Patients may be delayed into renal ischemia and renal injury, but acute renal injury usually presents with non-bright red urine. The urine manifestation of acute renal injury is usually dark urine and turbid urine.
Clinically, there are generally two indicators to distinguish acute kidney injury. One is urine volume. Low urine volume is the most typical clinical symptom of acute kidney injury. The other is serum creatinine value. According to urine volume and serum creatinine value, acute kidney injury can be divided into three levels. Clinical classification has always been used to guide clinical treatment plans. If it is classified as level three, it is necessary to consider starting a hemodialysis plan.
Now that the patient has returned to the ICU, his urine has become darker. The ICU doctor hurriedly sent urine and blood samples to the laboratory for testing. At this point, can we easily say that this patient may have acute kidney injury due to his previous illness? Obviously not.
Doctors should seek truth from facts and not put all the blame on the patient's previous illness. Doing so will be very detrimental to the patient's subsequent treatment.
Xie Wanying mentioned this to Senior Brother Xia: "It is estimated that the proportion of acute kidney injury caused by surgery is higher. The proportion of acute kidney injury after cardiothoracic surgery is very high."
This is an unavoidable surgical complication. As long as the patient adopts extracorporeal circulation during surgery, many harmful factors in the extracorporeal circulation, such as myoglobin inflammatory mediators, are too likely to cause acute kidney injury. At this time, the so-called acute kidney injury caused by insufficient renal perfusion is ranked as a lower possibility.
Xia Dongxian listened to her methodical analysis and nodded in his heart: I have heard that this junior sister has learned both surgical and internal medicine knowledge very well. Now it seems that it is more than that. The junior sister has the potential to become a big boss. Dai Ronghong's recommendation is right.
As an ICU doctor, Xia Dongxian has dealt with the bigwigs in various departments too many times. It can be said that he understands what the qualifications of a bigwig are better than doctors in other departments.
The perioperative management of critically ill patients is not only the key difficulty of the ICU, but also a test of whether a surgical expert has real ability.
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Some hospital surgeons pass these patients' problems to ICU doctors, but some do not. The higher the surgeon's rank, the less likely he is to pass the buck, especially when it comes to key patients that are related to other important matters, and the senior surgeons personally monitor them.
Not surprisingly, Xia Dongxian did not need to be notified and soon saw Fu Xinheng coming over after taking a rest after the operation.
Wearing slippers and standing at the door of their ICU office, Fu Xinheng took his hand out of the pocket of his white coat and waved it, indicating that Xia Dongxian didn't need to speak.
Seeing this robot sneaking around, it must have bad intentions and a purpose. Xia Dongxian's eyes rolled: Could it be that he wanted to examine his junior sister from all angles and be particularly picky?
This is very likely. One of the reasons why robots are called robots is that they are inflexible and too demanding.
Xie Wanying was buried in the patient's medical records. She didn't raise her head and didn't notice the visitor. She said, "Acute kidney injury is not enough to be analyzed by serum creatinine and urine volume alone. Usually biological markers are needed. The patient's urine is brown now, so the possibility of acute tubular necrosis should be considered. The influencing factors during the operation are no longer discussed after the operation. Judging from the other indicators of today's patients, I personally think the most critical point is blood transfusion."
"Blood transfusion?" Xia Dongxian was surprised.
When you have kidney problems, you don't use medicine and just think about blood transfusion?
"For the kidneys to recover after surgery, they must return to adequate renal perfusion, allowing the patient's kidneys to have the conditions to repair themselves."
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