Pulmonary arterial hypertension is a disease that is just afraid of this hypercoagulable state. Hypercoagulability is prone to pulmonary embolism and will further aggravate right heart failure.
Clinically, anticoagulation injections are sometimes required to deal with this disease. The most common method is belly injection of low molecular weight heparin sodium.
Pregnant women need special treatment. For patients undergoing surgery like this, it was the hypercoagulable state during pregnancy that caused the original mechanical valve to have blood clots and required heart surgery as soon as possible.
How to deal with these contradictions. It is best to avoid massive intraoperative bleeding. As Dr. Du said, on the one hand, obstetricians should shorten the time of cesarean section as much as possible and let them take over. On the other hand, anesthesiologists should play a role in
The mother plays the role of escort during the operation and must work hard to help the mother survive the cesarean section.
After receiving a call from Du Yeqing, the anesthesiologist Dr. Mo arrived.
Dr. Mo first introduced to the obstetrician and gynecologist: "The anesthesia plan should be planned for patients according to the mature and effective plan. General anesthesia is used for cardiac surgery. Can continuous epidural anesthesia be used for cesarean section or continuous epidural anesthesia?"
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Why is general anesthesia not used during cesarean section?
In the past, anesthesiology has always believed that general anesthesia has many disadvantages for cesarean section. The biggest disadvantage is that many general anesthetic drugs can easily enter the fetus and cause fetal respiratory depression. However, these drugs are the most important for anesthesiologists during general anesthesia.
Commonly used and very familiar drugs, if you do not use these commonly used drugs and replace them with rarely used special drugs, you will be afraid of causing other troubles.
For example, this patient is risking her own life just to have a child. She and her family are not willing to risk the child's life at this critical moment. Fetal respiratory depression means that the child will suffocate, and the baby's life will not be restored by then.
He may become a child with cerebral palsy. For this reason, the patient and his family, who have obtained medical information from various places, are unwilling to undergo general anesthesia.
Is it okay to use continuous epidural anesthesia instead of general anesthesia?
In this regard, anesthesiologists and cardiac surgeons dare not give a 100% guarantee. They may switch to general anesthesia during the operation depending on the situation. The main reason is that the patient's heart function is not good now, and other circulatory support may be required during the operation.
Du Yeqing said: "If the patient's condition becomes more critical, we may provide support for her to perform IABP in advance."
(What IABP is has been mentioned in previous chapters and will not be reiterated.)
In this case, how can we ensure that the current plan is feasible?
"Director Zhang presided over the ward round discussion this morning. Today, she will be given a different drug to use together. It is expected that the patient's condition will improve tomorrow." Du Yeqing said.
It turns out the big boss took action.
"Of course, according to our director Zhang's prediction, this medicine can only last until the day after tomorrow." Du Yeqing added, it is not that it should not be used before, but that the medicine should be used until the critical period. Some medicines seem to work very quickly.
But to put it bluntly, it does not cure the root cause, and it will soon become apparent that the effect will not be good after using it.
After Du Haiwei heard this, he knew that the surgeons and interventional cardiologists at the cesarean section center would be watching over him, so that the obstetricians and gynecologists would not be too worried.
While the meeting was going on, someone quietly came and sat next to Zhang Huayao, waving to classmate Xie secretly.
Xie Wanying turned around and saw the handsome eyebrows of Senior Brother Shen who was smiling brightly.
At the scene, all doctors from the surgical team except the neonatologist are basically present, and any questions can be discussed.
Du Haiwei turned around and asked the young doctors in the group, wanting to brainstorm: "Tell us what you think about this surgery. If you have any good suggestions, let's discuss them together."