Chapter 2964 How can I endure this?
The shadowless light in the operating theater of the demonstration room was turned on. Su Yun stood in front of the operating table and complained,”boss, if you don’t change into Isolation Clothes and sterile clothes, it doesn’t feel like a ceremony at all.”
“Then let’s change. We’ll probably have to stay here for a while. You’ll definitely feel better after changing into Isolation Clothes. ” Zheng Ren replied indifferently.
“There’s still half an hour before the printed lungs can be sent over. “
“Don’t worry, I still have something to do. Old he, you do it. ” Zheng Ren called out to old he.
Old he quickly ran over, his face full of smiles.”Boss Zheng, what are your instructions?”
“When I’m using ECMO, the pipeline trembles. Do you have any good solutions?” Zheng Ren asked.
“It’s highly likely to happen. We can’t predict the frequency and strength of the tremor in advance, so we can only adapt to the situation during the operation and constantly adjust the flow to deal with it. ” Old he replied.
“Be careful in this area.” Zheng Ren instructed. Then, he started to discuss the dosage of the anesthetic with old he.
There was a standard formula for calculating the amount of anesthesia. The amount of anesthesia that was injected into the patient’s body was calculated by the weight of the patient and even the surface area of the patient’s body.
However, little stone’s situation was a little special. Although he had gained some weight recently and looked more like a normal child, he could not be treated as a normal person.
The dosage of the medicine also had to be changed according to the calculation results of the basic formula. It had to be reduced by a certain amount to avoid causing too much damage to the body.
If one were to really look at the most detailed place, the pumping speed of every drug and every micro pump had a big explanation.
At first, old he was listening carefully, but as time passed, he said more and more.
Boss Zheng wanted the most accurate values, the smallest surgical trauma, and the least anesthetic impact.
On the basis of scientific calculations, old he combined his many years of clinical experience and made some changes to the values that Zheng Ren had fumbled out in the operating theater system.
Zheng Ren was discussing with old he. After he had the numbers, he went to the system operating room to get an experimental question to study.
On this point, Zheng Ren had fully utilized the advantage of a cheater.
The dosage given by old he was only the limit of what an experienced anesthetist could do. It was just a speculation, and the specific adjustments had to be made according to the situation during the surgery.
Zheng Ren took old he’s speculation to the system’s operating theater to verify it without any scruples. After he came out, he made even more fine adjustments.
Old he didn’t think there was anything wrong with boss Zheng’s deduction. In his opinion, boss Zheng’s deduction ability had already been maxed out.
That time at the Women’s and Children’s Hospital had involved a lot of cooperation in anesthesia. Every time there was a difficulty, boss Zheng would enter a state of meditation. However, this state didn’t last long before he woke up and had a new perspective.
It turned out that boss Zheng’s suggestion was right.
Old he had always admired boss Zheng for this, so he simply took out a pen washi and wrote down the results of boss Zheng’s deduction.
This was what he had to do during the surgery.
“Boss, it’s time for surgery training!” Su Yun called out.
“Wait a minute, you guys go first. I still have something to talk to old he about.” Zheng Ren shook his head. He was still discussing anesthesia with old he.
Old he had already written one and a half on the A4 paper in his hand.
Su Yun leaned over and listened for a while. The problem of the pipe trembling had been solved. The boss and old he were talking about the auxiliary value of the ventilator after the beginning of the ECMO auxiliary system.
It was still too early. After talking about the ventilator, there was still the problem of whether the external circulation should be used.
Although lung transplantation was considered a surgery, the technique of the surgery was not the most important. It paid more attention to the details. In order to succeed, everyone in the team had to play their best role, from anesthesia to surgery to the critical condition of the icu.
Su Yun knew that in lung transplantation surgeries, ventilators would be converted from equipment that supported oxygen synthesis and ventilation to tools that reduced the whole body’s inflammatory reaction.
During the ECMO transfer, the lungs still provided a small part of gas exchange, but the ventilation strategy was mainly aimed at excessive expansion, collapse, and injury. As the dependence on the lung during the period of ECMO decreased, the ventilator management changed to a lung protection strategy of reducing the tidal volume corresponding to the ideal body weight.
In general, 6ml/Kg was an ideal value. However, the boss was not satisfied with this “rough” theoretical value and was still calculating it with old he using cumbersome formulas. Furthermore, this fellow was constantly ‘in a daze’. Did his brain shut down?
This time, even Su Yun was dumbfounded.
Although low tidal volume was the standard lung protection strategy, reducing the lung propulsion pressure, which was also to reduce the pressure difference between the peak Qi pressure and end-exhaling positive pressure, and preventing lung tissue collapse were very important for recovery.
Collapsed lungs required higher pressure to overcome the lack of lung expansion, which was to overcome the natural lag phenomenon caused by insufficient ventilation. The increased pressure and loss of active substances caused by this would further aggravate the inflammatory reaction.
These details had already gone beyond the scope of simple surgery and were not in the scope of anatomy, but instead, physiological content.
The boss was actually so meticulous in the study of lung tissue. This made the future star of the cardiothoracic Department in Imperial feel embarrassed.
Su Yun was helpless in this regard. He listened carefully for more than ten minutes. The various cumbersome formulas and calculations, as well as the values calculated by old he based on his years of rich clinical experience, were almost perfect in his opinion, but the boss was not satisfied at all.
He was adjusting the end-breath positive pressure based on the individual’s Qi path peak pressure.
Su Yun understood the reasoning behind this. Since ECMO could directly transmit oxygen to the blood, the oxygen concentration inhaled by the ventilator could be reduced to the minimum to avoid oxygen toxicity.
Although there was no conclusion on the best mode and exact target of the ventilator during the ECMO auxiliary period, the traditional oxygen synthesis target was when the oxygen pressure was greater than 60 mmhugo and the oxygen saturation level was greater than 80%.
However, the tradition … Had already been smashed to pieces by the boss.
After making minor adjustments again and again, the A4 paper in old he’s hand had already filled up three pages.
“Boss, you guys study it first. I’ll bring Lin Yuan and ran to familiarize with the surgery.” Su Yun was helpless. Even after hearing so much, his brain still felt a little uncomfortable.
As for old he, from the looks of it, he would probably faint after studying it.
Zheng Ren and old he were almost done with their research, and he was quite satisfied with it. Anesthesia was the foundation, especially in the dual lungs orderly transplantation surgery with the assistance of ECMO.
Using the plan that he had developed with old he, Zheng Ren once again entered the operating theater system and began his surgery training.
The surgery completion rate had increased by 3 to 4 percent, and Zheng Ren was very happy.
However, during the fifth surgical training, when Zheng Ren had just started anastomosing the main windpipe, the experimental’s breathing cycle had undergone a drastic change.
Zheng Ren was dumbfounded. What was the problem with the process that was supposed to be perfect?