Mean arterial pressure can be affected by factors such as drugs. If drugs are used to increase mean arterial pressure, it is a false positive and meaningless. This corresponds to what Mr. Xie said before that drug tests should be conducted cautiously before weaning from the machine.
The specific operations have actually already begun.
Have you done it?
Director Wang and others at the scene were shocked, as it seemed that Xie had not mentioned any special medication for the patient.
Let's talk about another question. The significance of mean arterial pressure monitoring is that the perfusion of the human body is closely related to the cardiac output of the heart. Cardiac output can be measured using picco technology, but if picco technology is not available, it can be measured using transesophageal echocardiography.
Xie Wanying said: "We just tested the heart condition under full flow support of the membrane lung, mainly measuring the left ventricular ejection fraction and the function and capacity of the right ventricle."
Since the doctors are now gathering to discuss the issue of removing the ventilator, it means that the values found in the examination are very good.
The next thing to do is to gradually reduce the patient's flow rate to one-half, and use transesophageal echocardiography to perform the above examinations in the meantime. If the left or right ventricle is found to be dilated or the blood pressure drops, the full flow rate will be restored immediately.
So that's how it is. This is a very cautious procedure for removing the ventilator. The doctors present were writing down their notes, and no one thought the procedure was complicated. Medicine is never afraid of complicated procedures. The more complicated the procedure is, the more it shows that the procedure has been carefully studied, and the better it is that the procedure is under the control of the doctor.
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When Boss Zhang picked up the pen, his displeased gaze from his thick eyebrows and big eyes swept over the uninvited guests at the meeting.
It is said that Director Xia Dai of the National Association of ICU is so shameless that he comes to attend meetings every day. Why, people from M Company, who I only met once yesterday, come to listen to their meetings.
Could Mai Hui, a foreigner who spoke poor Chinese, really understand Mr. Xie's lectures? As it turned out, he actually brought a live translator to help him translate simultaneously, which was amazing.
Zhang Huayao's brows were almost wrinkled into two towering mountains.
The shameless person must have pretended not to see Mr. Zhang's expression and continued to listen to the lecture with the other doctors while craning their necks.
Mai Hui had never heard of the plan that Xie mentioned. It was a plan for the future.
“When the flow rate drops to twelve to fifteen and the VIS index is less than ten, conduct a capacity load test.”
The VIS index is a score for vasoactive and inotropic drugs. It is calculated by a complicated formula, which is the sum of the various drugs multiplied by the dose. From this simple formula, it can be inferred that the lower the VIS index is, even when it is equal to zero, the better, which is equivalent to not giving the patient these drugs to support the patient's blood pressure.
Judging the patient's heart under this premise can be close to truly assessing the original function of the patient's own heart without assistance, which helps doctors determine whether the patient can continue to be removed from the ventilator.
Volume loading test is to give patients a certain amount of fluid for a certain period of time to quickly replenish the patient's blood volume in order to determine the heart's response. Here, albumin is dripped. The doctor wants to give the patient a more difficult test before the ventilator is removed to further test the patient's heart. At this time, transesophageal echocardiography must be used to check the heart function indicators mentioned earlier.
Finally, dobutamine is used for a few hours to observe the heart function. If the heart values remain stable, the machine can be stopped for testing, which means it is safe to enter the formal weaning process.
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