I Can See Health

Remember [new] in one second! The middle-aged woman was very fast, and her application for Shuidichi was completed immediately.

Lu Chen took care of all the remaining parts that required signatures and certifications.

The Shuidichou project was launched immediately.

As a medical staff, Lu Chen can certify for patients.

At the same time, Lu Chen also donated two hundred yuan.

He is only a graduate student now, so the donation should not be too large.

After doing this, Lu Chen could only pray silently in his heart that the girl would wake up soon.

Otherwise, staying in the CCU for one day would cost tens of thousands of dollars.

…

Back to the doctor's office.

Before Lu Chen could sit down, the security guard at the CCU door started shouting.

"The patient is here!"

When Lu Chen heard this, he was shocked and his heartbeat jumped to 120 beats/min.

"coming."

Lu Chen and Gu Xinyue followed Zhou Bin to the door of the CCU.

An old man in his seventies was lying on the hospital bed.

The uncle was lying on the bed, emaciated and breathing heavily. The ECG monitor next to the bed was beeping an alarm.

Next to the hospital bed, there was an accompanying doctor, Director Lin Cui of the Eighth District in the heart.

"Director Lin, what's the patient's condition?" Zhou Bin asked immediately.

"A patient with heart failure, combined with renal failure and oliguria. The blood potassium just checked upstairs was over 7 mmol/l."

Zhou Bin frowned. This kind of patient should have reached the level of dialysis. "Director Lin, is the patient transferred here for CRRT?"

Lin Cui quickly shook her head: "That's not true. The patient has a history of long-term atrial fibrillation and chronic heart failure, and the family does not consider invasive rescue and continuous renal replacement therapy (CRRT)."

In fact, they are already used to seeing this kind of patients in the intensive care unit.

However, once CRRT is given up, there is very little that doctors can do!

Most of the time, doctors simply act as bystanders to a patient’s progress.

…

The patient was wheeled in quickly.

His condition was worse than Lu Chen imagined.

He was lying on the hospital bed, wearing an oxygen storage mask, rolling his eyes, and breathing heavily.

Lu Chen looked at his health. The value was red 47, and the trend was three minus signs!

…

Three minus signs!

After two days of treatment in the general ward upstairs, there were still three minus signs.

This means that the previous treatments were basically useless!

Zhou Bin patted the patient's shoulder and shouted several times, but there was no response.

Lin Cui said: "The family members said that when Qian got up two days ago, he suddenly felt weak in his left limb, could not speak properly, couldn't eat, couldn't get out of bed, and even had cramps, so he was rushed to the emergency room."

"I basically didn't pee in the past two days, but yesterday I peed 1000ml."

At this time, Lu Chen's mind had already seen the chain of diseases, the basis of chronic heart failure, acute cerebral infarction leading to an acute exacerbation of heart failure, and causing renal failure and oliguria.

"The blood sugar between fingertips is high."

As soon as he entered the ward, the nurse routinely measured the patient's blood sugar.

Zhou Bin frowned deeply, "With such high blood sugar, what kind of anti-diabetic medicine do you usually use?"

"I didn't know about diabetes before, and I haven't used anything before." Lin Cui said, "But after I came to the ward, I took some insulin and diuretics for a day. It's just that we were a little strange. This patient, in the ward, the more treatment he received, the more The heavier."

"The patient's condition is even worse today. There is really no other way. After communicating with the family, we can only push him to the CCU."

Lin Cui's expression was very helpless.

This is a very typical heart failure patient in the Department of Cardiology.

But after diuresis, the effect is extremely poor!

"Okay, I basically understand. Thank you, Director Lin." Zhou Bin nodded.

After Lin Cui briefly explained the patient's condition, she left the CCU ward.

Lu Chen and Zhou Bin conducted a detailed physical examination on the patient.

The patient's current heart rate is 90-110 beats/min, blood pressure is 8hg, breathing is 37 times/min, and blood oxygen saturation is 95% (oxygen storage mask).

There is no obvious edema in the whole body, the skin temperature is low, there are no obvious crackles on lung auscultation, and the heart sounds are okay.

…

Back to the doctor's office.

Lu Chen looked at the patient's examination tests.

On the day of entering the ward, the blood test was normal.

Brain natriuretic peptide (bnp) was 2855pg/ml, blood sugar was 43mmol/l, and serum potassium was 7.36mmol/l.

Creatinine 255mmol/l, urea 47mmol/l, urine glucose 4+, occult blood 3+.

The electrocardiogram showed atrial fibrillation, a heart rate of 96 beats/min, extensive st-segment depression in leads ii, iii, avf and chest leads, and mild st-segment elevation in lead avr.

The chest CT showed patchy shadows in the left lower lung, and the head CT showed deepening of the sulci, but no high-density shadows were seen.

"In the past two days, a lot of diuretics have been used in the ward!"

…

Continue to look at the test sheets.

After one day of rehydration and diuresis, the blood potassium dropped to 5.08mmol/l the next day, the blood sodium rose to 145mmol/l, and the blood sugar dropped to 16mmol/l. However, the renal function continued to deteriorate, and the creatinine rose to 405mmol/l. Urea also rose to 51.57mmol/l.

It seems that blood sugar has been basically controlled and urine has come out, but what caused the rapid deterioration of kidney function?

"This patient is very difficult!"

In the office, UU read www.uukanshu.net Zhou Bin sighed slightly after browsing all the examinations and tests.

"No wonder Director Lin would take the initiative to send patients down. With Director Yi Lin's character, he would not necessarily send patients to the CCU unless absolutely necessary."

Director Lin Cui has a strong reputation in District 8 and is a strong person. District 8 Director Li Yao cannot suppress her at all!

Li Hui, another attending doctor in the team, also joined in. "In the current condition of the patient, it would be best to go directly to CRRT, but the patient's family refused, which is really not easy to handle!"

…

Back to the patient’s condition.

"I have carefully analyzed the patient's condition. Now I am mainly trying to determine the cause of the patient's shock." Zhou Bin analyzed carefully, and a group of graduate students gathered around him. "Is it cardiogenic shock, septic shock, or hypovolemic shock?" ?”

Cheng Dongbo, a third-year graduate student, was the first to speak: "I think the low blood pressure and shock caused by heart failure should be cardiogenic shock."

Zhou Bin shook his head, "It's not that simple. If it's just heart failure, then after improving the heart function and diuresis, the patient's condition is not relieved in time?"