Spring Festival in the gang | Xiangya breathing ICU life race

Respiratory intensive care specialists at Xiangya Hospital are treating patients.

Red Net Moment February 7 news (correspondent Zheng Yunpeng) The New Year festival is a reunion of thousands of families, but there is always a group of people who give up their small homes for everyone, stick to medical posts, and protect the health and safety of the people, including many Xiangya breathing people. With the construction and promotion of the National Respiratory Regional Medical Center, this year's Spring Festival, the respiratory intensive care specialty (respiratory ICU) of Xiangya Hospital of Central South University carried the medical treatment task is heavier and more difficult, and in the race with life, a different Spring Festival was spent.

Less than 5 mm at the narrowest point of the trachea, multidisciplinary collaboration relieves the risk of asphyxia

On 29 January, the patient, Mr. Li (pseudonym), was transferred from the outer hospital to the outpatient clinic of the Respiratory and Critical Care Medicine Department of Xiangya Hospital due to severe breathing difficulties. After receiving the treatment, Associate Professor Li Yuanyuan, director of the respiratory intensive care sub-specialty, found that Mr. Li had respiratory distress and sweating heavily, which was manifested as "three concave signs". Ct scan of the outer hospital chest showed that it turned out that Mr. Li's esophageal tumor had severely compressed the trachea, and the narrowest part was less than 5mm, and there was a risk of sputum blockage and suffocation at any time.

The quickest treatment is to place a tracheal stent and prop open the narrow trachea to relieve breathing difficulties, but this is extremely risky. Time is of the essence, Associate Professor Li Yuanyuan quickly admitted Mr. Li to the respiratory ICU, organized multidisciplinary consultations to assess risks, improve preoperative preparation and formulate emergency plans. Under the escort of Associate Professor Hu Hao of the Department of Anesthesiology, Associate Professor Li Yuanyuan, with the cooperation of the team of the Respiratory Interventional Diagnosis and Treatment Center, successfully performed the "trans-rigidoscopic tracheal stenting under general anesthesia" for the patient in only half an hour, quickly unblocked his airway, Mr. Li's breathing difficulties were significantly alleviated, his vital signs recovered steadily, and he returned to the respiratory ICU ward safely. Three days later, Mr. Li was successfully discharged from the hospital and returned home to reunite with his relatives.

Patients with severe respiratory failure have been transferred hundreds of miles away, and ECMO has raced against time to save lives

On the second day of the Lunar New Year, Yang Wei, attending physician of the Department of Respiratory and Critical Care Medicine, treated a patient with severe respiratory failure who was transferred to the respiratory ICU from more than 300 kilometers away in the snow. Respiratory intensive care team doctors, nurses and respiratory therapists quickly assembled to carry out treatment. However, after nearly 24 hours of comprehensive treatment such as ventilator mode, parameter adjustment, and prone position, the patient's oxygenation is still difficult to maintain. Time is life, and you need to go to ECMO to buy time. The tricky thing is that the ECMO catheter insertion is a great obstacle, and the patient has been placed in the outer hospital with a vena cava strainer due to a thrombosis in the right lower extremity, and the catheter must be removed before the catheter must be inserted.

How to implement this time-critical, difficult, and extremely complex ECMO? Under the guidance of Professor Pan Pinhua, the leader of the discipline and the director of the Department of Respiratory and Critical Care Medicine, Associate Professor Li Yuanyuan, director of the respiratory critical care sub-specialty, quickly organized the general consultation of the whole hospital, and multidisciplinary experts jointly discussed the detailed treatment plan.

On the afternoon of the third day of the Chinese New Year, a "hard battle" was launched in the main operating room. Escorted by Associate Professor Jiao Hena of the Department of Anesthesiology, the team of attending physician of vascular surgery Wu Kemin and the nurse in charge of the operating room, Chen Huang, worked together to successfully remove the patient's inferior vena cava strainer. Peng Wenzhong, head of the ECMO team and attending physician of the Department of Respiratory and Critical Care Medicine, quickly organized attending physician Wu Gonghao and nurse Zheng Yunpeng to accurately insert the ECMO catheter. When the instrument connected to ECMO was running, only to see the dark red blood rapidly oxygenated into bright red, respiratory therapist Fang Yimin immediately lowered the parameters of the ventilator, blood gas analysis suggested that the patient oxygenation was significantly improved, and there was a cheer in the operating room.

"Every time I talk, my family members are full of tears and hold my hands," associate professor Li Yuanyuan said, "In the face of patients on the verge of life and death, in the face of the high hopes of family members, we must do our best to fight against death."

24-hour warmth and perseverance, continue to escort respiratory critical patients

Continuous bedside continuous renal replacement therapy (CRRT, referred to as "artificial kidney") provides a good means of treatment for patients with respiratory critical illness, and patients with chronic renal insufficiency, uremia, sepsis, etc. can continue to be on the machine for hemofiltration dialysis for 24 hours.

On the first day of the Chinese New Year, Wu Gonghao, who had been busy for a day, was preparing to go back to the Group New Year dinner after work. A newly admitted patient urgently needed CRRT treatment, and Wu Immediately decided to stay in the ward. Evaluation, catheterization, treatment... It's late at night. In the ward, there are a number of respiratory therapists, continuing physicians, etc. who have been staying at their posts and guarding patients day after day.

"Ask the CRRT group teacher to arrange to be on the machine." During the Spring Festival holiday, Chen Jie, the leader of the CRRT team and attending physician, can be seen at any time in the respiratory ICU ward, formulating an individual dialysis plan for each patient on the computer, carefully checking the operation of the equipment, and patiently guiding the nurse to operate in order to adjust the treatment plan in time and greatly improve the prognosis of these patients.

The quality and safety of nursing care during the Spring Festival is one of the important guarantees for patients to receive effective treatment. Lu Jingmei, head nurse and deputy chief nurse, managed the whole situation and was meticulous, and the nursing work was carried out in an orderly manner. Due to the large number of patients, the condition is critical and complex, Lu Jingmei specially dispatched the senior nurses of the CRRT group to maneuver, and the general nurses worked late and night shifts continuously, ready to be on standby, hard work and complaints, and worked together to ensure the continuity of treatment for all patients who need CRRT.