Chapter 3534 【3534】I've Never Heard of It

Mean arterial pressure is affected by factors such as medications. If medication is used to increase mean arterial pressure, it is a false positive and meaningless. This corresponds to what Mr. Xie said before that drug testing should be conducted cautiously before weaning off the machine.

How to do the specific operation has actually already started.

Did it?

Director Wang and others at the scene were shocked. It seemed that Student Xie had not mentioned any special medicine to be given to the patient before.

Let’s talk about one more issue. The significance of mean arterial pressure monitoring: Human perfusion is closely related to the cardiac output of the heart. Cardiac output can be measured using picco technology, but without picco technology it can be measured using transesophageal echocardiography.

Xie Wanying said: "What we just measured was the heart condition under full flow support of the membrane lung. It mainly measured the left heart ejection fraction and the function and capacity of the right ventricle."

Since doctors are now gathering to discuss the issue of weaning from the machine, it is equivalent to saying that these values ​​​​examined are very good.

The next thing to do is, Xie Wanying continued to add: "Gradually reduce the patient's flow to one-half, and use transesophageal echocardiography to do the above examinations. Once the left and right ventricles are found to be dilated or the blood pressure drops, they will immediately return to normal. Full flow.”

It turns out that this is a very cautious step to remove the machine. All the doctors present here were writing under their pens, and no one thought the steps were cumbersome. Medicine is never afraid of complicated procedures. The more complicated it is, the more careful research is in place, and the more it appears that it is a good thing that things are under the control of doctors.

When Mr. Zhang picked up his pen notebook, he glanced at the uninvited guests at the meeting with displeased eyes.

He said that Director Xia of the National Association's ICU was so shameless that he just came to visit every day. Why, people from Company M, whom I only met once yesterday, came to listen to their meeting.

Can the foreigner Mai Hui, who speaks poor Chinese, really understand Teacher Xie's lectures? It turned out that they actually brought an on-site translator to help him translate simultaneously, which was absolutely amazing.

Zhang Huayao's eyebrows were about to wrinkle into two towering mountains.

The shameless person must have pretended not to see his bossy expression, and stretched his neck along with the other doctors present to continue listening to the lecture.

Mai Huizhen had never heard of the plan that classmate Xie mentioned. It was a plan for the future.

"When the flow rate drops to 12 to 15, and the vis index is less than 10, conduct a capacity load test."

The vis index is the score of vasoactive drugs and inotropic drugs. It is calculated by a complicated formula. It is the sum of various drugs multiplied by the dose. From this simple formula overview, it can be inferred that the lower the vis index is or even equal to zero, it is best, which is equivalent to not giving the patient these drugs to support the patient's blood pressure.

Under such a premise, judging the patient's heart will tend to be able to truly judge the original function of the patient's own heart without assistance, which will help doctors determine whether the patient can continue to be weaned.

A volume load test is a rapid rehydration of a certain amount of fluid for a certain period of time to the patient, with the purpose of increasing additional blood volume to determine the response of the heart. Here, an albumin drip is administered. The doctor wants to add some difficult questions to further test the patient's heart before weaning him off the machine. At this time, he must use transesophageal echocardiography to recheck the cardiac function indicators mentioned before.

Finally, use dobutamine for a few hours and then observe the heart function. If the heart values ​​always maintain good stability, you can stop the machine for testing, which is considered to be the official weaning process.