Doctor: It's reasonable to perform surgery on yourself.

"Add 0.15mg/kg of rocuronium every 40 minutes. Maintain the BIS value at around 50."

BIS is the bispectral index, which is an indicator used to detect the depth of anesthesia. Generally, 85~100 is normal, and 0 represents no brain electrical activity, that is, cerebral cortex inhibition.

40~65 is in anesthesia, and the 50 specified by Xu Qiu is the optimal anesthesia depth for this operation.

"Give prostaglandin E1 at a dose of 35μg/(kg·min)."

Prostaglandins can reduce the afterload of the right heart and reduce the pressure on the already fragile donor heart.

"In addition, the positive inotropic drug is replaced with isoproterenol." Xu Qiu said in an orderly manner.

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

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

"In addition, add dobutamine cardiotonic drugs!"

The anesthesia team looked at each other in bewilderment.

There are many solutions proposed by Xu Qiu that they are arguing about. For example, for cardiotonic drugs, they are hesitating whether to use dopamine, milrinone or dobutamine; for positive inotropic drugs, choose isoproterenol or digitalis drugs...

However, Xu Qiu gave a direct answer.

The operating room was silent...Is this reasonable? He is the chief surgeon, why did he suddenly come to grab the job of the anesthesiologist?

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

"Yes!" The leader of the anesthesia team responded quickly.

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

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

"Quick, inject!" In the operating room, the anesthesia team quickly administered the drug according to Xu Qiu's instructions.

Ideal hemodynamics also have reference indicators.

For example, the central venous pressure is controlled at 8-12mmHg (1.1-1.6kPa).

Blood pressure is maintained at 100-110mmHg.

Heart rate is about 100-120 times/min.

Urine volume is best maintained at 100ml/h.

After a heart transplant, plus the sequelae of the donor heart just completed the transplant, this hemodynamic data can be explored downward, and it is good to try to get close.

However, after a short wait, the patient's various vital values ​​gradually recovered, tended to stabilize, and finally settled near the reference value.

"Success!" The anesthesia team was shocked.

Isn't this our job? Why does the surgeon understand it more thoroughly than us?

…

“Airway pressure 30 cmH2O, PaCO2 40mmHg…” The assistant glanced at the life monitor and then looked back. Xu Qiu had already freed the greater omentum from the transverse colon and freed the patient’s greater omentum.

Then the right lung was removed.

When the fibrotic pale right lung fell heavily on the tray, everyone’s pupils shrank.

The diseased lung was generally swollen, with a large number of honeycomb-like holes and scars on the surface. If a healthy lung is a loofah, then this patient’s lung has completely become a rotten, dried loofah, and is almost completely losing its respiratory function.

“It’s so serious…”

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

“Can such a lung really be transplanted?”

Many people began to worry… Meiguo rarely performs transplants for terminally ill patients. In their values, precious organs should not be given to dying people, but to healthier and younger middle and late-stage patients.

Patient No. 1 would have to undergo a double lung transplant, a heart transplant, or a liver transplant alone, which would be extremely difficult, not to mention a heart, liver, and lung transplant that combined the three.

Xu Qiu didn't care about that.

He only cared that the donor had died and only these organs could survive.

Although the patient who received the organ was in the terminal stage, he still had a chance of survival.

As long as the operation was successful, with the nursing ability of Miaoyou Clinic, the patient had a high chance of survival. The only thing he could do was to do every detail well and let the organ shine in the new body.

Bronchial anastomosis...

Pulmonary artery anastomosis...

Remove the ligature of the stump of the pulmonary vein, connect the openings of the upper and lower pulmonary veins, form a left atrial cuff, and finally suture it with the atrial cuff on the donor's right pulmonary vein with a 4-0 Prolene suture...

At the moment of completing the right lung transplant, Xu Qiu put down the scalpel, and took the opportunity to withdraw the Swan-Ganz catheter to the common pulmonary artery and inserted it into the right pulmonary artery.

Drum drum --

In an instant, the newly transplanted right lung was ventilated.

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

...

In the ninth hour of the operation, the arteries and veins of both lungs were opened one after another, and the transplanted lungs began to work.

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

Before the operation, the patient was already a dying person, with severe respiratory failure, poor heart function, and pulmonary hypertension. In addition to the first stage of heart transplantation, multiple factors caused the patient's blood oxygen saturation to be extremely low, and all data were hovering on the edge of death.

Who would have thought that Xu Qiu had a plan that included medication, dosage, and other details. Although he was the main surgeon, he was also the leader of the anesthesia team, the resection team, and the transplant team... With incredible scheduling, he turned the crisis around and completed the transplant!

"Next, it's the key."

"Liver transplantation is not as difficult as double lung transplantation and heart transplantation in theory, but... this is the last link of heart, liver, and lung transplantation. The patient's body has reached a limit. It's hard to say whether he can hold on!"

It was already more than seven o'clock in the morning of the second day.

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

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

"How is it possible!"

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

Not to mention the super-large operation of heart, liver, and lung combined transplantation, even if it was appendectomy, long-term concentration, coupled with the stimulation of the shadowless lamp on the eyeballs, would cause extreme fatigue and difficulty in holding on.

Like Omid, he was in his prime, only 44 years old, but he always took time to rest during the operation.

During the transplantation process, when the heart transplantation was performed by the resection team, he closed his eyes and rested.

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

He only performed the most difficult transplantation work.

The advantages of doing this are obvious - the surgeon can stay in good condition at all times and avoid the increase in mistakes caused by increased fatigue as much as possible.

Although there are disadvantages, they are not unacceptable.