Sleepless Doctor

"Did you see the preoperative radiography?" Dadley roared in a low voice.

"Mr. Dedley, I remind you again, this is the operating room, please keep quiet." Wu Mian said gently, "If you growl in the operating room again, I might drive you out, like a stray. Like a mad dog, mercilessly."

　　 Dedley's eyes were red, his fists were clenched tightly, and a creaking sound came out.

　　 "Don't even think about it, did you forget that I was beaten into a dog last time?" Wu Mian said indifferently.

　　 "Shameless!" Doctor Dadley squeezed a word from between his teeth, but his voice was indeed much lower.

　　 Wu Mian did not continue talking to Dadley, he stared at the liquid and waited silently.

After "　　", Wu Mian said, "Prepare for resuscitation and stop cardiopulmonary bypass. "

　　 "You are crazy!" Dadley said, "have not found the cause of hemorrhagic shock!"

　　 In Dadley’s imagination, Wu, who disgusted and nauseated him, must know where there was bleeding, and the amount of bleeding would not be small, otherwise the heart rate and blood pressure would not drop as soon as the machine stopped.

　　 But what I never expected was that Wu Mian stood in the position of the surgeon, and the first medical order after the infusion turned out to be-stop the cardiopulmonary bypass!

　　 is so crazy!

　　 "Are you a surgeon?" Wu Mianwei mocked, "Now I am standing here, and I am the only surgeon!"

　　 Chu Zhixi has opened the ascending aorta blocking forceps, and she carefully ensures that the left heart is drained smoothly and prevents the left heart from swelling.

　　 Under normal circumstances, if the conditions are right, the heart can recover automatically. But Principal Topt's heart remained motionless after the ascending aorta block was removed, as if he had died.

　　 "Prepare for electrical defibrillation." Wu Mian stretched out her hand, and the instrument nurse then handed him the defibrillator.

　　 Wu Mian adjusts the power of the defibrillator, 45J. Defibrillation is successful and the heart starts to work again. With the help of cardiopulmonary bypass, the load on the heart was not heavy, and Wu Mian was not in a hurry, but waited quietly for another 5 minutes.

　　 This period of time is especially necessary. After the rebound, the heart should be kept beating without load for a period of time to facilitate the recovery of myocardial function.

　　 After resuscitation, the upper and lower chamber blocking bands are opened, so that the total cardiopulmonary bypass is transformed into a parallel circulation to assist the heart beat and reduce the burden on the heart.

　　 checked another blood qi. After Wu Mian waited for the report, all the conditions were compounded, and he raised his head and said, "Go offline, don't neutralize heparin."

　　 Extubation and weaning, this is the second time this procedure has been repeated.

　　The cardiopulmonary bypass surgeon in the medical group of Dr. Daedley follows the normal procedure and habitually injects protamine to neutralize heparin.

　　 Before he could inject protamine, a hemostatic forceps flew out and hit the cardiopulmonary bypass division directly on the head.

　　 The cardiopulmonary bypass surgeon felt a pain on the top of his head, and then saw the silver-white hemostatic forceps fall to the ground, making a crisp sound.

　　 He stood up angrily, and heard a series of London accents before he spoke.

"You didn't hear what I said?!" Wu Mian scolded, "Don't neutralize heparin, you don't understand this sentence? Is my English not fluent enough or you are trying to murder?! How come the people in Mayo are like this Stupid, I can't understand even the most basic human words!"

　　 "..." The cardiopulmonary bypass master was taken aback, and then said angrily, "Don't you want to go offline? Don't you need to neutralize heparin?!"

　　 "Does not neutralize." Wu Mian said, "I reiterate for the last time, do not neutralize heparin."

　　 In the operating room, everyone was silent, Dadley looked at Wu Mian like a fool. He was stunned for a few seconds, then looked back at Mrs. Topt, his eyes full of indescribable banter and contempt.

　　Before the cardiopulmonary bypass is transferred, the whole body needs heparinization. The cardiopulmonary bypass machine must be prefilled with heparin in advance, and the patient can be transferred only seconds after the patient is checked, so there will be no blood clotting in the cardiopulmonary bypass.

　　 When stopping extracorporeal circulation, heparin must be neutralized. Even if this is the case, there will still be bleeding in the coronary anastomosis.

　　 But Wu Mian unexpectedly said that there is no need for protamine to neutralize heparin, then what?

　　 Waiting for anastomotic oozing, the patient suffered hypotension and shock due to continuous blood loss, and finally died?

　　 It's not that there is no similar operation, but it is a unavoidable situation, and the probability of a patient's successful operation is quite low, to a heinously low level.

　　Dr. Daedley didn’t understand Wu Mian’s operation at all. Is he worried that President Stephen Topte has a protamine allergy?

　　 The results of the preoperative allergen measurement have ruled out this, otherwise Da Deli would not choose the surgical procedure of coronary artery bypass surgery under cardiopulmonary bypass.

　　 "Wu, are you sure?" Mrs. Topt trembled. She didn't expect Wu Mian to give such an incredible doctor's order.

　　 "Madam, yes." Wu Mian replied softly.

　　 Mrs. Topt did not continue to ask anything, she had completely lost herself during the weird operation. Although she is a world-renowned cardiologist, Headmaster Topt’s situation is so weird that she can’t tell what’s going on anyway.

　　The drugs used have all been tested for allergens, and the operation was very successful. At least Mrs. Topte couldn't fault her. But because of this almost perfect process, Principal Topt's heart beats weakly.

　　While changing the surgeon under tremendous pressure, Wu Mian refused to use protamine to neutralize the heparinization of the whole body and went offline directly!

　　 Not to mention anything else, just postoperative bleeding from the anastomosis is enough to be fatal!

　　 Mrs. Topte had countless questions in her heart, but she didn't ask, she just stood quietly behind Wu Mian and watched.

　　After the shutdown ~www.wuxiaspot.com~ Wu Mian observes Stephen Topt's situation. The vital signs are stable, and there is continuous blood oozing from the anastomosis part of the graft vessel.

　　 He pulled out the upper cavity cannula and retracted the lower cavity cannula into the right atrium. Observed for 3 minutes, the condition continued to be stable, and the lower cavity cannula was removed. Enter blood in the machine and remove the arterial cannula as early as possible.

　　 The last time I had a weak heartbeat after the cardiopulmonary bypass was stopped.

　　 And now, it stops again. The difference lies in the protamine, which is that the whole body is heparinized and not neutralized.

　　 Both Mrs. Topte and Dr. Dadley knew this. They had long wondered that Wu Mian might suspect that protamine-induced allergies caused Stephen Topte’s heart to beat weakly.

　　 This is the only reasonable explanation.

　　 After the cardiopulmonary bypass was shut down, the operating room was silent. Everyone's eyes were on Stephen Topt's heart, even if the coronary arteries still ooze blood.

　　 Within a few minutes, a few milliliters of blood oozing is not enough to be fatal. The key lies in whether the act of neutralizing heparinization is not effective.

1 minute……

　　 Stephen Topte’s heart beats vigorously, and the ST-segment changes under the ECG monitoring oscilloscope are alleviated.

2 minutes……

3 minutes……

5 minutes……

　　 Except for the bleeding at the bridging vessel anastomosis, Stephen Topte’s vital signs did not have any problems!

　　 So that's it!