I can see the status bar

Chapter 1096 ECMO (addition 03.04 for the leader "Melos Weisser")

This chapter is specially added to thank the lord "Meros Weiser" for the reward, and there will be another chapter for him to add.

The courier master in black, red and gray uniforms has been silent on the road.Sun Lien sat on the truck seat next to him, not knowing whether he should say something.

This kind of small truck used to transfer express goods has nothing to do with ride comfort from the beginning of its design.In order to reduce the cost, the manufacturer only stuffed two thin pieces of foam into the seat cushion.After Sun Li'en sat on it, he could feel the hard steel plates under his thighs almost instantly.

The truck roared and started, but the truck that couldn't run fast passed through the streets of Yunhe. On average, every three or five intersections, Sun Lien could see an intersection guarded by traffic police comrades.Now the temperature outside is about six or seven degrees, and the sky is gloomy with no sun.I don't know how they persisted in such an environment.

Every intersection, Sun Lien and the courier had to undergo a body temperature check and ID check.After learning that the courier master was going to send Sun Lien to the hospital, the comrades in the traffic police would subconsciously take a step back after returning their documents, and then salute and let him go.

After being sent to the hospital with courtesy all the way, Sun Li'en climbed out of the car—he couldn't help it, the bumpy and hard ride all the way had already made his legs numb.After climbing off the truck, Sun Lien limped all the way to the inpatient building of the High-tech Branch of Tongde Medical College, and successfully found Song Wen and Zhu Minhua who had ugly faces.

"Total glucosides of paeony has been stopped, and now we are using the plasma of recovered patients for antiviral treatment." Zhu Minhua informed Sun Lien of the current situation and said, "We are already contacting the experimental group at Yunhe University People's Hospital, please They have provided corresponding data. Don’t worry—total glucosides of paeony may not be useless, as an immunosuppressant, at least it will not do much harm to Lao Liu.”

Sun Li'en took two deep breaths to calm himself down, and then said, "After the plasma from the convalescent is used up, don't use plasma replacement for the time being. I'll go in and see how he is doing."

"You go in later, let's catch your breath outside first." Song Wen said from the side, "Old Liu's condition is still stable now, he has been given ECMO, and there should be no major changes. "

Sun Li'en nodded, and then leaned against the wall to rest for a while.After his breathing calmed down, he began to put on the protective clothing silently and prepared to walk into the red zone. While changing the protective clothing, Sun Lien said, "Since you haven't given him hydroxychloroquine phosphate, don't rush to continue using it for him." .The most effective antiviral drug should still be the plasma of convalescents, and it doesn’t make much sense to use other medicines.”

"We also know about this kind of thing." Zhu Minhua could see that Sun Lien looked calm on the surface, but his heart was still in a mess.So he deliberately interrupted Sun Lien's action of putting on the protective clothing, patted Sun Lien's shoulder and said, "You need to calm down a bit—it's not sure that total glucosides of paeony will not work, nor can you be sure that hydroxychloroquine will definitely work. Don't mess around Once you are on your feet, you must stabilize yourself first.”

Zhu Minhua's reminder made Sun Lien calm down. He nodded and said, "Anyway, we'll talk about it after we've seen the situation." He asked while putting on his clothes, "Dean Liu, is he okay now?"

"On ECMO, the oxygen saturation has risen, but other organ injuries are very troublesome." Zhu Minhua stared at Sun Lien's eyes and said, "He has acute liver injury, acute kidney injury, and the recent myocardial markers are also increasing. high."

When Sun Lien heard this, his heart skipped a beat.

When respiratory distress syndrome progresses to multiple organ failure... the possibility of saving people is very low. ECMO can guarantee that Dean Liu Lianzhi's respiratory distress syndrome can be reversed, but hypoxemia and hyperlactic acidemia have already caused damage to other organs.Such damage can only be repaired by the body's own repair ability.

Sun Lien didn't know if he went in and took a look at the status bar, whether it would bring any changes to President Liu Lianzhi's treatment.Judging from experience and science, there is nothing he can do about it—he can only see whether Dean Liu can carry it on himself, and whether he can break out of the gate of hell with the help of life support equipment.

But although he understood it intellectually, Sun Li'en couldn't accept it emotionally.He must go in and take a look, at least try again, to see if he can find any new entry points.

After entering the red zone, Sun Lien went directly to the intensive care unit.There are sixteen patients lying here, and Liu Lianzhi is the one with the highest level of life support.

Standing beside Liu Lianzhi, Sun Lien quickly checked his status bar.However... the prompt on the status bar made Sun Lien's heart sink little by little.

What Liu Lianzhi faced was not just liver and kidney damage.The bad luck wrapped around him seems to be far from over.Sun Lien saw two symptoms at the end of the status bar: "Multi-drug-resistant Klebsiella pneumoniae infection" and "Multi-drug-resistant Acinetobacter baumannii infection".

Multi-drug resistant bacterial infection is a huge difficulty that patients in the ICU ward need to face.In the intensive care unit, many patients with different etiologies gather here and need to be treated here for a long time.During the treatment process, the antibacterial drugs that doctors use over and over again for patients become the conditions for passive "screening" of bacteria.Only bacteria that can survive the repeated attacks of various antibiotics are eligible to survive in the ICU.

Bacteria that have been screened for dozens or even hundreds of generations are generally resistant to various types of antibiotics.Therefore, it is called "multi-drug resistance".Fortunately, Liu Lianzhi was infected with "multi-drug-resistant" bacteria rather than "pan-drug-resistant" or "all-drug-resistant" bacteria - such bacteria are resistant to some antibiotics, but there are still some antibiotics that can effectively treat the disease. kill them.

When Sun Lien was about to ask for Liu Lianzhi's blood routine report, and was looking for clues to remind the doctors here of the problem of multidrug-resistant bacteria infection, a new status bar suddenly appeared on the status bar, which Sun Lien had seen many times. But so far, I can still see the state where the hairs all over the body stand upright.

"Disseminated Intravascular Coagulation 00.00.01"

"Nurse!" Sun Li'en turned his head and yelled, and at the same time rang the call bell on Liu Lianzhi's bedside.After pressing the call bell, Sun Lien immediately began to rummage through boxes and cabinets to find sampling bottles.The fastest way to detect disseminated intravascular coagulation (DIC) is to check platelet count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrin level, D-dimer, etc.Now Liu Lianzhi's DIC state has just started, and it is obvious that he should be in the hypercoagulation period among the three stages of DIC.

As long as the DIC is determined as soon as possible, and then he is given anticoagulant treatment, everything should be in time.

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Sun Lien took off his protective clothing and sat in the corridor outside the red zone with a solemn expression.

It was not difficult to persuade the nurse to take blood to test Liu Lianzhi's coagulation function.Everyone is now wearing protective clothing with masks and gloves, and Sun Lien has an unquestionable aura like a director when he gives orders.The nurses didn't even realize it until they finished the sampling and examination and were ready for the doctor to make a doctor's order—this doesn't seem to be a doctor from the department?
"The doctor told me to ask Professor Zhu Minhua to make it up for you." Sun Lien saw the nurse's doubts, and then said, "I am the doctor who came for consultation."

After leaving the cabin, Sun Lien conveyed to Zhu Minhua the problems of multidrug-resistant bacterial infection and early DIC.The matter of multi-drug resistance can be put aside for a while, but the results that have appeared have proved that Liu Lianzhi has indeed appeared in a hypercoagulable state.If it was just Gao Ning, maybe Zhu Minhua would not be so nervous, but Liu Lianzhi still has the problem of acute liver injury.Under liver injury, the coagulation substances that can be synthesized in the liver will decrease rapidly.The clotting substances in the blood continued to decrease, coupled with severe systemic infection... It was a rare thing that DIC did not appear.

Zhu Minhua hurried into the cabin to organize the rescue, while Sun Lien sat on the bench alone.He lowered his head and remained motionless for a long time—as if the electricity had been completely drained.

As a doctor, Sun Li'en does not regret his choice of choosing one or the other.In the absence of sufficient information and relevant research, he chose total glucosides of paeony for Liu Lianzhi, entirely out of the doctor's sense of responsibility and professional ethics, and after careful consideration of the patient's condition based on the existing relevant research knowledge. choice made.Using total glucosides of paeony, Sun Lien's conscience is worthy of this choice.

There is no problem with conscience, but the choice itself has gone wrong.This kind of frustration is like a huge stone falling from a cliff, it instantly crushed all of Sun Lien's defenses.

And the current situation of Liu Lianzhi...is probably like a boulder that has begun to loosen and has a tendency to roll.Doctors have tried their best to strengthen this dangerous stone through ECMO and various other life support equipment.But... the signs of loosening still continue to appear, and in this case, the most worrying symptom is probably DIC.

Even for patients with other diseases, once DIC occurs, they need to concentrate on rescue immediately. Liu Lianzhi is on ECMO, which means that once DIC occurs, the running resistance of ECMO will start to rise rapidly.Once the resistance exceeds the limit of the machine's ability to operate, ECMO will stop immediately.

Without the ability to breathe on his own, pulmonary embolism, and without ECMO support...Liu Lianzhi's fire of life would be extinguished in an instant.There is not even a means of resuscitating it.

The so-called rescue must first be established on the premise that the patient is still "something to save".It is impossible for doctors to save a patient with severe head injury, and it is impossible to rescue a patient with DIC, which caused ECMO to stop completely.

Such a patient is as hopeless as a severe head injury.

It is the same as the patient who used ECMO in the first batch of death cases announced by Yunhe City but suddenly had a heart rate of zero and blood flow dropped rapidly to 0.2 liters per minute.

Liu Lianzhi's condition required many experts to formulate a plan together, while Sun Lien sat on the bench for a long time before slowly standing up and preparing to leave.

Song Wen said to Sun Lien, "I can't take care of you now, you can go back by yourself later." After sitting on the bench for a long time, Sun Lien finally accumulated some strength to support his activities.He walked out of the hospital slowly, and then found in the sun that there was a large white mark of dried soybean milk on his pants.It looked like the result of a piece of tofu being smeared on the pants and left to dry in the shade.

He looked at the sky that was gradually clearing up, but the dark clouds in his heart had not been able to dissipate.

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Today's bad news is far more than one.Sister Pan's condition deteriorated rapidly after using plasma from convalescents. Her left ventricular ejection fraction dropped all the way to 35%, and it continued to decline rapidly.

Director Li Chengping and Director Lu Zhimin judged that this should be acute left heart failure caused by acute myocarditis, and called the ECMO team in the shortest possible time, and decisively used VA ECMO for vital signs support for Sister Pan.

Li Chengping looked at Big Sister Pan whose condition suddenly deteriorated, and then sighed.

"This disease is like a rope around the patient's neck. When we enter the hospital, we have to put our hands between the rope and the patient's neck. If it is blocked, the person can still live. If it can't be stopped... then there is a little way It's all gone."

In fact, according to the experience of doctors in Yunhe City Infectious Diseases Hospital, more than [-]% of ECMO patients cannot be stopped or pulled back in the end.As of today, Yunhe City Infectious Disease Hospital has carried out a total of ten ECMO treatments, and among them, Mr. Shen is the only one who survived offline.Among the remaining patients, four are still receiving ECMO treatment, and the remaining five...none of them survived until the moment of offline.

Being on ECMO does not mean that the person is safe, on the contrary, it means that the patient has entered a battle with a higher mortality rate.

"Her sudden heart failure was caused by acute myocarditis, so there is still hope for safe offline." After all, Lu Zhimin has more experience in dealing with ECMO than Li Chengping. He comforted, "Those patients with severe pulmonary fibrosis are troublesome." How can pulmonary fibrosis be cured? You can’t put on ECMO and find a source of lungs to transplant them.”

"I heard that Academician Li is trying to develop stem cell combined therapy, the purpose is to reduce the lung damage of these patients with interstitial pneumonia during inflammation." Li Chengping sighed, "The name of stem cell therapy has been used by those hospitals. It’s rotten, and I can’t even try it now—if it weren’t for the protection of the title of academician, if those of us want to engage in stem cell therapy, we might be scolded to death by those idlers on the Internet.”

"I found that Mr. Li, you are very concerned about the news on the Internet." Lu Zhimin was 14 years younger than Li Chengping. He looked at Li Chengping with some curiosity and asked, "The other elderly directors in our hospital, I think they are No one likes to go online."

"Don't compare me with those old and stubborn old people." Li Chengping rolled his eyes, and he said seriously to Lu Zhimin, "I have an account on Bilibili——I also posted a lot on Bilibili. How about popular science videos?"

(End of this chapter)