I can see the status bar

Chapter 346 Synchronous Peripheral Vein Exchange Transfusion
In the end, Sun Li'en still failed to enter the NICU and meet his little cousin.Qian Hongjun received Sun Lien and Yuan Pingan together with another pediatrician whom Sun Lien had met once before.

"Sit." It was also a doctor who came to participate in the exchange, which made Qian Hongjun feel a lot more relaxed.Many words often encounter troubles when communicating with ordinary family members, which are basically impossible to happen when the other party is also a doctor. "The child's condition is very bad."

Sun Li'en nodded heavily. From his preliminary understanding, he also probably guessed this point.But he wasn't sure how serious his cousin's condition was.

"In the inspection report just now, the total bilirubin is almost 400." Qian Hongjun sighed, "Such a high bilirubin is likely to be accompanied by nerve damage. And the most troublesome thing is that we are still not sure what caused it. What is the cause of such severe jaundice."

"It should not be simply hemolytic jaundice of newborns. We will make another anti-human globulin test and serum antibody test to confirm the diagnosis." Another doctor spoke, and Sun Lien recognized this person for the first time. The one who makes tea out of a quarter cup of tea leaves when going to the pediatric duty room. "I read the treatment records of Changning Maternal and Child Health Hospital. If it's just hemolytic jaundice, it should improve after combining phototherapy and intravenous albumin."

From this perspective, presumably all diagnoses are similar.Use all available information to rule out all possibilities as much as possible, so that the scope of suspects can be narrowed down as much as possible, so that the cause of the disease can be determined as soon as possible.

"And the B-ultrasound also ruled out congenital bile duct malformation and hepatitis." Sun Lien guessed along this line of thought. Anyway, he didn't have to decide what treatment plan to use for his cousin, so it would not be a problem to come up with some ideas of his own. "So, it should be hemolysis caused by infection?"

"I'm too young, and I haven't been in contact with the outside world. Where did the source of infection come from? Mother-to-child transmission?" Yuan Pingan disagreed with Sun Lien's formulation, "Even if it is mother-to-child transmission, the antibodies in breast milk can also Protect the baby from infection? It's not even six months."

The antibodies that can be provided to the baby in breast milk can last for about six months. During these six months, the baby's immunity is actually not weak.It is also infants and young children, the risk of acute gastroenteritis is about six times that of breastfed children who grow up on milk formula.

"At present, the suspicion of infection is still the biggest." After pondering for a while, Qian Hongjun supported Sun Lien's opinion. "There are only a few reasons for pathological jaundice, not hemolysis, not biliary abnormalities, not neonatal hepatitis, and from the current monitoring and electrocardiogram, the child does not have congenital heart disease. It can only be infection."

"To determine the type of infection as soon as possible, first check the bacteria and viruses that can cross the placental barrier and can be transmitted from mother to child." Another pediatrician nodded the table, "But I think it is more important now , It is to perform plasma exchange on the child as soon as possible. His bilirubin level is too high, and if this continues, it is only a matter of time before kernicterus occurs."

"Plasma replacement directly is risky." Obviously, the pediatrician had not communicated with Qian Hongjun about this before.His suggestion was first held down by Qian Hongjun, "Do a simultaneous blood exchange first and see the situation."

Synchronous transfusion, the full name is "peripheral arteriovenous synchronous blood therapy".It is an effective treatment method that uses normal blood or blood products to replace the blood containing certain harmful factors in the child's body.This method is relatively milder than plasma exchange, and it has been used in the neonatal field for a longer time. Doctors have a deeper understanding of the side effects of this therapy, which is easier to deal with.

Qian Hongjun continued, "Here is the part about pathological jaundice first, about the problem of neonatal atelectasis..." He looked at Sun Lien, "I think the diagnosis of Changning Maternal and Child Health Hospital is all right, lung hypoplasia combined with inhalation pneumonia is most likely."

"Then continue to use mechanical ventilation and bovine lung surfactant treatment?" Sun Lien asked, "Will the treatment plan of Changning Maternal and Child Health Hospital not be changed?"

"There are still some changes, but after the source of infection is determined and ruled out." Qian Hongjun sighed, "We will inhale budesonide for the child, but this glucocorticoid will also suppress the immune response after all. If the jaundice is caused by infection, then it must not be used.”

In short, the most critical goal now is to determine the source of jaundice.Regardless of whether it is infected or not, it has to be determined first.

"Then I'll ask the nurse to take the blood first." The four doctors discussed with each other, and they agreed that performing a simultaneous transfusion first and suspending budesonide inhalation treatment is currently the most appropriate and safest treatment method.So Qian Hongjun stood up, and took out a consent form for blood transfusion treatment from the file bag beside him.At the same time, he took out a critical illness notice.

"The child's condition is really troublesome and tricky. You still need to discuss this with your relatives." Qian Hongjun sighed, "I thought it might be an ordinary child."

"I'm causing you trouble this time." Sun Li'en took the two documents and bowed to Qian Hongjun, "My uncle left early, and my cousin has suffered a lot over the years. Now that I finally have a child, It turned out like this..." He sighed, "Anyway, sorry for your trouble."

"It should be." Qian Hongjun nodded, "Hurry up and ask for a signature. When the signature arrives, we will immediately perform blood exchange treatment."

·
·
·
"Critical illness..." Wang Tian looked at the critical illness notice that Sun Lien brought, and tears began to flow on his face again.

"I can't help it. After all, I have already lived in the NICU, and the critical illness notice must be issued." Sun Lien sighed, and he sighed a lot more than usual today. "Look at the consent form for blood transfusion treatment. If you have any questions, I will answer them for you—we strive to complete the search for these written documents as soon as possible. The sooner they are completed, the sooner the treatment can be started."

Wang Tian nodded, wiped away the tears on his face indiscriminately, raised his head and asked Sun Lien, "Lien... you tell me the truth, he... can he be rescued?"

"We will do our best to treat with all methods without reservation." In front of his relatives, Sun Li'en has nothing to hide. Looking at the current situation, apart from explaining the risks of treatment to Wang Tian , Sun Lien had to cheer him up, "Pathological jaundice in newborns is not uncommon. As long as we find the cause of jaundice, we still have a solution."

Not only must encouragement, but also pay attention to the measure of encouragement, and be careful not to mislead.It's really hard to grasp the sense of proportion here. Sun Li'en thought about this passage several times along the way, and dared to say it only after he was sure that there was no problem.

"Your sister-in-law is still lying in the hospital..." Wuyou said desperately, and signed with trembling hands, "She only had such a child after a narrow escape, if something happened to him, how should I explain... ..."

If you're just worried about not being able to explain it, it's easy to handle.Sun Li'en cheered up his cousin again, and then returned to the nurse's station at the entrance of the NICU with the letter of permission.

"You can put it here if you allow it." The little nurse said to Sun Li'en very considerately, "I will inform Director Qian."

"Please hurry up." Sun Li'en nodded towards the little nurse, then turned and left the door.When walking towards the door, he happened to meet Qian Hongjun who was holding two bags of liquid in his hand.

"Have the things been delivered?" Qian Hongjun asked Sun Lien as soon as he saw him, "Have the family members agreed?"

Sun Li'en nodded, looked at Qian Hongjun's hand with a bag of light yellow liquid, and a bag of dark red liquid and asked, "This is... the blood used for simultaneous replacement?"

"Yes." Qian Hongjun nodded, and raised the things in his hand towards Sun Lien, "Red blood cells of type O blood and plasma of type AB blood are both RH negative."

This is the most "ideal" mixed blood ratio from an immunological point of view. There are no A and B antigens on type O red blood cells, and there is no coagulation antibody in type AB plasma. Therefore, in theory, such mixed blood types will not cause any ABO blood type intolerance, so that transfusion-type hemolysis can be avoided.And RH negative is even more valuable - this rare panda blood is suitable for patients with both RH negative and positive blood types.If it weren't for the fact that the two bags of RH-negative red blood cells and plasma were still in stock in the blood bank, and they were to be used for neonatal rescue treatment, the staff of the blood bank might not be willing to take them out.

"It's really not easy to get such things from the people in the blood bank." Qian Hongjun smiled, "Let's stop chatting, I'll arrange treatment."

(End of this chapter)