"Did you even look at the pre-op imaging!" Dudley yelled under his breath.

"Mr. Dudley, I remind you again, this is the operating room, please be quiet. Wu Mian said gently, "If you roar in the operating room again, I may kick you out, like a stray mad dog, without mercy." ”

Dudley's eyes were red, his fists clenched, and a creaking sound came out.

"Don't think about doing it, have you forgotten that I was beaten into a dog last time?" Wu Mian said indifferently.

"Shameless!" Dr. Dudley squeezed a word out between his teeth, but it was much quieter.

Wu Mian didn't continue to talk to Dudley, he stared at the liquid, waiting silently.

11′12", Wu Mian said, "Prepare for resuscitation, stop cardiopulmonary bypass." ”

"You're crazy!" said Dudley, "haven't found the cause of hemorrhagic shock yet!"

In Dudley's imagination, the annoying and disgusting Wu must know where the bleeding is, and the amount of bleeding will not be small, otherwise there will be a decrease in heart rate and blood pressure as soon as the machine is stopped.

But what I never expected was that Wu Mian stood in the position of the surgeon, and the first doctor's order after the infusion turned out to be - stop cardiopulmonary bypass!

It's crazy!

"Are you a sorcerer?" Wu Mian sneered slightly, "Now that I'm standing here, I'm the only sorcerer!"

Chu Zhixi had already opened the ascending aorta blocking forceps, and she carefully ensured that the left heart was drained smoothly to prevent the left heart from expanding.

In general, if the conditions are right, the heart can restart on its own. However, Headmaster Toput's heart remained silent after the ascending aorta blockage was lifted, as if he had died.

"Prepare for electrical defibrillation. Wu Mian stretched out his hand, and the instrument nurse then handed him the defibrillator.

Wu Mian debugs the power of the defibrillator, 45J. Defibrillation is successful, and the heart begins to work again. With the help of cardiopulmonary bypass, the load on the heart was not large, and Wu Mian was not in a hurry, but waited quietly for another 5 minutes.

This period is especially necessary to keep the heart beating without load for a period of time after the rebound to facilitate the recovery of myocardial function.

After resuscitation, the upper and lower chamber blocking bands are opened to transform complete cardiopulmonary bypass into parallel circulation to assist heart beating and reduce the burden on the heart.

After checking the blood qi again, Wu Mian and the others reported back, all the conditions compounded, and he raised his head and said, "Weaning, don't neutralize heparin." ”

Extubation, weaning, this is the second time this procedure has been repeated.

The cardiopulmonary bypass specialists in Dr. Dudley's medical team habitually inject protamine to neutralize heparin according to the normal procedure.

Before he could inject protamine, a hemostatic forceps flew out and smashed straight into the cardiopulmonary bypasser's head.

The cardiopulmonary bypass specialist felt a pain in the top of his head, and then saw the silver-white hemostat drop to the ground with a crisp sound.

He stood up angrily, and before he could speak, he heard a barrage of London accents coming from English.

"Didn't you hear what I said?!" Wu Mian reprimanded, "Don't neutralize heparin, you don't understand this sentence? Is it because I don't speak English fluently enough or are you trying to murder?!"

"......" The cardiopulmonary bypass master was stunned for a moment, and then said angrily, "Aren't you going to be weaned?

"Not neutralized. Wu Mian said, "I reiterate one last time, do not neutralize heparin. ”

In the operating room, everyone was silent, and Dudley looked at Wu Mian like a fool. He was stunned for a few seconds, then looked back at Mrs. Topter, his eyes full of indescribable banter and disdain.

Before the cardiopulmonary bypass is transferred, systemic heparinization is required, and the cardiopulmonary bypass machine should also be prefilled with heparin in advance, and the patient's ACT should be greater than 480 seconds before the transfer, so the cardiopulmonary bypass will not cause blood clotting.

When stopping cardiopulmonary bypass, heparin should be neutralized. Even so, there will still be bleeding from the coronary anastomosis.

But Wu Mian actually said that protamine is not needed to neutralize heparin, and then what?

When the anastomosis leaks blood, the patient goes into hypotensive shock due to continuous blood loss, and finally dies?

It's not that there are no such procedures, but they are forced to happen, and the patient's chances of success are quite low, to the point of being ridiculously low.

Dr. Dudley couldn't figure out how Wu Mian operated, was he worried that Principal Stephen Topt had a protamine allergy?

This has been ruled out by the results of preoperative allergen testing, otherwise Dudley would not have chosen coronary artery bypass surgery with cardiopulmonary bypass.

"Wu, are you sure?" asked Mrs. Topter in a trembling voice, she didn't expect Wu Mian to give such an unbelievable medical order.

"Ma'am, yes. Wu Mian replied softly.

Mrs. Topt didn't ask any more, she had completely lost herself in the strange course of the operation. Although she is a world-renowned cardiologist, Principal Topter's situation is so strange that she can't tell what's going on.

The drugs used had been tested for allergens, and the surgery had been so successful that at least Mrs. Topter could not fault it. But in this almost perfect process, Principal Topter had a weak heartbeat.

However, under great pressure to replace the surgeon, Wu Mian refused to neutralize protamine and systemic heparinization, and went directly to weaning!

If nothing else, the postoperative anastomosis bleeding alone is fatal!

Mrs. Topter had countless questions in her heart, but she didn't ask, just stood quietly behind Wu Mian and watched.

After the shutdown, Wu Mian observed Stephen Topter's situation. Vital signs are stable, and there is constant blood oozing from the anastomosis site of the graft vessels.

He removed the upper cavity cannula and retreated the lower cavity cannula into the right atrium. After 3 minutes of observation, the condition continued to be stable, and the lower cavity cannula was removed. Blood is transfused into the machine and the arterial cannula is removed as soon as possible.

The last time was when the cardiopulmonary bypass was shut down, and the heart beat weakly.

And now, again, downtime. The difference is that protamine is that systemic heparinization is not neutralized.

Both Mrs. Topt and Dr. Dudley knew this, and they had long figured out that Wu Mian might have suspected that protamine-induced allergies were causing Stephen Toppt's heart to beat weakly.

This is the only plausible explanation.

After the cardiopulmonary bypass was shut down, there was silence in the operating room. All eyes were on Stephen Topter's heart, even though the coronary arteries were still bleeding.

A few milliliters of oozing blood is not fatal enough, the key is whether the act of neutralizing heparinization is effective.

1 minute ......

Stephen Topter's heart beats vigorously, and ST-segment changes are relieved by ECG oscilloscope.

2 minutes ......

3 minutes ......

5 minutes ......

Aside from the bleeding at the graft anastomosis, there were no problems with Stephen Topter's vital signs!

So that's it!