C13 Ecmo's Science Stream
Tan Sitong was so excited.
It could be said that he and Liu Handong were fated.
The two of them had a shockingly coincidental professional background, and they were both clinics who had undergone emergency treatment.
Therefore, the topic and intimacy level instantly increased by several levels. Even Tan Sitong's student, Xie Hui, felt that he was being ignored.
The topic of their conversation had always been focused on the keywords ECMO, right heart, right heart, machine loop support and heart load.
Every time they talked about ECMO, Tan Sitong couldn't help but feel dissatisfied with Xie Hui.
Especially when he ridiculed Xie Hui when he tried to install it, as well as his doubts after installing and debugging. All of these made Tan Sitong very unhappy. Although Xie Hui had already read his PhD, his professionalism was far from his PhD. Therefore, Tan Sitong felt that it was necessary to save him during the time when the treatment work was relatively short. He wanted to make a general popularization of all critical patients in Silver Pond Hospital, especially the application knowledge of ECMO on right heart failure.
Under Tan Sitong's proactive support, the universal teaching was quickly carried out.
Although it was in the form of a video conference, everyone who was thirsty for knowledge still actively asked questions and made speeches.
Just as Tan Sitong had said, Doctor Liu Hendong would soon return to work in the Golden Pagoda Hospital. The time and opportunity to impart experience to everyone was limited.
The more he said this, the more serious the people with serious illnesses became.
"Right heart failure means that due to the damage to the right heart itself or the increase in load after the right heart is overloaded, it can't maintain a sufficient amount of heart failure before the right heart is overloaded. The treatment for right heart failure includes: optimizing the pre-overload. By using vascular pressure increasing drugs and cardiovascular stimulants to increase contraction, as well as inhalation of vascular vessels and expansion drugs, the right heart is unable to maintain a sufficient amount of cardiovascular infusion. However, When the medication was not effective, it required mechanical circulatory support (MCS) to maintain the infusion of the entire body and right heart. Currently, The data regarding the MCS for pure right heart failure is relatively low, but it seems to be the most effective and practical method. . . " Liu Handong first introduced.
"This afternoon, another new case was released. What is the cause of right heart failure?" Someone in the live broadcast room asked.
"That patient is a simple right heart failure patient caused by acute low oxygen respiratory failure. For such a patient, a simple right heart failure caused by acute low oxygen respiratory failure, even if the patient is in a state of shock, VVV-ECMO is still an appropriate initial choice!" Liu Handong replied.
"Great, it solved the question that I have been puzzled about for a long time. "
"Why does that sound so strange? Could Professor Tan Sitong be air?"
"Of course, Professor Tan is not air. He is the ECMO, the most expensive and important part of the whole department. "
"All of you, stop arguing. I want to ask a question. "
"Alright. You ask, you ask. "
For a moment, the entire live broadcast room was filled with intense discussions. Liu Handong did not immediately stop them. Instead, he quietly listened and tried to find the answer to the question. However, after searching for a long time, it was only their complaints and interrogations. There were no actual questions.
At this moment, someone asked: "Professor Liu, how do you deal with the original right heart injury or right heart failure?"
Xie Hui, who was sitting in his seat, was very unhappy when he heard Professor Liu's name. He muttered in his heart, 'With just you, you're still a professor!' 'F * ck. . . '
He brought his doubts to examine Liu Handong. Xie Hui's eyes were almost glued to the screen of his phone.
Liu Handong naturally had no way of knowing all of this. All of his focus was on the questions.
After thinking for a while.
Liu Handong immediately replied, "When it comes to the original right heart injury or right heart failure, accompanied by left heart failure, it should be supported by VA-ECMO. "
"Thank you, Professor Liu, for your explanation. Oh, right. What's the difference between the principles of these two modes? In actual practice, how do you choose to use them correctly?"
"Both modes provide indirect support to the right heart by reducing the front load, lowering the right ventricle wall tensile, and transferring oxygen fusion blood to the carotid artery. External intubation is also needed in VVVC-ECMO. And it is most commonly used in VA-ECMO. Even in emergency situations, it can be inserted quickly. The changes in the catheter wave-shaped pulse could indicate the changes in the clinical situation. This included the changes in the cardiac function, the lack of front load, the worsening of right heart failure, and excessive VA-ECMO support, which led to an increase in left heart load. The cardiovascular function can be improved by dripping strong cardiovascular drugs or vascular expansion drugs. It can also be improved by using IMPERA, intravascular balloon rebound, or by adjusting VA-ECMO support. . . "
Liu Handong's smooth reply made Xie Hui, who was full of anger, admire him from the bottom of his heart.
It seemed that this fellow still had some skill. He must have accumulated it for many years. These characteristics were exactly what he lacked.
In order to ease the atmosphere, he began to mention simple but more practical questions.
"Many teachers are still not very familiar with the concept and principles of the ECMO. They are not very clear about the application, and they do not know much about the relevant summary of acute right heart failure. Professor Liu, can you tell me more about it? Thank you. " Xie Hui's proactive question broke the silence in the live broadcast room.
"Okay! Thank you for Dr. Xie Hui's question. Then I'll answer each and every one of these questions. First, exovascular membrane oxygen fusion (ECMO), also known as exoskeleton life support, developed in the early 1950's, At that time, the purpose was to perform oxygen synthesis on the blood during prolonged surgeries that required external circulation. Recently, the structure and technical improvements made the ECMO and other types of mechanical circulatory support (MRCS) become more widely used among adult patients. Especially in patients with acute respiratory failure or cardiovascular failure. Similarly, people's recognition and treatment of right heart failure also increased the choice of treatment for right heart failure patients. Although the clinical experience of using the ECMO to treat right heart failure was constantly accumulating, However, there were still very few relevant documents. Considering the differences in pathology between right heart and left heart, as well as the existing different support plans, The management principle of the left heart is not necessarily applicable to the right heart. This summary involves the management strategy for acute right heart failure and the MCS problem in right heart failure. The main point is ECMO. . . "
"Professor Liu is truly talented. Even I am ashamed of my knowledge reserves and accumulation of complex problems! However, since this is a rare opportunity, I would like to invite everyone to ask questions. After all, I missed this opportunity. I don't know when the next time will be. " Tan Sitong didn't hesitate to praise her.