When he came to the hotel, Wu Mian sat in the main seat, chatting and laughing with the president of Pengcheng People's Hospital.

I could feel that Wu Mian was very happy, and even some emotions called pleasure were diffusing in him.

"Teacher Wu. The group came in and greeted Wu Mian first.

"Sit down. Wu Mian smiled and said, "The operation was done very well. ”

In a word, Ren Haitao finally let go. After all, it is the first time to do a new operation such as mitral valve clamping on the human body, and Mr. Wu is not there, so it is inevitable that he will be a little worried.

"Teacher Wu, your side has learned to open smoothly. Gao Baixiang asked.

"It's ok. Wu Mian nodded, "Tentatively set to cooperate with Lanke and Huaxia Minimally Invasive Corporation, Director Gao may be busy recently." ”

"Oh, do mitral regurgitation patients have to come to the operation intensively?"

"It's not. Wu Mian said, "Lanke is ready to charity to donate 5,000 sets of interventional surgery consumables for infants with congenital heart disease. ”

5000 sets......

Although I don't know the cost, according to the sales price, it is at least a few hundred million yuan.

Gao Baixiang looked at Wu Mian in surprise, he didn't know that there was such a thing.

"Dean Zhao, I'll leave it to you in the future. Wu Mian smiled and said, "If there are suitable patients who can't afford surgery or can barely do it, but have to hurt their muscles and bones at home, go to my side." ”

"No problem, Mr. Wu, this is a kind deed, and I will have to toast you later. Dean Zhao said.

"It should be done. Wu Mian shook his head and said, "If nothing else, Dean Zhao has to help screen patients more." After all, there are so many free consumables, and those who have money will be treated normally, leaving opportunities for children who have no money. ”

Wu Mian was very serious when he spoke, Dean Zhao knew the priorities of this, nodded and said, "Teacher Wu, don't worry, although it is more troublesome to screen the patient's family conditions, I will do my best." ”

There are too many things involved, and Wu Mian doesn't want to set the conditions too strictly. When the water is clear, there are no fish, and when people are observed, there are no disciples, and the most basic truth Wu Mian understands.

"Go back and implement it quickly, your side is economically developed, and there may not be many people in need, anyway, you can help contact it first. Wu Mian said politely.

"Look at what you said, isn't that what we should be doing? Dean Zhao said.

While speaking, the waiter passed the food, and Ren Haitao finally found an opportunity.

"Mr. Wu, the partial pressure of oxygen in the blood gas analysis of the patient just now is really low. Ren Haitao said the result directly.

"Oh, have you regained your lungs ventilation? What kind of medicine have you given?" Wu Mian asked.

"Hmm. Ren Haitao nodded, and briefly said the rescue medication used at that time, "The patient is in good condition after rescue, and I see the end of the operation." ”

"I'm relieved to have you here. Wu Mian looked at Ren Haitao and said with a smile.

"Mr. Wu, at that time, I just felt that something was wrong, but I couldn't say what was wrong. Ren Haitao said, "I have no choice but to call you." ”

"Oh, haven't you met it before?" Wu Mian asked.

Ren Haitao shook his head, and the two directors of the People's Hospital looked at Wu Mian without blinking, listening to Teacher Wu's explanation.

If this matter is not as alert as Ren Haitao, it is similar to intuition, and he is vigilant, and even does not hesitate to call Mr. Wu, it is very likely to cause serious consequences. As for why this happened, they thought it was a paranormal event.

Something like this is certainly not the norm, and if it is, the oxygen saturation is meaningless.

"A severe imbalance in the ratio of ventilated blood flow during single-lung ventilation is the most likely cause of this. During single-lung ventilation, blood flowing through the non-ventilated lung returns to the left atrium without oxygenation, resulting in venous blood doping and a decrease in PaO2. ”

Wu Mian began to tell the story, although he didn't see the patient with his own eyes, he could guess it just by guessing.

"Normally, the right lung has about 10% more blood flow than the left lung, so the incidence of hypoxemia is increased when the right lung collapses compared with the left lung. In this case, due to the left decubitus position, the right lung was not ventilated and there was blood flow, resulting in arteriovenous blood shunt, and the ratio of blood flow to the right lung decreased, which eventually led to a decrease in PaO2. ”

"This is the most basic principle of single-lung ventilation, although the chance of problems is very small, so that everyone basically can't remember it, but Lao Ren still has the most basic vigilance. ”

Wu Mian looked at Ren Haitao with approving eyes.

It turned out that this was the case, Ren Haitao recalled some memory fragments at this time. When I saw the patient lying on the left side, I felt a little uneasy in my heart, and there was a reason for this.

"The patient has a lot of sputum in the left bronchi before surgery, which is easy to block the bronchi. In addition, when the abdominal contents are pushed up by the diaphragm in the lateral decubitus position, the functional residual volume decreases, causing atelectasis, resulting in a decrease in the ventilation function of the left lung, which further aggravates the imbalance of the ventilation and blood flow ratio. ”

What Wu Mian said was easy to understand, and all the anesthesiologists present were director-level anesthesiologists, and they immediately understood what Teacher Wu was talking about. But...... Mr. Wu's explanation still can't perfectly explain the patient's situation.

Seeing that a few people looked puzzled, but didn't dare to ask, Wu Mian smiled slightly and said, "Many years ago, about 30 years ago, domestic anesthesiologists began to perform single-lung ventilation. There is a phrase that several directors should have heard often - your double lumen tube is not in good position. ”

Indeed, this sentence almost reached the hearts of several directors present.

The poor position of the double-lumen tube leads to the decrease in blood oxygen is the main problem to be faced by intubation, and it is also one of the landmark operations to evaluate the intubation level of an anesthesiologist.

"Although hypoxic pulmonary vasoconstriction or thoracotomy affects pulmonary blood flow and causes imbalance in blood flow during the same period, although it is an important and theoretical factor, if you encounter a decrease in pulse oxygen and a change in airway pressure, then the monistic diagnostic thinking tells you to consider the location of the double-lumen tube first. ”

"Mr. Wu, but the situation of this patient is that the blood oxygen display is different from the actual display. Ren Haitao had already figured out what Wu Mian had just said, his mind was full of the previous situation, and he didn't think about anything else, so he asked directly.

"A little bit of explanation. Wu Mian was not angry, but said with a smile.

"Uh-huh, what do you think, Mr. Wu?" Ren Haitao didn't realize that his words were too upright, and continued to ask.

Several other people also looked at Wu Mian curiously, wanting to hear his explanation.

It certainly won't be a paranormal event, but some rare situation.

"How the oxygen saturation clip works, which of you have studied?" Wu Mian asked.

Several directors shook their heads.

"It's normal that there is no research, after all, it is rare. "The difference in the measurement methods of SaO2 and SpO2 led to a mismatch between the two in severe hypoxemia in this case, and there was a false increase in pO2." ”