Surgery Godfather

Chapter 147: Chapter 0141: Magic Lung

Director Kong anxiously watched the elevator door. As soon as Yang Ping came out, he immediately greeted him.

“Doctor Yang, I’m sorry to call you over on the weekend!” Director Kong looked troubled.

Yang Ping modestly said: “Director Kong, you’re overestimating me. I’m at your service anytime, anywhere. How can I assist?”

In the urgent situation, Director Kong did not beat around the bush: “Mr. Ning suddenly suffered respiratory failure this morning. His blood oxygen level has been hovering around 70 and is not rising. Director Jiang from ICU came over and decided to use ECMO. After the tube was inserted into the patient’s vein in the emergency ward and connected to the ECMO, the blood oxygen level did rise slightly, but it was still low, only 78. They believe this might be due to the tumor compressing and invading the right external iliac veins, resulting in the constriction of the veins and therefore an insufficient blood flow. The amount of blood oxygenated per unit time is too low to meet the demand. Miss Ning took the initiative to ask you to come over.”

ECMO, known as the ‘miracle lung’, is an upgraded artificial heart-lung machine, its official name being Extracorporeal Membrane Oxygenation. It can replace a person’s lung or heart function to a certain degree and for a certain period of time.

It draws blood from veins, oxygenates it through the machine, turns it into oxygen-rich blood, and then returns it to the human body via veins or arteries.

If it is returned via veins, it can replace lung function; if it is returned via arteries, it can replace both heart and lung functions. Doctors call ECMO the last life-saving straw!

However, this machine is very expensive, so the use cost is also high, and it is not covered by medical insurance. The start-up cost is sixty thousand, and the subsequent daily cost is between ten to twenty thousand. This is astronomical for ordinary people, but for Mr. Ning, it is not even a matter of consideration.

As the two walked towards the ward, Director Kong explained the situation to Yang Ping. By the time they reached the emergency ward, he had given a full account of the situation.

The emergency ward of the Overseas Chinese Building is equivalent to a mini ICU, fully equipped with all kinds of emergency equipment, including the expensive ‘miracle lung’. Moreover, these equipment were not purchased by the hospital itself. Many were donated by patients who lived or have lived here.

Inside, Director Jiang from ICU was inserting the tube with his assistant, but they had already stopped, probably waiting for Yang Ping. Nearby, there were also chief physicians or deputy chief physicians from vascular surgery, general surgery, oncology surgery, and the ultrasound room.

“Don’t go any further, quickly retreat a bit, or the vein will rupture!” The deputy chief physician of vascular surgery warned Director Jiang.

“Lower the pressure a bit! Look clearly!” Director Jiang commanded the doctor from the ultrasound room.

The ultrasound doctor’s probe pressed slightly lower, making the image of the blood vessel clearer on the ultrasound.

Mr. Ning lay on the bed, his face sallow, and somewhat delirious. He was covered with a blue sterile sheet. Director Jiang had just completed the catheterization of bilateral femoral veins. The catheterization on the left femoral vein was smooth, but there was a narrowing on the right side, so the catheter could not be inserted deeply. The tube on the right was used to draw blood and the tube on the left to input blood.

Because of the narrowing of the right external iliac vein, the blood drawn did not reach the expected flow rate. If they swapped and used the right side as the input tube and the left side as the output tube, the result would be no different. Even if enough blood is oxygenated on the left side, if the blood flow back is too slow, it still cannot achieve the expected purpose.

“Doctor Yang, I have to trouble you again!” said Miss Ning.

She had been accompanying him by the side, squatting beside the bed, holding her father’s hand and smiling: “Dad, don’t be afraid, Doctor Yang is here, he has a solution.”

Mr. Ning heard his daughter’s words, seemed to understand, but he couldn’t speak. He nodded with difficulty.

In fact, for a patient with advanced liver cancer and systemic failure, what can be done? Yang Ping was also helpless.

A doctor to a patient is, as stated on the tombstone of Dr. Trudeau from New York, America: Sometimes to cure, often to help, always to comfort.

Mr. Ning strenuously and tremulously extended a hand. Yang Ping tightly held his cold, skinny hand.

He trembled his lips, trying to say something. Yang Ping bent his ear to his mouth and heard the vague words.

“Help—me—hang on for a few more—days” After uttering these words, Mr. Ning seemed to have exhausted all his strength.

Yang Ping nodded gravely and tightly held his hand, indicating that he had heard his words. Trust, how precious this trust was, with just a few words exchanged on the operating table, a life could be entrusted to him.

“I will do my utmost to fight for you!” Yang Ping let go of his hand.

Mr. Ning had once been hospitalized in the attached first hospital. For his condition, the attached first hospital had invited all the top tumor experts in the industry, even overseas experts were invited for consultation. However, it was already late-stage, with systemic exhaustion, multiple tumor metastases, and the loss of the opportunity for surgery. Tumor resection, liver transplantation, and lung transplantation were all impossible. So he underwent interventional treatment for liver cancer, then targeted treatment with Lefatinib. When it became drug-resistant, they switched to Regorafenib, and invited famous old traditional Chinese medicine practitioners from the provincial Chinese Medicine Hospital to carry out traditional Chinese medicine treatment.

Because the inpatient conditions of Sanbo’s Overseas Chinese Building can be said to be the best VIP wards in G City, he transferred to Sanbo, planning to walk through the last journey of life in the Overseas Chinese Building of Sanbo.

“The bilateral subclavicular and internal and external jugular venous region is severely invaded by the tumor, and we dare not puncture for catheter placement, so we want to place two tubes in the bilateral femoral veins. The left side is no problem, but the tube on the right side cannot be placed correctly. Looking at the X-rays, the tumor had pushed open the external iliac vein, causing compression, and the tube cannot go in. Forced insertion may rupture the blood vessel, resulting in heavy bleeding. If left here, the outflow from the exchange is too low, not up to standard, and the blood oxygen still cannot go up, as you can see, it’s only 80, which is not good–”

Director Jiang didn’t care about face at this time, he was a pragmatic person, at the brink of life and death, he would listen to whoever had a solution, regardless of whether he was a young doctor or a great professor.

As for Yang Ping, he was familiar with him. He had heard about the previous nerve root block, not to mention the five-section replantation, Director Han’s precious gem, if his skills were not up to par, he had no right to stand here at this time.

“You have worked hard, let me take a look!”

The emergency ward had a film viewing light, and the film was already hanging properly. Yang Ping went to the viewing light to view the film. Indeed, as Director Jiang said, the bilateral subclavicular and internal and external jugular veins were no longer available for puncturing. Only the bilateral femoral veins could be punctured. The right femoral artery and vein had already been invaded and compressed by the tumor, and the lumen was flattened. If puncture was forced, a rupture of the blood vessel would cause heavy bleeding.

If Mr. Ning had such a massive abdominal hemorrhage, his whole body would immediately collapse, multiple organ functions would fail, and cannot be saved by artificial lung.

But now, if only to leave the catheter of the artificial lung in its current position, it is a narrow mouth above, the amount of blood drawn out is too small, the amount of blood oxygenated per unit time is too small, and it does not meet the needs of the vital organs. If a stent was used to prop it open, it would need to be able to pass through before it can be propped open.Nôv(el)B\\jnn

No wonder, the last time he examined him, the temperature of his right lower limb was lower than his left, and the circulation at the extremities was especially poor.

Yang Ping stood in front of the viewing light using the knowledge of systematic anatomy training combined with Mr. Ning’s CT scan, started forming images in the brain, stacking section upon section, slowly, a three-dimensional anatomical image was presented in the brain.

This time it was still strenuous, several assembly attempts were unsuccessful, but it was easier than the last time, which showed there was improvement.

Based on the speed of the body’s blood flow, Yang Ping simulated the blood flow in his mind and added the dynamic image of the blood flow, presenting a clear dynamic three-dimensional anatomical image in his mind.

It appeared that the brain’s image construction was very significant in improving medical skills. The system was training his ability using the anatomy tirelessly to lay a strong foundation for future medical skills enhancement. Yang Ping understood the intention of the system.

To successfully puncture and place the catheter, it was also necessary to construct the catheter of the artificial lung. Yang Ping preserved the image in his brain and turned to ask Director Jiang, “Director Jiang, do you have the catheter of the artificial lung? May I see it?”

“Xiao Li, open a tube for Doctor Yang to see.” Director Jiang directed a nearby ICU doctor.

A tube was very expensive, costing thousands or tens of thousands, but now was not the time for calculation, nor was it necessary.

Xiao Li opened the sterile packaging of the tube. Yang Ping inspected the complete catheter, replicated a similar catheter in his mind, then combined it with the image constructed in his brain to simulate the puncture and catheter placement. Now, Yang Ping had a plan.

“That’s enough!” Yang Ping let Xiao Li pack up the catheter.

“Let me try!”

Yang Ping put on sterile gloves, put on a disposable sterile gown, and stood by the bed.