Sleepless Doctor

Latest website: When I came to the hotel, Wu Mian was sitting in the main seat, chatting with the dean of Pengcheng People's Hospital with a smile.

It can be felt that Wu Mian is very happy, and even some emotions called pleasure are permeating him.

"Mr. Wu." A group of people came in and greeted Wu Mian first.

"Sit down." Wu Mian said with a smile, "The operation was done very well."

In a word, Ren Haitao was finally relieved. After all, this is the first time that this new technique of mitral valve clamping has been performed on the human body. It is inevitable that Mr. Wu will be a little worried if he is not there.

"Mr. Wu, your side has been able to drive smoothly," Gao Boxiang asked.

"It's okay." Wu Mian nodded, "It is preliminary to cooperate with Orchid and China MicroPort. Recently, Director Gao, you may be busy."

"Oh? Should patients with mitral regurgitation focus on surgery?"

"No." Wu Mian said, "Orchid is ready to charity aid 5000 sets of consumables for interventional surgery for infants and young children with congenital heart disease."

5000 sets...

Although the cost is not known, it is at least several hundred million yuan in terms of sales price.

Gao Boxiang looked at Wu Mian in surprise, he didn't know that this happened.

"Dean Zhao, I will beg of you in the future." Wu Mian said with a smile, "There are suitable patients, who can't afford the operation or can barely do it, but if the family is going to hurt the muscles and bones, go to my side."

"No problem, Teacher Wu, this is a kind deed, and you have to toast you a cup later." Dean Zhao said.

"It should be done." Wu Mian shook his head and said, "Aside from anything else, Dean Zhao will help identify patients. After all, there are so many free consumables. If you have money, you can treat them normally, leaving the opportunity. For children who have no money."

Wu Mian was very serious when he spoke. Dean Zhao knew the priorities and nodded and said, "Teacher Wu, you can rest assured that although it is troublesome to screen patients with family conditions, I will do my best."

There are too many things involved, and Wu Mian doesn't want to set the conditions too harsh. Wu Mian understands the most basic truth.

"Let's go back and implement it quickly. Your economy is developed and there may not be many people in need. Anyway, you can help contact me first." Wu Mian said politely.

"Look at what you said, isn't this what we should do." Dean Zhao said.

While talking, the waiter passed the food, and Ren Haitao finally found an opportunity.

"Ms. Wu, the oxygen partial pressure of the patient's blood gas analysis just now was really low." Ren Haitao directly said the result.

"Oh, the lungs have been ventilated again? What medicine was given?" Wu Mian asked.

"Yeah." Ren Haitao nodded and briefly talked about the rescue medication used at the time. "The patient is in good condition after the rescue. I see the operation is over."

"I don't worry if you are there." Wu Mian said with a smile looking at Ren Haitao.

"Teacher Wu, I just felt something was wrong at the time, but I couldn't tell what was wrong." Ren Haitao said, "I can't help but call you."

"Oh, haven't encountered it before?" Wu Mian asked.

Ren Haitao shook his head, and the two directors of the People's Hospital looked at Wu Mian unblinkingly and listened to Teacher Wu's explanation.

Without Ren Haitao's alertness on this matter, he was vigilant like his instinct, and he even did not hesitate to call Teacher Wu, it would very likely have serious consequences. As for why this happened, they thought it was a supernatural event.

Similar things are certainly not normal. If they are, the monitoring content of blood oxygen saturation is meaningless.

"Serious imbalances in the ratio of ventilation to blood flow during one-lung ventilation are the most likely cause of this situation. During one-lung ventilation, the blood flowing through the non-ventilated lung flows back to the left atrium without being oxygenated, causing venous blood. Doping, causing PaO2 to drop."

Wu Mian began to talk about it. Although he didn't see the patient with his own eyes, he could guess at all times by just guessing.

"Under normal circumstances, the blood flow of the right lung is about 10% more than that of the left lung. Therefore, the incidence of hypoxemia in the collapse of the right lung is higher than that of the collapse of the left lung. In this case, the right lung was not ventilated due to the left side lying position. There is blood flow, which causes false shunt of arteriovenous blood, and the ratio of blood flow to right lung ventilation decreases, which ultimately leads to a decrease in PaO2."

"This is the most basic principle of one-lung ventilation. Although the probability of problems is so small that everyone can hardly remember it, the old man still has the most basic vigilance."

Wu Mian looked at Ren Haitao with approval.

It turned out to be so, Ren Haitao recalled some memory fragments at this time. When seeing the patient lying on the left side, there is a trace of anxiety in my heart, which is due to this aspect.

"Preoperatively, there is more sputum in the left bronchus of the patient, which is easy to block the bronchus. In the lateral position, the contents of the abdominal cavity push the diaphragm and move upwards, and the functional residual capacity decreases, causing left atelectasis, resulting in decreased left lung ventilation function , Further aggravate the imbalance in the ratio of ventilation to blood flow."

What Wu Mian said is easy to understand. All of you present here are director-level anesthesiologists, and they immediately understand what Teacher Wu is talking about. But... Teacher Wu's explanation still couldn't explain the patient's situation perfectly.

Seeing a few people who looked puzzled, but didn't dare to ask, Wu Mian smiled slightly and said, "Many years ago, probably more than 30 years ago, domestic anesthesiologists began to perform one-lung ventilation. Several directors should have heard one sentence often. Words—your double-lumen tube is not in good position."

Indeed, this sentence almost speaks to the hearts of several directors present.

The poor position of the double-lumen tube leads to a decrease in blood oxygen, which is the most important problem for intubation, and it is also one of the landmark operations for evaluating the intubation level of an anaesthetist.

“Although hypoxic pulmonary vasoconstriction or thoracotomy affects pulmonary blood flow, the imbalance of blood flow at the same time is an important and theoretical factor, but if you encounter a drop in pulse oxygen and a change in airway pressure, then the monistic diagnostic thinking tells You first consider the location of the double-lumen tube."

"Mr. Wu~www.wuxiaspot.com~ But this patient’s situation is that the blood oxygen display is different from the actual display." Ren Haitao already wanted to understand what Wu Miangang said. He was full of the previous situation, and did not consider anything else. Yes, asked directly.

"A little bit of explanation." Wu Mian was not angry, but said with a smile.

"Hmm, what do you think of Teacher Wu?" Ren Haitao continued to ask without realizing that he was too straightforward.

Several other people also looked at Wu Mian curiously, wanting to hear his explanation.

It will definitely not be a supernatural event, but a rare situation.

"Which of you has studied the working principle of the blood oxygen saturation clip?" Wu Mian asked.

Several directors shook their heads.

"No research is normal, after all, it's rare." Wu Mian said, "The difference in the measurement methods of SaO2 and SpO2 caused this case to be inconsistent with severe hypoxemia, resulting in a false increase in pO2."