Chapter 2120： 【2120】Protect together

Chapter 2120 [2120] Common protection

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

In clinical treatment of this disease, anticoagulation injections are sometimes required, and the most common belly injection is low molecular weight heparin sodium.

Pregnant women need special treatment. Like this surgery patient, it is the hypercoagulable state during pregnancy that causes the original mechanical valve to have thrombosis and needs to have heart surgery as soon as possible.

How to deal with these contradictions. It is best to avoid massive intraoperative bleeding. 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. On the other hand, the anesthesiologist should play a role in escorting the mother during the operation, and try to help the mother survive the period of cesarean section.

received a call from Du Yeqing, anesthesiologist Dr. Mo was present.

Dr. Mo first introduced to the obstetrician and gynecologist: "The anesthesia plan should be based on a mature and effective plan to plan patients. General anesthesia for cardiac surgery, continuous epidural anesthesia for cesarean section, or continuous epidural anesthesia should be used. ."

Why is general anesthesia not used for cesarean section?

In the past, anesthesiology has always believed that general anesthesia has many unfavorable factors for cesarean section. The biggest disadvantage is that many general anesthesia drugs easily 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 these commonly used drugs are not replaced by special drugs that are rarely used, they will be afraid of other troubles.

Like the current patient who is risking her own life to just want a child, she and her family will not be willing to risk the child's life at this juncture. The child represented by fetal respiratory depression will suffocate, and the baby may also become a child with cerebral palsy when his life returns. For this reason, the patient and his family members who had obtained medical information from various places were reluctant to perform general anesthesia.

Can I use continuous epidural anesthesia instead of general anesthesia?

In this regard, anesthesiologists and cardiac surgeons do not dare to make a 100% guarantee, and they may switch to general anesthesia depending on the situation during the operation. Mainly, the patient's cardiac function is not good now, and other circulatory support may be required during the operation.

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

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

In this case, how to ensure that the current plan is feasible.

"Director Zhang presided over the ward round discussion this morning. Today, she will be given a different drug to be used in combination. It is estimated that the patient's condition will improve tomorrow." Du Yeqing said.

It turns out that the big guy shot.

"Of course, according to our Director Zhang's prediction, this medicine can only last until the day after tomorrow." Du Yeqing added, it is not that it was not used before, but the medicine should be used in the critical period. Some medicines seem to work quickly, but to put it bluntly, they do not cure the root cause.

Du Haiwei heard that, knowing that the surgeons of the cesarean section center will be guarding the interventional cardiology doctors, and their obstetrics and gynecologists will not be too scared.

While the meeting was going on, someone quietly came and sat beside Zhang Huayao, beckoning to Xie secretly.

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

At the scene, all the doctors in the surgical team except the neonatologist were basically there, and any questions could be discussed.

Du Haiwei turned around and asked the young doctors in the group, and wanted to brainstorm: "Talk about your thoughts on this surgery. If you have good suggestions, share them with us."

(end of this chapter)