"Add 0.15 mg/kg of rocuronium bromide, once every 40 minutes. Keep the bis value near 50."

bis is the bispectral index of the brain, which is an indicator used to detect the depth of anesthesia. Generally, around 85 to 100 is considered a normal state, and 0 represents no brain electrical activity at all, that is, cerebral cortex suppression.

The depth of 40 to 65 is under anesthesia, and the 50 specified by Xu Qiu is the optimal depth of anesthesia for this operation.

"Give prostaglandin e1 at a dose of 35 μg/(kg·min)."

Prostaglandin drugs can reduce right heart afterload and reduce the pressure on the already fragile donor heart.

"In addition, the inotropic drug is replaced by isoproterenol." Xu Qiu said methodically.

Isopropanol is a direct sympathomimetic drug that can directly act on beta receptors to increase heart rate. Compared with general inotropic drugs, it can also increase ventricular diastolic filling and increase stroke volume.

"The dose is controlled at 0.15μg/(kg·min)."

"Also, add dobutamine cardiotonic medication!"

The anesthesia team looked at each other.

Many of the plans proposed by Xu Qiu are what they are debating, such as cardiotonic drugs. They are hesitating whether to use dopamine, milrinone or dobutamine; for inotropic drugs, they choose isopropanol or foreign drugs.

Rehmannia drugs...

However, Xu Qiu gave the answer directly.

The operating room was completely silent... Is this reasonable? He was obviously the chief surgeon, so why did he suddenly come here to steal the anesthesiologist's job?

But Xu Qiu had already established his authority. As soon as he finished speaking, the anesthesia team had no time to think before a response immediately came out.

"Yes!" the anesthesia team leader responded quickly.

If Xu Qiu had not shown absolute control over the surgery, no one would have listened to him.

But at this time, everyone realized that Xu Qiu was definitely Omid's second. Even if he was not as good as Omid this time, when the triple crown champion left, the surgery competition would become Xu Qiu's performance venue.

"Quick, inject!" In the operating room, the anesthesia team hurriedly followed Xu Qiu's instructions to administer the drug.

There are also reference indicators for ideal hemodynamics.

For example, the central venous pressure is controlled at 8~12mmhg (1.1~1.6kpa).

Blood pressure is maintained at 100~110mmhg.

The heart rate is about 100 to 120 beats/min.

It is best to maintain urine output at 100ml/h.

After undergoing a heart transplant, and having the sequelae of a donor heart that had just been transplanted, the hemodynamic data can be explored as closely as possible, which is pretty good.

However, after a short wait, the patient's various life values ​​gradually rebounded, stabilized, and finally settled near the reference value.

"Successful!" the anesthesia team was shocked.

Isn’t this our job? Why does the surgeon understand it more thoroughly than we do?

…

"Airway pressure 30cmh2o, paco 240mmhg..." The assistant glanced at the life monitor and then looked back. Xu Qiu had already freed the omentum from the transverse colon and freed the patient's omentum.

This was followed by right lung resection.

When the fibrotic, pale right lung landed heavily on the tray, everyone's pupils also shrank.

The diseased lungs are generally swollen, with a large number of honeycomb-shaped holes and scars on the surface. If healthy lungs are like a loofah, then this patient's lungs have completely turned into rotten, dry loofah flesh, and the respiratory function is almost completely lost.

"It's so serious..."

"Without a ventilator, this patient would have died long ago."

"Can such a lung be transplanted really?"

Many people are beginning to worry...Berry country rarely performs transplant operations for terminally ill patients. In their values, precious organs should not be given to dying people, but should be reserved for healthier and younger mid- to late-stage patients.

group.

Patient No. 1 is extremely difficult to undergo a double lung transplant alone, or a heart transplant, or a liver transplant, let alone a heart, liver, and lung transplant that combines the three?

Xu Qiu didn't care about this.

He only cares that the donor is dead and only these organs can survive.

Although the patient who received the organ is in the terminal stage, he still has a chance to live.

As long as the operation is successful, with the nursing capabilities of Miaoyou Clinic, the patient has a high chance of survival. The only thing he can do is to do every detail well so that the organs can shine and heat in the new body.

Anastomizing the bronchus...

Anastomize the pulmonary artery...

Remove the ligation line of the pulmonary vein stump, connect the openings of the upper and lower pulmonary veins to form a left atrial sleeve, and finally sew continuously with the atrial sleeve on the donor's right pulmonary vein with 4-0 prolene suture...

The moment the right lung transplant was completed, Xu Qiu put down the scalpel, retreated the swan-ganz catheter to the common pulmonary artery, and inserted it into the right pulmonary artery.

Drum drum——

Instantly, the newly transplanted right lung opened for ventilation.

Xu Qiu immediately opened the left pleural cavity and began the left lung transplant operation...

…

On the ninth hour of the operation, the arteries and veins of both lungs were opened successively, and the transplanted lungs began to work.

Seeing the patient's new lungs rising and falling, everyone in the operating room felt indescribably moved...

Before the operation, the patient was already on the verge of death. He had severe respiratory failure, poor heart function, pulmonary hypertension, and the heart transplant in the first stage. Multiple factors caused the patient's blood oxygen saturation to be extremely low, and various data were even worse.

On the brink of death.

Who would have thought that Xu Qiu’s plan, including medication, dosage, etc., was meticulous. Although he was the chief surgeon, he was also the leader of the anesthesia team, the leader of the resection team, and the leader of the transplant team... With incredible scheduling, he suddenly turned things around.

Crisis situation, complete the transplant!

"The next step is the key."

"Theoretically, liver transplantation is not as difficult as double lung transplantation or heart transplantation, but... this is the last step of heart, liver, and lung transplantation. The patient's body has reached a limit, and it is hard to say whether he can survive it!"

It was already past seven o'clock in the morning the next day.

The all-night operation and nearly ten hours of concentration almost drained the energy and strength of all the medical staff.

But what they couldn't understand was that although Xu Qiu's face was tired, his technique and accuracy were not affected in any way!

"How is that possible!"

At this time, everyone in the competition committee and judging panel felt incredible.

Let alone a super-large operation such as a combined heart, liver, and lung transplant, even if it is an appendicectomy, long-term concentration, coupled with the stimulation of the eyeballs by the shadowless lamp, will cause the body to be extremely tired and difficult to support.

Like Omid, he was in his prime, only forty-four years old, but he had been taking time to rest during the operation.

During the transplant process, during the heart transplant session, the heart resection was performed by the resection team, and he just closed his eyes and rested.

There is also a double lung transplant, and the trivial work is also handed over to another surgical team.

He himself only performs the most difficult transplants.

The advantage of this is obvious - the surgeon can stay in good condition at all times and avoid as much as possible the increase in errors caused by increased fatigue.
Chapter completed!