I can see the status bar

Chapter 1014 D+2 day (6)

As a patient with a tracheotomy, Sister Pan cannot speak—her airway is open, and if she wants to speak, she has to pull out the trachea in her throat and then plug the hole.Otherwise the air would come out of the tube and not cause the vocal cords to vibrate.

Sun Li'en has high hopes for Sister Pan's condition, the reason is very simple - her condition has not deteriorated.

Every patient whose bed number is marked with the word "robbery" is critically ill.Their condition is deteriorating almost all the time, even if the doctors have begun to adjust the patient's intake and output in units of 1 milliliter, trying to reduce the heart load and their pulmonary edema.But this kind of operation only "relieves" the rate of deterioration of the patients.

Among the eight patients in the temporary ICU, only Sister Pan's condition did not deteriorate.Her heart rate has dropped a bit compared to yesterday, and has stabilized at around 90 beats per minute.At the same time, the blood oxygen saturation also increased to a certain extent - with the help of incision and mechanical ventilation, Sister Pan's blood oxygen saturation reached 96%.

Under the condition of finely controlling the amount of entry and exit, it is inevitable that Sister Pan's situation will improve.But to be honest, such a change is still beyond Sun Lien's expectations.

Sister Pan, like Uncle Peng who passed away yesterday and Mr. Shen who was on ECMO, is a patient that the medical team paid close attention to when they first entered Sun Lien.She was very ill and had underlying circulatory problems.In this case, her condition suddenly improved, which naturally attracted Sun Lien's attention.

If Sister Pan's condition changes because her condition has improved, that's of course good.But what Sun Lien was more worried about was whether this... would be her last effort before her body collapsed.

It's really not a legend in clinical work to reflect on such things.

It was also out of this consideration that we first searched for Sister Pan, and then checked the 14th bed.If it really is a flashback, at least the doctors can judge it in advance, and find a way to provide Sister Pan with other means of support.

Sun Li'en made up his mind in his heart that if he was sure that Sister Pan's condition was not good, then he would report to the Yunhe City Health Committee.Anyway, let’s get some tocilizumab and use it first—Sister Pan’s peripheral blood lymphocyte count is slightly better than Uncle Peng’s.Her current lymphocyte count is 0.17*10^9/L, and her D-2mer is as high as 1526ng/ml.Interleukin-6 level was 169pg/ml, while C-reactive protein was 112mg/L.

Every item in these data is not good news-every indicator is considered a "critical value".

But in Sun Lien's view, Sister Pan's situation is still better than Uncle Peng's.

彭大叔离世之前做过一次相关检查，其中外周血淋巴细胞计数下降到了0.06*10^9个/L。比潘大姐的数据差得多。其他数据也高的吓人——D2聚体高达3785ng/L，白介素-6的水平也超过了240ng/ml。

And more importantly, Sister Pan is younger.Although she also has basic diseases, but the foundation is much better than Uncle Peng.She has a history of coronary heart disease and type [-] diabetes.However, these underlying diseases are much milder than liver cancer hypothyroidism.

Sun Lien firmly believes that Sister Pan has hope.Her foundation is better, and she is more likely to carry it down.

The CT examination report confirmed Sun Lien's opinion. Although Sister Pan still had a large number of ground-glass shadows in both lungs, and the density shadows in some places showed signs of increased density, the overall lesion area has shrunk.

This shows that the inflammation is gradually improving, and some ground glass shadows have been absorbed by the body.

Looking at the CT scan image on the computer screen, the corners of Sun Lien's mouth, hidden under the two-layer mask, turned up uncontrollably.What he saw didn't seem to be severely infected lungs, but a peerless beauty hidden in the mist.The fog gradually dissipated, and the breath-taking scenery was gradually revealing its graceful figure.

"You can be more generous." Sun Lien looked at the computer screen and muttered in a low voice, "Please save face, be more beautiful, be more beautiful..."

"What are you muttering about?" Hu Jia wiped his hands from the side, then lightly kicked Sun Li'en's calf, "Go and disinfect."

"Look at this." Sun Li'en didn't bother to wipe his hands first, he pointed to the screen, and then said to Hu Jia, "Look at these lungs, they are much more beautiful than yesterday!"

"Oh?" Hu Jia leaned over and squinted her eyes. Looking at the image in front of her, it took her a while to distinguish that the frosted glass image on it had shrunk a little.

"It's a little prettier." Hu Jia nodded and asked, "Then do you think the lungs are prettier, or me?"

"It's really more beautiful now." Sun Li'en's eyes were shining, "I can only enjoy your beauty. But it is beautiful, it can save a life, it can save a family... If you can give us some Hint, it could even save thousands of families."

Sun Lien turned his head to look at Hu Jia's smiling eyes and said seriously, "Really, it looks better now."

"I think you are more suitable for the imaging department than me." Sun Lien and Hu Jia were talking about love in a special way, when a sour voice came from behind.Luo Sanguan's voice sounded behind him, "Why can't I see that this lung looks better than Xiaohu?"

"That means you have no vision." Hu Jia immediately spoke up for her fiancé, "Brother Luo, you can't speak so well, maybe you don't have a girlfriend?"

"As far as you can tell." Luo Ge, who was poked at the sore spot, immediately stared, but unfortunately his resistance seemed a little too... a little soft.

After all, the girls in the courtyard basically know that Brother Luo is single.It's not that no one tried to introduce some good girls for Brother Luo, but... he couldn't seize the opportunity himself, and he couldn't speak clearly when he met other girls.Everyone worked hard, but the result...was really not good.

"We'll send another patient down for investigation later." Sun Lien tried his best to preserve the last bit of dignity for Brother Luo.It's just that under the attack of Hu Jia's eyes, he couldn't stand it a bit, so he could only quickly change the subject, "Brother Luo, are you still waiting?"

"Yes, I've been here all the time." Luo Ge rolled his eyes, "Two radiologists in the Infectious Disease Hospital were infected, and they couldn't keep up with the schedule. Then I'll give you an extra top—anyway, I Without a girlfriend, a single dog has no human rights."

The first half of the speech was heroic and fearless, but the second half of the speech suddenly became sad.Luo Ge's speech caused a burst of laughter from everyone.Sun Li'en asked, "Are you standing alone? Can you withstand this?"

"That's not enough." Luo Ge wiped his gloves with his hands first, and then scratched his head through the protective clothing, "N95 wears for more than ten hours, and Iron Man can't handle it. I have a nurse here Help, she came from Tongde Hospital for support. The two of us will be better off as companions."

Speaking of this, Sun Li'en asked curiously, "That can't last, right?"

"Actually, it's okay." Luo Ge said with a smile, "Before I came here this time, I brought an electric air supply filter, and the filter element still has a month's supply. It can be used for twelve hours on a single charge-basically no What's the matter?"

"Do you still have this high-tech equipment?" Sun Li'en suddenly became interested. He looked at Luo Ge who was wearing a two-layer mask like himself and frowned, "You are useless now?"

"That thing can't be used every day." Luo Ge chuckled, "I came to Yunhe anyway, and I haven't even worn an N95. After waiting for more than ten or twenty years, how can I brag to my son?" Your father and I carried a department in Yunhe Infectious Hospital by myself back then. I said it out loud, but I didn’t wear a mask myself—doesn’t this weaken the credibility of my words?”

Hu Jia blinked at the side, her little mouth ready to attack Luo Ge - it's not her fault, there are too many flaws in Luo Ge's words.It's like a peerless master seeing his opponent suddenly reveal a flaw. If he doesn't target it, it will be really disrespectful to himself and the opponent.

"Doctor Luo, have you finished the scan of the North Fifth District?" A hurried "Dabai" outside the door pushed the door and barged in. Hearing the voice, this person seemed to be a northern girl.He is not very old, and it is very pleasant to listen to his crisp words.

Sun Li'en and Hu Jia's eyes were fixed on the girl's face immediately.There is no way, she wears an ugly rubber mask on her face, and there is a gray electric blower pinned to her waist.

Hu Jia and Sun Li'en's eyes loosened from the nurse's face, and then looked at Luo Ge who was wearing a double mask.Then he looked at the girl, and then at Brother Luo.The case goes back and forth several times.

Brother Luo moved his body slightly, as if he wanted to avoid these two gazes, but just after moving a little, he stood up straight again, and even raised his chest a little.

"Brother Sun, have you finished the examination?" Xiao Guo, who was wearing a lead suit in the CT scanning room, couldn't bear it anymore.He pressed the communicator and shouted, "I can't move the patient to the bed alone."

"Let me go." Luo Ge, Hu Jia and Sun Li'en said this at the same time, and then the room fell into a breathless silence.After a few seconds, the nurse with the gray electric blower said cautiously, "Then... I will go too?"

Hu Jia and Sun Lien laughed together.The two of them laughed and leaned forward and back together, and they didn't stop for a long time.Sun Li'en felt that he hadn't been this happy for a long time. He patted Luo Sanguan's shoulder vigorously and said, "Okay, let's go. You have a heavy task today, take it easy."

Hu Jia followed Sun Lien out of the examination room. When the door was closing, the two of them heard the crisp voice and asked timidly, "Dr. Luo, what were they laughing at just now?"

"Oh, they..." Luo Sanguan coughed lightly, and said in a nonchalant voice, "I'm just greedy."

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The fourteenth bed also came down for an examination, and his condition has also improved significantly compared to two days ago - the imaging examination showed that the area of ​​his lung lesions has decreased by more than 25% compared with before.

Two, no, three good news in one day.Sun Li'en felt as if he had received two injections of adrenaline, and his whole body was full of energy.

"This is a good thing." After listening to Sun Lien's description, Yuan Ping'an and Xu Yourong also regained their spirits.It has been three days in Yunhe, and they have sent several patients away, and their spirits are almost reaching their limit.Now when they heard the news, they immediately felt their confidence regained.

"It's a good thing." Sun Li'en nodded, and then continued, "Let's maintain the previous plan and fine-tune the amount of input and output."

"I think, can we consider using prone position ventilation for those patients with poor blood oxygen saturation?" Zhou Ce suggested from the side, "ARDS is mainly caused by small airway occlusion and alveolar collapse in gravity-dependent areas. The depression is not long, and the alveoli in the non-gravity-dependent area are hyperventilated. Prone position ventilation can increase the negative pressure in the dorsal thoracic cavity, increase the transpulmonary pressure, and reopen the dorsal alveoli—this may increase the patient’s blood oxygen saturation. "

"It's a little troublesome to operate, but I think I can give it a try." Xu Yourong first expressed his support for this proposal, "There is a recommendation in the third edition of the guideline, and it is indeed used in the clinical practice of critical care and respiratory medicine." .”

"First pick patients who are seriously ill but can tolerate flipping." Sun Lien nodded and said, "Don't worry about the ICU, let's flip the severe ones first to see if there is any change. "

(End of this chapter)