At the critical moment, Xie Wanying gave a warning to the teachers who had never done it before: "After being connected to the machine, there may be no improvement in the first two days, and it may even look a little worse. After two days, if the machine is effective, the patient's dependence on the machine will gradually decrease."
Everyone was anxious to see the effect of the new machine. But after hearing what she said, they knew that this battle would have to be fought slowly and there was no time to rush.
All the doctors present at the scene can understand that rescuing a critically ill patient will never be completely reversed in a few hours or a day or two.
During this period, it is very important to protect the patient and find and correct problems in time. In the future, specially trained nurses will stay by the patient's side and watch the machine all the way.
At this stage, there are no well-trained nurses, and the doctors themselves are not familiar with the situation. The doctors can only watch over it themselves and accumulate experience first.
Director Wang was mentally prepared to move a chair and sit beside the patient's bed to fight to the end.
Director Wang is not the only one who is prepared to fight the disease to the death.
Zhang Huayao said, "Arrange the shifts."
After hearing what Chief Zhang said, the others nodded in response: How could such a good learning opportunity be taken advantage of by Director Wang alone?
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Here we have to talk about Zhang Desheng, the student who expressed his opinion first. He suddenly found that everyone around him was competing with him for the opportunity, including teachers who were vying for it.
Feng Yicong and the others patted Zhang on the shoulder and said: Look at you, what's the point of rushing to speak?
The clever student Zhang Desheng ran to find classmate Xie. He did not compete with the teachers and just acted as Xie's little follower.
As a result, all the teachers wanted to be Xie's followers.
I heard Zhang say, "Teacher Xie, just tell me what to do, and I'll do it."
Several classmates who were about to run to find Xie were screaming in their hearts: Even the big guys are trying to snatch the position of follower, what should they do now?
I don't care what Zhang said for the moment. After the ECMO machine, it's time for the blood filter machine. Xie Wanying and Dr. Liu continue to discuss the key points of CRRT technology.
Since crrt is a type of hemodialysis, the working principle is similar. The purpose of using such a machine is to replace the damaged kidneys to perform kidney-like functions, filter out excess water and metabolic waste toxins in the patient's body, correct water and electrolyte disorders, and ensure the patient's nutritional support.
From the above description, we can know that this machine is mainly aimed at the patient's body fluid balance. For critically ill patients, since they cannot eat for a long time and need other anti-inflammatory treatments, fluid rehydration is essential. In short, you can't let the patient "starve" to death by dehydrating him.
There is a technical difficulty at this point, which is how to control the amount of fluid the patient takes in to avoid continuous supplementation during treatment, to prevent the machine from having no effect or even worse situations from occurring.
In addition to the conventional blood test indicators, the monitoring method usually used in clinical management is the central venous pressure (CVP) mentioned by Xie before. This is a very old and traditional monitoring program.
Medicine is advancing and developing all the time. CVP has advantages as well as limitations.
"CVP cannot monitor the patient's cardiac preload, so it cannot judge some special situations. In addition, there are many factors that affect its measurement, so the measured value may not be very accurate." Xie Wanying said, "So it is better to use PICCO."
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