuing, this can also be done.

But is doing this meaningful?

Professor Zhang was somewhat angry.

Young man, to show off your skill, you take the patient's life as a sacrifice—do you really do things like this!

He stared at Zheng Ren and coldly said: "Zheng Lao Ban, tell me, what's the patient's condition?"