bookpower Chapter 353
Chapter 353
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After being transferred to the Harmony ICU, repeat the ECG, normal.
Normal blood pressure range is low, blood oxygen saturation 93%...
"That's all for the specifics... Just transferred to hospital, then the examination has not been done, but the hospital next door"
"Let's express your opinion..."
Professor Chen, the director of the ICU, looked at everyone expectantly.
All the doctors spoke up.
The first doctor: ""Brain natriuretic peptide" everyone understands, indicating heart failure... That chest tightness and shortness of breath should be caused by heart failure. "
The second doctor: "Breathing difficulties are nothing more than the heart and lungs, and the patient's previous CT, since it is only effective pneumonia, there is no pulmonary embolism and the like, so it is unlikely to be a lung problem." Then only heart diseases remain, such a high brain natriuretic peptide, and heart failure. "
Other doctors, each with their own opinion.
PS: The so-called heart failure (heart failure) refers to the failure of the venous blood volume to fully discharge the venous blood volume into the heart due to the dysfunction of the systolic function and/or diastolic function of the heart, resulting in blood stasis in the venous system.
Heart failure occurs: pulmonary congestion, vena cava congestion.
A doctor uses a stethoscope to auscultate a patient's lungs.
A very heavy crackle was heard.
The whole lung is a wet rale!
"That's right, this crackle sound is exactly the sound of pulmonary congestion, vena cava congestion... Corresponds to heart failure! "
"The most common cause of heart failure is myocardial infarction, but the electrocardiogram shows that unlike myocardial infarction, it should also be closely monitored, and myocardial enzymes should be reviewed for disease..."
What causes heart failure?
Speaking of this, everyone scratched their heads.
Suddenly......
At this moment,
The female patient in the breathing mask suddenly began to struggle.
Then the blood oxygen began to fall rapidly.
89%...... 87%...... 85%...... It's still falling!
And the heart rate, even higher, ran to 140.
What does this say?
It shows that the body is urging the heart to increase the power of pumping blood.
And the female patient's face was cyanostic, and her eyes were confused.
"Not good!"
"It seems to be more difficult to breathe!!"
At this moment, all the doctors were nervous.
In particular, Director Chen knew that this was a relative of a certain 'big boss', not an ordinary patient.
You know, the amount of oxygen of the patient in front of you is a high-flow mask that inhales oxygen.
And the patient is still severely deprived of oxygen!
"Intubate immediately, connect the ventilator..."
Director Chen roared.
The ventilator will inject oxygen into it, which can shorten the time of oxygen inhalation and can improve the problem of hypoxia to a certain extent.
Soon, the ICU nurse with numb hands and feet gave anesthesia to the patient, and then inserted the trachea...
"Give 100% oxygen first..."
The nurse quickly followed Director Chen's orders while adjusting the parameters of the ventilator.
As soon as the ventilator is put on, the effect is immediate.
The female patient's blood oxygen saturation quickly rose to 100%, and the heart rate gradually slowed down to 100 beats per minute...
Director Chen: "Do an electrocardiogram again, and confirm the myocardial infarction again..."
The ECG is connected...
And then
All doctors see an electrocardiogram without a heart attack.
What's going on here?
Could it be, not heart failure?
At this moment,
All the doctors in the entire ward were thinking.
The female patient was lying quietly on the hospital bed at this time, and the tranquilizer was entered...
Booster input ing...
Ventilators working ing...
"The patient has no previous hypertension, coronary heart disease, diabetes and other underlying diseases, and the possibility of sudden heart failure is too low..."
"Could it be myocarditis?"
"That won't be, if it's inflamed, it can cause a significant increase in heart muscle enzymes... This is an absolute elevation, so it cannot be myocarditis. "
"Makes sense..."
"The brain natriuretic peptide is super high, coupled with the wet rales full of lungs, this must be heart failure, but why heart failure, I don't know, it's very weird..."
"Could it be hyperthyroidism? Hypertension? Other diseases of the endocrine system? "
At this time,
Lin Feng spoke.
"I do have a little idea..."
All the doctors came to see it.
Since Lin Feng came in, he has been looking at the patient's medical records and has not spoken much.
Director Chen: "Lin Feng, what did you find..."
Director Chen still valued Lin Feng very much, otherwise he would not have called Lin Feng over alone.
Lin Feng: "Now everyone's eyes are on the heart and lungs, but I look at the patient's condition, heart and lung problems, and muscle weakness... Even the patient said that he was so weak that he couldn't walk..."
"The average person may feel sick, and they will definitely be weak, but the disease of being so weak that they can't walk is generally impossible... Unless it's a neuromuscular disease itself..."
The crowd pondered.
Some people, suddenly their eyes lit up, thought of something.
Lin Feng continued: "Last night, I received a patient with general weakness, but no obvious chest pain and stomach pain, and later thought that the patient was "Guillain Barré syndrome"! "
"Guillain Barré syndrome"?!
Those doctors who didn't expect it, their eyes lit up at this moment!
Lin Feng: ""Guillain Barré syndrome", the essence is peripheral nerve inflammation, resulting in weakness of the patient's limb muscles, even respiratory muscles have no strength, if the respiratory muscles do not have strength, it will be manifested as shortness of breath, chest tightness, severe respiratory failure... When the respiratory muscles have no strength, of course, it will cause the blood to not pump out, and then reflect the "heart failure" symptoms that we have been considering. "
"The patient's investigation now is definitely not a lung and heart problem, then this "Guillain Barré syndrome" just corresponds to all the patient's conditions."
finally
Lin Feng added another sentence.
"Of course, also consider myasthenia gravis, myelitis and other possibilities."
After hearing this, the doctors agreed.
"Dr. Lin's consideration, I think it makes sense."
"Yes, I think it does look a lot like Guillain Barré syndrome..."
"Why didn't you think of it?"
"Although Dr. Lin is young, he is still very powerful..."
All praised.
Professor Chen nodded: "Then let's check it according to "Guillain Barré syndrome" first... Electromyography, and lumbar puncture ... If they are all positive, then the disease can be identified. "
Electromyography, which cannot be done now, is still being maintained in the ICU.
However, a spinal tap can be done.
Soon, the ICU nurse took a spinal puncture, removed the patient's pulp fluid, and sent it for testing!
At this time, the director of Harmony Hospital also came, also to see the relatives of the big boss, which shows that he attaches great importance to this patient.
"How's it going?"
"At present, some clues have been found, which may be "Guillain Barré syndrome", thanks to Lin Feng's reminder..."
Lin Feng hurriedly humbled: "That's also because yesterday I received a patient suspected of "Jilan Barré syndrome", so I consciously thought over there..."
Director Chen smiled and said, "That's also your strength..."
The dean smiled: "Lin Feng is good..."
As long as the relatives of the big boss are rescued, the whole harmony can benefit.
If it is really "Guillain Barré syndrome", then Lin Feng is a big contributor to it!
At that time, it is estimated that Lin Feng may 'go up to heaven'!
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