The mean arterial pressure will be affected by factors such as drugs. If the mean arterial pressure is high due to the use of drugs, it is a false positive and meaningless. This corresponds to what Xie said before that drug testing should be carried out carefully before weaning the machine.
How to do the specific operation has actually already begun.
Did it?
Director Wang and others at the scene were shocked. It seemed that Student Xie had not mentioned any special medicine to be given to the patient before.
Let’s talk about one more issue. The significance of mean arterial pressure monitoring is that human perfusion is closely related to the cardiac output of the heart. Cardiac output can be measured using the O technique. Without the O technique, it can be measured by transesophageal echocardiography.
Xie Wanying said: "What we just measured was the heart condition under full flow support of the membrane lung, mainly measuring the left heart ejection fraction and the function and capacity of the right ventricle."
Since doctors are now gathering together to discuss the issue of weaning the machine, it is equivalent to saying that the values detected by the examination are very good.
The next thing to do is, Xie Wanying continued to add: "Gradually reduce the patient's flow to one-half, and use transesophageal echocardiography to do the above examinations. Once the left and right ventricles are found to be dilated or the blood pressure drops, they will immediately return to normal.
Full flow.”
It turns out that this step of weaning off the machine is really done out of caution. All the doctors here swiped their pens, and no one thought the steps were cumbersome. Medicine is never afraid of cumbersome steps. The more cumbersome it is, the more careful research is in place, and the better.
It seems that things are under the doctor's control which is a good thing.
When Mr. Zhang picked up his pen notebook, he glanced at the uninvited guests at the meeting with his thick eyebrows and displeased eyes.
He said that Director Xia of the National Association's ICU was so shameless that he came to attend meetings every day. Why, people from company M, whom he had only met once yesterday, came to attend their meetings.
Could Mai Hui, a foreigner who speaks poor Chinese, really understand Teacher Xie's lecture? It turned out that someone actually brought an on-site translator to help him translate at the same time, which was amazing.
Zhang Huayao's eyebrows were about to wrinkle into two towering mountains.
The shameless person must have pretended not to see his bossy expression, and craned his neck along with the other doctors present to continue listening to the lecture.
Mai Huizhen has never heard of the plan that classmate Xie mentioned. It is a plan for the future.
"When the flow rate drops to twelve to fifteen, and the vis index is less than ten, conduct a capacity load test."
The vis index is the score of vasoactive drugs and inotropic drugs. It is calculated by a complicated formula. It is the sum of the various drugs multiplied by the dose. From this simple formula overview, it can be inferred that the lower the vis index, even
When it is equal to zero, it is best, which means that the patient is not given these drugs to support the patient's blood pressure.
Under such a premise, judging the patient's heart will tend to be able to truly judge the original function of the patient's own heart without assistance, which will help the doctor determine whether the patient can continue to be weaned.
The volume load test is to give the patient a certain amount of fluid for a certain period of time to quickly replenish the fluid. The purpose is to increase the blood volume to judge the response of the heart. Here, an albumin is dripped, and the doctor wants to add some difficult questions to the patient before weaning him from the machine to further test the patient.
At this time, transesophageal echocardiography must be used to recheck the cardiac function indicators mentioned before.
Finally, use dobutamine for a few hours and then observe the heart function. If the heart values always maintain good stability, you can stop the machine for testing, which means you have safely entered the formal weaning process.
