C14 Liu Handong
Xie Hui, who was about to reconcile, heard his mentor Tan Sitong's praise for Liu Hendong in the live broadcast room. He was instantly filled with jealousy. In his opinion, someone who could be called a "genius of the Eight Trials" was. . . Other than him, Xie Hui, no one else was human. And now, Liu Handong had appeared out of nowhere. No matter what he said, he would not be convinced. Since the instructor had clamored to ask questions, and it had been half a day since then, it had been a cold one. In that case, the heavens had given him a chance.
Since Liu Handong was talking about experience on his live stream, there was no chance for him to prepare at all, so many questions might be difficult for him.
Didn't Gu Yu say that he would fail miserably at an easy task?
This was the logic. The simpler the problem seemed, the easier it would be to ignore it. In the end, the boat really capsized.
Thinking of this, he immediately asked: "Since Professor Tan asks for a question, then can Professor Liu answer 'Pathological Physiology of Right Heart Failure'?"
When Xie Hui asked this question, even the medical intern who had been staring at the screen of his mobile phone was sweating profusely. Although such a question was simple, it was not easy to give a comprehensive answer. After all, the simpler the question, the more he did not care about it, the higher the percentage.
Just as he was deeply sweating for Liu Handong, Liu Handong had already spoken frankly and frankly.
"Actually, this question is also a question that everyone is familiar with. I don't think I need to say it. No matter if it is Dr. Xie Hui or every teacher on the phone, they can speak very well. Since you're giving me this chance here, I also want to relearn with everyone. Right Heart Failure refers to the fact that the right heart is unable to maintain a sufficient amount of the right heart's output under sufficient load. Original right heart failure can be caused by the damage to the right heart itself. For example, after a right heart deficiency or infarction, myocardial infarction, myocardial infarction, or cardiovascular surgery. The occurrence of secondary Right Cardiovascular Deficiency was mainly due to the increase in pulmonary vascular resistance (PVR). For example: pulmonary embolism, pulmonary hypertension, or serious contraction of lung blood vessels caused by low oxygen. . . "
Liu Handong spoke very fluently. People thought that he was reading a textbook, especially Xie Hui. He stared at the screen in disbelief. The muscles on his face began to tremble unnaturally. He originally hoped that he would fail miserably, but he did not expect that it would give him a chance to show off his solid foundation.
Of course, at this moment, Liu Handong was facing the camera. There was no time or space for cheating.
Just as everyone was in awe of Liu Handong's knowledge reserve, they suddenly felt that he was out of words and began to pause for a long time.
At this moment, Xie Hui began to get excited.
He muttered to himself. This fellow must have memorized the first part before and did not have the time to memorize the latter part.
"To be honest, I had a few minutes of brain ringing just now, which delayed everyone's time. I'm very sorry. "
Liu Handong's face was in pain, but he slowly recovered.
"Brain ringing? At such a young age, his brain is already ringing. He must be exhausted. "
"Why don't we start the lecture again next time? Professor Liu, Doctor Liu, take a rest first. "
Many people began to worry about Liu Handong's health. They all left messages of concern.
Tan Sitong also left messages, and she even walked towards Liu Hendong's room to find out what was going on.
However, Liu Hendong insisted on smiling: "I might be leaving Silver Pond Hospital soon and returning to the Golden Pagoda Hospital. Time is limited, so it's better to share it with everyone as soon as possible and not leave any regrets. "
"Thank you for your hard work, Doctor Liu. . . "
"Thank you for your hard work, Doctor Liu!"
"Thank you for your hard work. . . "
. . . ""
Seeing the comments in the comments section, Xie Hui felt that he was being immoral.
After all, it was indeed a bit unreasonable to watch an exhausted comrade make a fool of himself.
"Let's continue, the right ventricle has the structure of a thin wall. It has a strong tolerance for large changes in volume, but it is extremely sensitive to changes in pressure. Because the basic physiological characteristics of the lungs and blood vessels are low resistance and low pressure, The rise of PVR had a significant impact on the right heart. If the PVR suddenly continued to rise, the right heart may not be able to effectively resist the increase in load. This led to a rapid heart failure. If the PVR increased gradually and slowly, the right ventricle could gradually adapt. However, it was still in a fragile state. Even if it was a relatively small physiological change, it would result in a loss of remuneration. What was worth noting was that. . . Due to the contraction of low-oxygen lung blood vessels, the PVR increased, causing 25% of ARS patients to have right heart failure. It is also related to the decline in the survival rate of patients who require VVV-ECMO support. . . "
Liu Handong said so much in one breath and once again fell into a pause.
"What about the early stages of right heart failure? What will happen in the early stages?" Xie Hui interrupted.
Tan Sitong frowned slightly. He felt that his disciple was a bit worried, but he still continued to observe his attitude.
Liu Handong thought for a moment and then said, "In the early stages of right heart failure. . . The pressure at the end of the right ventricle and right ventricle was higher than the baseline. With the reduction of blood from right ventricle, the right ventricle capacity has significantly increased. It caused the ventricle interval to deviate from the left ventricle, causing the left ventricle to be filled with obstacles and the heart rate to decrease. As the pressure on the pulmonary artery increased, The right ventricle was unable to maintain a sufficient amount of output per beat. If both ventricles were exhausted, it would result in a decrease in the output of the heart. The right ventricle wall's tensile increased, the pressure from the coronary artery reduced. In turn, the infusion of the myocardial infusion will be insufficient, followed by myocardial insufficiency. "
"What about acute right heart failure? How to manage and treat it? " Xie Hui seemed to be giving him a difficult question. This seemed to be more about the Cardiology Department.
Liu Handong continued to answer calmly, "The management treatment for acute right heart failure should start from optimizing the patient's capacity. Patients who used to be healthy in the heart should have acute and primary right heart failure. They have a preoverload reliance and are more sensitive to the insufficiency of the vascular capacity. As for the damaged or chronic damaged heart. . . On the contrary, overload capacity could further increase the tensile strength of the right ventricle wall. Subsequently, it caused the output of the heart to drop. However, the activation of the ECMO would cause the release of the cell factor, cause vascular paralysis, and bleeding, causing the capacity to be lost. Thus, In most cases, once the ECMO was decided to be activated, The pesticide treatment should be postponed. The failing right ventricle was very sensitive to the increase of the front load, especially when the right ventricle started to deteriorate. If the lung oxygen pressure was lower than 60 mHg or acidic anemia, it could cause the contraction of the lungs and blood vessels. PVR was also very sensitive to the lung volume. The lungs were not open and the lungs were overinflated. For example: Mechanical ventilation, especially when using high-level PEEP. It can also increase PVR. Thus, hypoxic and high-carbonate syndrome, As well as positive pressure ventilation therapy, it would cause the worsening of right heart failure. Even though the treatment and optimization of preload, cardiac contraction, and postload were given to the greatest extent, Some patients were still in a difficult position to treat right heart failure. For these patients, they may need MCS. . . "