Back in 2002 as a doctor

The machine model has no decisive significance for the operation of extracorporeal circulation. Only doctors who are extremely powerful and familiar with extracorporeal circulation will formulate personalized plans based on various types of machines.

"Prepare 1000mL of Bomalis A solution and Ringer's solution, 90mg of heparin, 2000mL of banked blood, 200mL of hydroxyethyl starch, 125mL of mannitol, 125mL of sodium bicarbonate, 4mL of potassium chloride, and 4mL of magnesium sulfate."

"Systemic Heparinization."

"Director Wang, perform heart compressions. Director Zhang and I will do extracorporeal circulation." Zhou Congwen said in a deep voice.

At this time, Wang Chengfa had been squeezed to the edge of the operating table near the headrest, and he was doing heart compressions in an extremely awkward posture.

He was dissatisfied, but he also knew that he would not be able to save the patient.It's all about death, let Zhou Congwen be arrogant... so what?

What Wang Chengfa wanted in his mind was to let Zhou Congwen try it, but his subconscious mind was already filled with the scene of Zhou Congwen arbitrarily commanding the rescue of air embolism during the last esophageal cancer operation.

Maybe... it really works?

He didn't even have time to think about Zhang You's defection, so he concentrated on pinching the patient's heart.

After systemic heparinization, the aorta and superior and inferior vena cava were intubated to establish extracorporeal circulation, total bypass, and the temperature was lowered to a nasal temperature of 25°C.

Zhang You finally realized Chen Houkun's happiness, which was a kind of happiness that he had never felt before.

He didn't say that he had done thousands of extracorporeal circulation operations, at least seven or eight hundred cases.But when Zhou Congwen was standing opposite, everything seemed to have changed unconsciously.

The operation was unprecedentedly smooth, and the intubation of the superior and inferior vena cava was pushed smoothly, so fast that it would fly off.

No matter what Zhang You needs, even when it is just a thought, it will be handed over.

Zhang You was in a daze for a moment, feeling that the person standing opposite him was his former teacher, and he was the only one who was most familiar with his surgical habits and technical abilities.

Even his own teacher is not good enough. If the supporting stage can reach this level, the operation should crush him by at least an order of magnitude.

Chen Houkun must have felt this way when he performed the fourth operation on Geng Haoran's son that day.

At this moment, just as at that moment.

The time to establish extracorporeal circulation was unexpectedly short, and when Liu Di ran back panting with blood in his arms, the extracorporeal circulation had been successful.

With the assistance of the bypass start ring, Zhang You explored the heart and found a large amount of active bleeding in the pericardial cavity.

Careful examination revealed that, as Zhou Congwen said, there were two cracks in the free wall of the patient's heart and the atrioventricular groove, which were about 6cm and 3cm long, and a large amount of active blood flowed out from the cracks.

Two wounds, in which the rupture of the right ventricular free wall is deep and full-thickness, reaching the right ventricular cavity.

This look is so accurate!

Zhang You sighed in his heart, saying that it is impossible not to be convinced, not only convinced, but also completely convinced.

Before opening the heart, people had already seen the size of the wound clearly. You must know that the operation area was full of blood at that time.

"Mannitol 100ml, now, at full speed." Zhou Congwen said in a deep voice.

As he spoke, he assisted Zhang You in suturing the heart.

"In vitro, rewarmed, 28.5 degrees."

When Zhou Congwen's body temperature reached the required temperature, he looked back at the extracorporeal circulator.

"Lidocaine 200mg, prepare a defibrillator, energy 20J."

Hearing what Zhou Congwen said, Zhang You and Wang Chengfa's hearts arose.

Chapter 0173 There is only one truth

The patient underwent extracorporeal circulation directly after cardiac arrest. Both of them looked similar, and the heart was at rest.

But one can be saved, and the other cannot.

They don't know whether the patient is dead or alive under hypothermic extracorporeal circulation and ventilator-assisted breathing.If the defibrillation is successful, then you will live; if it fails...

The energy of the defibrillator was 20 joules, and Zhou Congwen pressed it directly on the heart after confirming it.

"Wait..." Zhang You still wanted to calm down, but only said one word, and Zhou Congwen pressed the button of the defibrillator.

There was a soft "pop".

The heart began to beat again, although it didn't look very powerful, but it was beating, full of vitality.

"Woo~~~" Zhang You let out a long breath.

"Xiao Zhou, why use extracorporeal circulation?" Zhang You asked.

"On the one hand, the use of extracorporeal circulation can recover blood loss from the surgical field, reduce the loss of the patient's own blood, save the amount of banked blood, and try to avoid the probability of postoperative dic in patients.

On the other hand, artificial pumps can be used to quickly transfuse blood to maintain blood volume and arterial pressure. "

Zhou Congwen replied lightly.

"The more important thing is that with the support of extracorporeal circulation, controlled blood pressure reduction can be used more effectively, and even the method of deep hypothermic circulatory arrest can be used to find the bleeding site and repair it."

"There is too much bleeding and the fingers cannot be held down. Deep hypothermic extracorporeal circulation is a method that can be tried. Other methods are also available, but the success rate is not as good as this."

Zhang You didn't look at the surgery area, but silently looked at the young doctor standing opposite him.

Before, he regarded Zhou Congwen as a thorn in his side and a thorn in his flesh, but Zhang You was still thinking about the process of establishing extracorporeal circulation just now.

Wrong, all wrong!

Chen Houkun's level is not that high!

The reason why he seemed to be a level stronger than himself was because of this doctor Zhou Congwen who was opposite him.

My feeling just now was right, even the most powerful heart surgeon I have ever seen in my life could not suppress me by an order of magnitude, but the little doctor on the opposite side did it with ease.

Although it was difficult to accept, Zhang You knew that this was the only possibility.

Zhou Congwen, his surgical skills and even his vision surpassed his own.

"The operation continues." Zhou Congwen suddenly raised his head and met Zhang You's eyes, "Does the operation continue?"

Surgery to continue? !

Zhang You was in a trance all of a sudden.

Deep hypothermia, rewarming, the heart has already started beating, how can the operation continue?What did Zhou Congwen mean?

"Xiao Zhou, the operation... let's go on. It's too late, too late." Zhang You said in a discussing tone, even with a little respect.

"The patient is in hemorrhagic shock, and it is difficult to ensure that there will be no coronary problems after surgery. And if this continues, it will be difficult to perform another operation." Zhou Congwen said flatly.

"..."

Zhang You was speechless.

He knew what Zhou Congwen said.

But what about surgery?

The heart was cut, and it took a lot of effort to save it.If things go on like this, explaining to the patient's family is the best result Zhang You can think of.

If the surgery is performed regardless, will the patient be able to bear it?

And this is not the main point. The key point is that the patient's heart has resumed beating. Is it necessary to undergo another deep hypothermia arrest and coronary artery bypass surgery under extracorporeal circulation?

Don't bring it to death.

Zhang You frowned at Zhou Congwen, his young face reflected the light of the shadowless lamp, as if his whole body was shining.

Every word he said seemed to be asking himself, but Zhang You was sure that if he said "no", it would be difficult to end today.

This is a strange "illusion", but Zhang Youbian thinks that there is nothing wrong with his feeling.As for what the little doctor opposite would do if I didn't agree and forced it, I really couldn't say.

"Director Zhang, did you bring the octopus?" Zhou Congwen asked suddenly.

"..." Zhang You was taken aback.

The octopus is a necessary equipment for coronary artery bypass surgery. Its shape is similar to an octopus, so it is called an octopus.

The device is buckled on the heart to minimize the impact of the beating heart on the vascular anastomosis.

Zhang You does not have this technical level. He can do coronary artery bypass surgery without beating, but he has never done beating surgery.

At present, there are not many doctors in China who can perform off-pump coronary artery bypass surgery, and it can even be said that there are only a handful of them.

What does Xiao Zhou mean?Could it be that he wants to go straight to a heart bypass surgery that doesn't stop beating? !

Looking into Zhou Congwen's eyes, Zhang You was a little confused.

This is impossible.

"Try it? You'll die if you go down anyway." Zhou Congwen asked lightly.

"I can't do it, you can do it?" Zhang You no longer regarded Zhou Congwen as a little doctor, but asked in an equal and even slightly respectful tone.

He was very curious about who gave Zhou Congwen the courage to say that he could build bridges with a beating heart.

Although unbelievable, Chen Houkun's live broadcast surgery and the process of establishing extracorporeal circulation have proved that his level has absolutely nothing to do with his youth.

"Understood."

Slightly...understand...

Zhang You didn't know how to describe the person in front of him.

Doesn't he know how difficult it is to build a bridge with a heart that keeps beating?How to explain to the patient's family members that one stitch is not good, and the coronary artery is bleeding after the operation?

If it goes on like this, although the patient will not live long, the cause of death is myocardial infarction; if the operation is barely completed, death due to the operation is a completely different concept.

Even though he thought so, Zhang You unconsciously tended to let Zhou Congwen complete the operation.

"Director Zhang, if you agree, I'll go home and get a 10x lens."

"Do you have a 10x mirror at home?" Zhang You was stunned.

How could a little doctor have such a thing as a 10x mirror!Zhang You made a quick decision and thought of countless possibilities in an instant.

All possibilities point to the final result - Zhou Congwen can do it.

His level is beyond the guesswork of doctors in the province!

"Have."

"Go get it, I'll wait for you." Zhang You said firmly.

Zhou Congwen smiled, turned his head to look at the ECG monitor, the value was stable.For hemorrhagic shock, as long as the bleeding is stopped and enough fluids are given, the patient should be fine.

"Measure blood gas and ions, Director Zhang, please correct the disorder in the internal environment. My house is very close, so go back as soon as you go."

After Zhou Congwen finished speaking, he turned and stepped down.

He left in a hurry, and he didn't have time to untie the strap of the sterile surgical gown, so he tore off the surgical gown.

The crunchy surgical gown made creaking noises due to frequent disinfection, and was thrown on the ground by Zhou Congwen as a rag, like a scumbag.

When Zhou Congwen left, Wang Chengfa asked suspiciously, "Director Zhang, do you really believe that he can bridge the heart without stopping?"

"Letter." Zhang You said firmly, without any hesitation.

Wang Chengfa was taken aback, he heard a hint of ominousness from Zhang You's tone.

Chapter 0174

"But he didn't even open his chest... only once, really, I swear he only did it once!" Wang Chengfa said anxiously.

"Director Wang, do you really think so now?" Zhang You looked at Wang Chengfa like a fool, with stern eyes.

There was no contempt in Zhang You's eyes, only indifference.

"..."

Wang Chengfa understood what Zhang You meant, but he began to recall a year and a half ago that Zhou Congwen was indeed a white man who came to his subordinates.

There are few operations in Corey, and Wang Chengfa knows that if he needs to undergo surgery, he can only feed one person at most.So at the first department dinner, Wang Chengfa carefully observed the doctors under him, and finally chose Wang Qiang.

Now that one person is chosen, others will never have another chance. Wang Chengfa is very intoxicated by this feeling of controlling life and death.Poor little doctor, he doesn't know what happened, he is doomed to be mediocre all his life.

Every time he saw Zhou Congwen and Shen Lang, he would think so.Without a trace of mercy, Wang Chengfa thought it was all an arrangement of fate.

As fate would have it, if Zhou Congwen wanted to complain, he would blame his ancestral grave for bad feng shui.

For 19 and a half months, Zhou Congwen has never used a knife at all, except for closed thoracic drainage, and he can't even open his chest... Wang Chengfa thought of this, and suddenly remembered that he drank too much that day, Zhou Congwen had an emergency rescue from the beginning to the end thing.

Have you lost your eye...

Can't I hold him back...