Chapter 2636 [2636] Secret Investigation

It is possible that the patient will be delayed into renal ischemia and renal injury, but acute renal injury usually manifests as 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 renal injury. One is urine volume. Low urine volume is the most typical clinical symptom of acute renal injury. The other is serum creatinine value. According to urine volume and serum creatinine value, acute renal injury can be divided into three levels. Clinical classification has always been used to guide clinical treatment plans. If it is classified into level three, it is necessary to consider starting a hemodialysis plan.

Now this patient's urine has become darker after returning to the ICU. The ICU doctor hurriedly sent urine and blood samples to the laboratory for testing. At this time, can it be easily said that this patient may have acute renal injury due to previous illness? Obviously not.

Doctors should seek truth from facts and cannot blame everything on the patient's previous illness. This is 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 easy to cause acute kidney injury. At this time, the so-called acute kidney injury caused by insufficient renal perfusion is ranked at 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 be a big boss. Dai Ronghong's recommendation is right.

As an ICU doctor, Xia Dongxian has dealt with big bosses in various departments too many times. It can be said that he knows what big boss qualifications are better than other doctors.

The perioperative management of critically ill patients is not only the key difficulty of ICU, but also a test of whether a surgical big boss has real ability.

Some hospital surgeons throw such patient problems to ICU doctors, while others do not. The bigger the boss in the surgery department, the less likely he is to shirk responsibility, especially when it comes to key patients that are related to other important matters, and the boss is watching them personally.

Not surprisingly, Xia Dongxian did not need to be notified and soon saw Fu Xinheng coming over after taking a break after the operation.

Wearing slippers and standing at the door of their ICU office with someone, Fu Xinheng took his hand out of the pocket of his white coat and waved it, suggesting that Xia Dongxian didn't need to speak.

Seeing that this robot was 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 in all aspects and be particularly picky?

This possibility is very high. One of the reasons why robots are called robots is that they don't know how to adapt and are too harsh.

Xie Wanying was studying 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 analyze 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. From the other indicators of today's patients, I personally think that the most critical point is blood transfusion."

"Blood transfusion?" Xia Dongxian was surprised.

When there is a problem with the kidney, you don't use medicine but only think about blood transfusion?

"After the operation, the kidney must be restored to adequate renal perfusion to allow the patient's kidney to repair itself."