Chapter 1861: 1796 Recklessly Bold (Monthly Ticket 15500 Bonus Chapter ×31)

Zheng Ren felt the patient's heart.

The myocardium twitched incessantly, irregularly, as if making a final struggle, but all its efforts were in vain.

Even with direct cardiac compression, it could only give the powerless heart a little momentum.

He lifted his head, Zheng Ren's eyes narrowed as he looked at the ECG on the monitor.

Three or more ventricular premature contractions appeared in succession!

The QRS complex morphology was deformed, duration exceeded 0.12 seconds, and the ST-T wave direction was opposite to the main direction of the QRS complex!

The ventricular rate exceeded 220 beats per minute, the rhythm was irregular!

Atrial activity had no fixed relation to the QRS complexes, forming AV dissociation. Occasionally, individual or all ventricular activations conducted retrograde to capture the atria!

Damn it! Zheng Ren cursed in his heart.

He was very angry.

No one delayed the rescue; all procedures were as fast as possible, yet they still missed the optimal window.

"Magnesium sulfate, 2g IV push!" Zheng Ren shouted in a low voice.

The nurse was running, while Su Yun and Zhao Yunlong were placing the patient on extracorporeal membrane oxygenation.

After pushing 2g of magnesium sulfate, Zheng Ren observed for 10 seconds; the effect was poor.

"Epinephrine, 1mg, IV injection!"

"Epinephrine, 1mg, IV injection!"

"Epinephrine, 1mg, IV injection!"

The continuous epinephrine pushes made even Su Yun a little panicked.

Epinephrine had once been the first-line drug for treating ventricular arrhythmias, but because excessive doses could cause ventricular fibrillation, it is now rarely used.

Boss, are you crazy?

But there's no problem; we're doing an open-chest cardiac massage in the ward under direct vision, so we shouldn't fear ventricular fibrillation… probably not.

Su Yun hesitated a bit.

He had never experienced a rescue with such a large dose of epinephrine pushed intravenously.

The key lies in the timing of extracorporeal membrane oxygenation insertion.

The earlier extracorporeal membrane oxygenation is used, the greater the patient's hope of survival.

"Epinephrine, 1mg, IV injection!" Zheng Ren kept giving orders, his hand squeezing the patient's heart to sustain the last beat.

He could feel the weakness of the patient's heartbeat.

If it weren't for his hand holding it, it would probably have already stopped.

After the sixth epinephrine push, Zheng Ren finally heard the sound he most wanted to hear. The ECMO machine started; Su Yun had already cannulated the femoral artery and vein for ECMO from the femoral vessels, and ECMO was running to support circulation.

On the ECG, ventricular tachycardia eased somewhat under the effect of large-dose epinephrine and magnesium sulfate.

"Su Yun, prepare for intracardiac defibrillation!" Zheng Ren said.

"Okay." Su Yun didn't even have time to catch his breath before he began looking for the electrodes and called Zheng Ren directly.

The two electrodes were placed respectively on the anterior and posterior walls of the patient's heart.

"Boss, how much?" Su Yun asked.

Su Yun meant the energy level; generally, intracardiac defibrillation starts at 10 joules and is slowly increased to 30 joules.

But repeated defibrillation consumes a lot of ATP, so even after resuscitation the patient's condition won't be very stable; even after a brief sinus rhythm, the patient may soon suffer cardiac arrest again.

Because last time in Sweden, Zheng Ren had used maximum energy to revive Dr. Mei Ha'er's heart, leaving a deep impression on Su Yun, he didn't think and just asked directly.

"22J!" Zheng Ren paused, then said.

Upon hearing that, Professor Zhang immediately said: "10J! It can't be too large; we need to gradually increase the energy!"

Su Yun didn't even look at him, completely treating him as air, set the energy to 22J, and glanced at Zheng Ren.

Their eyes met, and Su Yun pressed the button.

With a soft sound, the piercing alarm from the ECG monitor stopped.

The heart rate returned to sinus rhythm!

"Wow..." Su Yun exhaled a breath.

Professor Zhang stared dumbfounded; everything before him exceeded his comprehension.

Zheng Ren also calmed a bit, saying, "Tell the operating room to push the patient up directly."

"Wait?" Su Yun asked.

"We can't wait; re‑heparinizing could cause a cerebral hemorrhage at any moment." Zheng Ren said.

"Okay." Su Yun removed his sterile gloves and pulled out his phone.

"Boss, let's start both machines together; we need to suture the chest wall." Su Yun said.

"Um… three machines, call Fugui'er and Lao Liu right away." Zheng Ren said, "Once on ECMO, bleeding could happen at any time; I need arterial angiography."

"……" Su Yun finally couldn't help cursing in his heart.

Three machines running together… Boss really dares to think that.

But who made him the boss? With a big mouth, whatever he says goes. Su Yun muttered a complaint in his heart and started calling people.

Zheng Ren applied compression to the chest for hemostasis, watched the patient's ECG, saw that sinus rhythm had returned, and then breathed a sigh of relief.

But there was only time for that one sigh.

With the chest cavity open, not to mention infection, even just a pneumothorax is unbearable.

They hurried to send the patient to the operating room; everyone was busy.

Soon, a crowd pushing the hospital bed, ventilator, ECG monitor, and ECMO machine left the ward in a mighty throng for the operating room.

Professor Zhang stood alone in the empty ward, lost in his own thoughts.

What just happened?

Opening the chest at the bedside, directly performing cardiac compression, epinephrine injections were pushed in one after another, and internal cardiac defibrillation directly applied 22J of energy…

These are things Professor Zhang knows how to do, but he doesn't dare to do them lightly.

Nothing will go wrong, right?

Professor Zhang still has Doubt about whether he is dreaming even now.

Is the patient still salvageable? What did Zheng Lao Ban say again? It sounded like three machines running simultaneously.

He wanted to simultaneously perform a Smog Disease bypass on the head, disinfect and suture the chest, and add interventional angiography?

This isn't just boldness; this is sheer audacity.

You know the patient has heart failure, and even with IABP support, ventricular arrhythmias keep occurring continuously.

With three surgeries running simultaneously, can the patient withstand such a blow?

Professor Zhang doesn't believe it.

Although he hopes the patient can survive, Zheng Lao Ban's approach contradicts the medical common knowledge he is familiar with.

Impossible, absolutely impossible!

A few minutes later, Professor Zhang thought it over several times in his mind, feeling that such a possibility simply did not exist; the patient was surely doomed.

He hesitated a moment, but ultimately decided to go up and check the situation.

In his heart, there was no thought of wanting to see Zheng Lao Ban make a fool of himself. After all, the operating room for coronary artery bypass graft surgery was something he and Zhao Yunlong had done together; now he and Zheng Lao Ban are like grasshoppers on the same rope.

Really…… young people just know how to cause trouble!

It would be good to just abandon treatment and have the family take him away.

There are many people in this world who cannot be cured; three machines running simultaneously…… just thinking about this, Professor Zhang's heart sank.

It's too terrifying, simply too terrifying.

I must follow along; otherwise, after the surgery they won't know how to write the medical record and the operation record.

Don't push all the mistakes onto yourself.

After working for several decades, Professor Zhang has seen many such shady things, and he knows he definitely cannot leave.

He sighed, Professor Zhang turned and walked out of the EICU, preparing to go up and have a look.