Chapter 359: 352 Beriberi Is Not a Disease

"Have the vitamins been checked?" Zheng Ren asked.

"Vitamins?" Su Yun was stunned for a moment.

ICU, the habit of emergency rescue simply does not include vitamin testing, except for certain special diseases.

However, trauma does not belong to special diseases.

"Vitamin B1 deficiency, I'm currently considering this." Zheng Ren said: "Stop the patient's sedative for a moment."

Su Yun was slightly taken aback.

"I want to see if the patient has any symptoms of oculomotor nerve paralysis when agitated."

Paralysis of the extraocular muscles innervated by the oculomotor nerve will present symptoms such as abnormal eye position, dilated pupils, and loss of light reflex.

Su Yun was about to retort, but suddenly recalled the scene of Yang Lili's eyes constantly trembling when she was awake. That is why Su Yun felt as if Yang Lili had seen a ghost.

He pondered for a few minutes, then suddenly looked up, his eyes lighting up: "Boss, I think you're right."

Director Qian and the other consulting directors were stunned.

Are these two young people joking?

The city is still waiting for today's condition report, and they……

If it weren't for Su Yun having already demonstrated emergency rescue skills surpassing everyone's in the ICU, and if it weren't for Zheng Ren having shown exceptionally high surgical skill in numerous emergency surgeries, they would have already been drowned in spit.

Vitamin B1 deficiency?

What a joke.

"Little Zheng, Little Su, stop joking." Director Qian's voice was deep, expressing his dissatisfaction.

"Director Qian, I'm not joking." Su Yun laughed.

Zheng Ren's words dispelled the mist before his eyes, revealing a sky clear for thousands of miles.

Sometimes the difference is just that little bit. Once that layer of window paper is pierced, looking back, it's actually nothing.

"What does the patient's symptoms have to do with vitamin B1 deficiency!" the Director of Medical Affairs angrily shouted: "Beriberi?! Nonsense!"

"You've studied pathophysiology, right?" Su Yun glanced around, the corner of his mouth curled into a mocking smile that begged for a punch: "This vitamin B1 deficiency syndrome is commonly called beriberi, and that's correct."

As he spoke, the smile at the corner of his mouth grew more intense, causing the eyes of many little nurses in the ICU to sparkle with starlight.

"Vitamin B1 is also called thiamine, and thiamine, after intestinal absorption, is phosphorylated by enzyme action to become thiamine pyrophosphate."

"Thiamine pyrophosphate is an important cofactor in the decarboxylation of pyruvate and alpha-ketoglutarate in the TCA cycle, and also a cofactor for red blood cell ketol-acid transferase."

A string of professional terms poured down like rolling thunder from the void, landing on everyone's heads.

Director Qian pondered; Xiao Su's words seemed like a line of thought.

The Director of Medical Affairs' face was grim, because…… he simply couldn't understand.

His position is important, responsible in the middle for integrating various rescue links, handling medical disputes, controlling medical quality, etc.

But having been away from clinical work for too long, things like pathophysiology have been mostly forgotten.

Su Yun ignored the thoughts of the big shots present and continued: "In brain and myocardial tissues with high oxidative metabolism, glucose and pyruvate metabolism must have sufficient vitamin B1 participation; otherwise, due to thiamine pyrophosphate deficiency, pyruvate cannot easily enter the TCA cycle."

"A large amount of pyruvate accumulating in the blood leads to dilation of small arterioles, decreased peripheral resistance, increased venous return, and increased cardiac output and cardiac workload."

"Huh? Finally talking about right ventricular output and cardiac load?"

The Director of Medical Affairs pretended to think; at this moment he couldn't let people see that he didn't understand.

But…… this damned guy, can't he just say it simply?

"So…… I……" Su Yun's usually fluent tone stalled for a moment: "My boss said, considering Yang Lili's agitation and psychiatric symptoms, it should be a complication of vitamin B1 deficiency."

After saying that, Su Yun glanced at Zheng Ren.

"I'm right, boss."

"That's basically the meaning." Zheng Ren, not being polite, then said: "I recommend an intramuscular injection of 100 mg vitamin B1, but since intramuscular drugs are absorbed slowly by the body, we can try administering it simultaneously with an intravenous injection of 20 ml saline plus 50 mg vitamin B1."

"A slightly larger dose on the first day is fine." Zheng Ren said.

All the directors and the Director of Medical Affairs present exchanged bewildered glances, but in each other's eyes they saw only confusion.

Although not everyone agreed with Zheng Ren and Su Yun's views, if they wanted to criticize, they needed a reason.

They laid out the facts and judgments one, two, three, four, five, clearly explaining from a biochemical perspective.

Although they didn't understand, they still felt it was impressive.

So what should we do?

What else can we do?

"Let's give it a try; there's no better option." Director Qian said.

He has had the longest contact with Su Yun and knows this person. Generally speaking, once Su Yun's face shows that "deserving a beating" expression, it means what he says is correct.

At this moment, one must never refute; even a senior director, when faced with a well-supported medical condition, will be slapped in the face.

Moreover, ingesting several tens of milligrams of vitamin B1 will certainly have no negative impact on Yang Lili's condition.

"Stop the sedative in half an hour." Zheng Ren stood up and gave his final instruction.

"Okay, boss." Su Yun went to write the medical order.

Watching Zheng Ren's departing back, Director Qian faintly felt some emotion.

This is a little tiger that has grown up.

With such vigor, even a veteran senior director wouldn't have it.

Medicine has no absolute certainty; who dares to speak so definitively? Just say it casually, and soon you'll be slapped—left cheek, right cheek, a few slaps and you'll end up looking like a pig's head.

Director Qian has only seen this temperament in a few professors from Di Du and Modu, while City First Hospital…… has never had such a person.

Su Yun issued the medical order; a little nurse hurriedly carried it out, then administered an intravenous vitamin B1 injection and gave an intramuscular shot.

After glancing at the time, Su Yun sat in the chair beside the bed, staring unblinkingly at Yang Lili.

Half an hour, the boss's said time should be fine. By then, the sedative will be reduced; after waiting for Yang Lili's body to mostly metabolize the sedative, it should be about two hours later.

If it truly is ocular nerve symptoms caused by vitamin B1 deficiency, as well as cardiovascular symptoms, they will definitely improve.

This diagnosis is really interesting.

……

At the same time, in the Big External Operating Room, the Orthopedics Department's surgery to remove the vertebral body is underway.

"Little Zhou, was yesterday's embolism certain?" Di Du's Orthopedics Professor Tian Jiaoshou asked while opening the skin.

Zhou Yisheng said: "The embolism time is relatively long, because we only have one Intervention Department doctor here. I can't tell whether it will succeed or not. But previously he performed embolism on a patient with pelvic fracture and postoperative peritoneal hematoma, and the effect was quite good."

"Yeah, Intervention Department doctors are few; having one is already not bad." Professor Tian began blunt dissection of muscle tissue, carefully avoiding a location where capillaries are relatively dense.