Chapter 2120 【2120】Together Guard

The disease of pulmonary hypertension is just afraid of this hypercoagulable state. High coagulation, prone to pulmonary embolism, will further aggravate right heart failure.

Clinically, anticoagulant injections are sometimes required to deal with this disease, and the most common belly injection is low molecular weight heparin sodium.

Pregnant women should be treated specially. For this surgical patient, it was the hypercoagulable state during pregnancy that caused the original mechanical valve to have thrombus and required cardiac surgery as soon as possible.

How to deal with these contradictions. It is best to avoid heavy maternal bleeding during surgery. As Dr. Du said, on the one hand, obstetricians should shorten the time of cesarean section as much as possible and let them take over from the heart. On the other hand, anesthesiologists should play the role of escorting the puerpera during the operation, and try to help the puerpera survive the cesarean section.

After receiving a call from Du Yeqing, the anesthesiologist Dr. Mo came to the scene.

Dr. Mo first introduced to the obstetrician and gynecologist: "The anesthesia plan should be planned according to the existing mature and effective plan. General anesthesia is used for heart surgery, and continuous epidural anesthesia can be used for cesarean section or continuous epidural anesthesia .”

Why is general anesthesia not used for cesarean section?

In the past, anesthesiology has always believed that general anesthesia has many disadvantages for cesarean section. The biggest disadvantage is that many general anesthesia drugs are easy to enter the fetus and cause fetal respiratory depression. However, these drugs are the most commonly used and familiar drugs for anesthesiologists in general anesthesia. If you do not use these commonly used drugs and change them to special drugs that are rarely used, you will be afraid that other troubles will arise.

Like the current patient who is risking her own life just to have a child, she and her family are not willing to let the child risk their life at a crucial point. Fetal respiratory depression means that the child will suffocate, and the baby may become a child with cerebral palsy when he returns. For this reason, the patient and his family, who had obtained medical information from various places, were unwilling to undergo general anesthesia.

Can I use continuous epidural anesthesia without general anesthesia?

In this regard, anesthesiologists and cardiac surgeons dare not give a 100% guarantee, and may switch to general anesthesia during the operation depending on the situation. Mainly, the heart function of this patient is not good now, and other circulatory support may be needed during the operation.

Du Yeqing said: "If the patient's condition is more critical, we may provide support for her to do IABP in advance."

(What IABP is mentioned in previous chapters will not be repeated.)

That being the case, how to ensure that the current plan is feasible.

"Director Zhang presided over the ward round discussion this morning, and today she will be given a combination of drugs. It is estimated that the patient's condition will improve tomorrow." Du Yeqing said.

It turned out that the boss made a move.

"Of course, according to Director Zhang's prediction, this medicine can only be lasted until the day after tomorrow." Du Yeqing added, it's not that it was not used before, but that the medicine should be used until the critical period. Some medicines seem to work quickly, but to put it bluntly, they don’t cure the root cause, and the effect will not be good after using it quickly.

After Du Haiwei listened, he knew that the surgeons in the cesarean section center and the interventional doctors in the cardiology department would be guarding them, and their obstetricians and gynecologists would not be too frightened.

While the meeting was in progress, someone quietly came and sat beside Zhang Huayao, secretly beckoning to classmate Xie.

Xie Wanying turned her head and saw the handsome eyebrows of Senior Brother Shen who was present.

At the scene, except for the neonatologists, the doctors of the surgical team were basically present, and any problems could be discussed.

Du Haiwei turned around and asked the young doctors in the group, wanting to brainstorm: "Talk about your thoughts on this operation, if you have good suggestions, share them and discuss them together."