As soon as antifibrinolytic drugs are hung in the ward and she sees them, she can immediately associate them with the patientâs laboratory blood indicators.
However, since she wasnât a clinical doctor in her past life and didnât understand their use, she needed to check the information. Xie Wanying admitted: "Itâs not in the textbooks, so I went to the library to check journals. Statistics show, as you just said, that after extracorporeal circulation, the patientâs blood fibrinolytic function becomes overactive."
The key point here is: "The fibrinolytic effect is the result of a balance between two things in the patientâs body, fibrinolysis activator tPA and fibrinolysis activator inhibitor PAI."
Geng Yongzhe held his breath as he listened to her speak about a point he was not familiar with, lacking her depth of laboratory exploration before her rebirth.
"From the first to the twelfth hour post-operation, a patientâs tPA can increase, while PAI gradually decreases within twelve hours and maintains a low level for up to seventy-two hours. The amount of post-operative bleeding is related to the decrease in PAI. If the PAI drops too drastically, the volume of post-operative bleeding will increase, and such a drastic drop in PAI generally occurs within the first hour after surgery. Therefore, it is recommended to perform antifibrinolytic treatment on the day of heart valve replacement surgery and coronary artery bypass surgery, and to conduct anticoagulation treatment as early as possible after 24 hours to adapt to these post-operative changes in the patientâs body. I guess Teacher Duâs hesitation in standing here post-operation is due to this."
The coagulation function of the patientâs blood could be more profoundly experienced by the surgical doctors who may have observed it firsthand during the operation. Du Yeqingâs decision not to administer antifibrinolytic drugs to the patient temporarily might be based on this consideration.
What? Geng Yongzhe was shocked by the bombshell she dropped: The chief surgeon remains here post-op because of this?
Usually, if the surgery goes smoothly and ends with the patientâs indicators looking good, thereâs no need for the chief surgeon to personally accompany the patient to the ward. There are other assistant young doctors to assist, and the chief surgeon is notified if needed.
Contrary to the norm, Du Yeqing personally accompanied the patient back to the ward and stayed for a while before leaving.
The first thing that came to Geng Yongzheâs mind was whether this was because the patient was a VIP donor of twenty million, prompting Du Yeqing to upgrade the service.
It turns out: he was completely wrong.
Indeed, Teacher Du being a boss of sorts, wouldnât need to posture in the ward. The family could not see from outside, the patient was unconscious, and there was no need to act. A doctorâs every move is fundamentally based on technical requirements, not other factors.
It is evident that privately, the teachers comment that Student Xie is like a parasite in the bossâs stomach. This obviously refers not only to Student Xieâs technical level being close to the bosses but also to her self-recognition of the medical profession being very much like the bosses.
Geng Yongzheâs face turned pale with nervousness. Observing Student Xie while speaking to him, her eyes were not on the monitor numbers like his but on the drainage tube and the fluid volume in the drainage bottle.
This is precisely the focus of post-operative observation for this patient. He drifted ten thousand eight thousand miles away.
In cases of severe hemorrhage leading to shock, waiting until the patientâs heart rate and blood pressure become problematic before rescuing would be too late. The key to a doctorâs control is to predict data in the early stages of severe hemorrhage, judging in advance based on other indicators. Especially since the patient is sedated and on a ventilator, the heart rate and blood pressure are aided by medication and machines, which cannot accurately reflect the patientâs internal state.