Text/Yangcheng Evening News all-media reporter Yu Yanhong
Photo/Courtesy of the hospital
Recently, the team of Qianhai Life Guangzhou General Hospital Emergency and Critical Care Medical Center successfully treated drowning men who were dying using ECMO (extracorporeal membrane oxygenation) technology. ECMO treatment lasted 6 days, and the patient whose life was hanging on the line finally escaped the disaster, successfully offline, and transferred to the general ward for follow-up treatment.
Life hangs in the balance, emergency treatment
On the afternoon of December 15, 2021, the Emergency Medical Center of Qianhai Life Guangzhou General Hospital received a 120 dispatch order that someone drowned in a roadside ditch and needed emergency assistance. When the ambulance arrived at the scene, it was found that the drowning man was a middle-aged man who had been rescued to the shore.
However, the situation is not optimistic, although the patient still has a reaction but is not conscious, the mouth and nose can see a large amount of sewage flowing out, shortness of breath, cyanosis, fast heart rate, irritability. Emergency doctors gave emergency airway treatment to alleviate the patient's lack of oxygen and transfer him back to Qianhai Life Guangzhou General Hospital.
Upon arrival at the hospital, the team at the Center for Acute and Critical Care Gave the patient a ventilator to support breathing, but the lack of oxygen did not improve, and the patient's finger pulse oxygen saturation could only reach 80% with 100% pure oxygen support on the ventilator. The oxygenation index >
Apparently, the patient developed severe acute pulmonary edema, ARDS, alveoli were full of mucus and could not exchange gases, in which case even the use of a ventilator and high concentration oxygen therapy could not effectively oxygenate these alveoli.
At the same time, patients with severe septic shock, procalcitonin up to 72 ng / ml, the use of large doses of vasoactive drugs to maintain blood pressure, if you can not improve the patient's hypoxia state in a short period of time, the patient's organ function will quickly fail and then die. At this time, extracorporeal membrane oxygenation (ECMO) is the patient's only hope.
ECMO technology, saving lives
However, ECMO was a very high-risk operation when the patient's family was not present and the written consent of the family could not be obtained. Time is life, under the leadership of Professor Kou Qiuye of the Acute critical care medical center, the treatment plan was discussed with a number of doctors, and while waiting for the family to arrive, active anti-infection, bronchoscopic suction, anti-shock, lung protection ventilation strategy, hemodynamic monitoring, etc.
After the family finally arrived at the hospital at 22:00 at night, after the medical team of the Acute and Critical Care Medical Center repeatedly communicated with the family about the condition, and the family signed the informed consent form, the ECMO team of the department quickly prepared the goods, disinfected, spread the towel, pre-flushed, puncture catheterization, and turned around in one go, with the successful oxygenation of the blood in the ECMO system, the patient's oxygen supply was improved, and the vital signs gradually stabilized.
In the following days, the medical staff did everything possible to make the patient's lungs recover as soon as possible, bronchoscopic alveoli cleaning, vibration atomization, lung protection ventilation, various monitoring and adjustment, and so on. The longer the ECMO, the more complications there are, and the more complex the situation becomes. Finally, after 6 days, the patient's pulmonary edema and ARDS improved, lung function resumed, and ecmo was removed.
ECMO is the top life support technology in the Department of Critical Care Medicine, which can provide effective cardiac and lung function support for patients with severe heart failure and respiratory failure, that is, to let the patient survive first, so as to win valuable time for the treatment of the primary disease. Therefore, ECMO is known as the "nuclear weapon" of the intensive care department. Because ECMO has extremely high requirements for technical conditions, many complications, and requires support from many disciplines, it is expensive and can generally only be carried out in hospitals above the provincial level. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Cui Wencan