BXBX NOVEL Chapter 2636: 【2636】Undercover
Clinically, there are generally two indicators to distinguish acute kidney injury, one is urine volume, and low urine volume is the most typical clinical symptom of acute kidney injury. The other is the serum creatinine value. Acute kidney injury can be divided into three grades according to urine output and serum creatinine value. Clinical grading has always been used to guide clinical treatment plans. If it is divided into three levels, it is time to consider starting a hemodialysis program.
Now this patient has darkened urine after returning to the ICU. The ICU doctor hurriedly sent urine samples and blood samples to the laboratory for testing. At this time, can it be easily said that this patient may have acute kidney injury because of the previous illness? Obviously not.
Doctors should seek truth from facts, and should not throw all blame on the patient's previous illness, which is very detrimental to the patient's subsequent treatment.
Xie Wanying mentioned to Brother Xia: "It is estimated that the proportion of acute kidney injury caused by postoperative surgery is higher. The proportion of acute kidney injury after cardiothoracic surgery is very high."
This is an unavoidable surgical complication. As long as the patient adopts cardiopulmonary bypass during surgery, many harmful factors in cardiopulmonary bypass, such as myoglobin inflammatory mediators, are too easy to cause acute kidney injury. At this time, acute kidney injury caused by so-called renal hypoperfusion is ranked at a lower probability.
Xia Dongxian listened to her methodical analysis, and nodded her head thinking: I have heard this little sister before, and she has learned a lot about surgery and internal medicine. Now it seems more than that, the little junior sister has the potential to be a big brother. Dai Ronghong recommended it.
As an icu doctor, Xia Dongxian has dealt with the bosses of various disciplines too many times. It can be said that he understands the qualifications of a boss better than other doctors.
Perioperative management of critically ill patients is not only the key and difficult point of icu, but also a reflection of whether a surgeon has real skills.
Some hospital surgeons throw this kind of patient problem to the icu doctor, and some don't. Surgery is the bigger the boss, the less the blame-shooter, especially when it comes to these key patients that are related to other important matters, the boss is staring at it in person.
No surprise, Xia Dongxian didn't need to notify, and soon saw Fu Xinheng who came over after the surgery and rested.
Wearing slippers and leading someone to stand at the door of their ICU office, Fu Xinheng took out his hand from the pocket of his white coat and placed it, implying that Xia Dongxian did not need to speak.
Seeing this robot sneaking, it must be malicious and purposeful. Xia Dongxian rolled his eyes: Could it be that he wanted to inspect his younger sister in an all-round way to be very picky?
This possibility is very high. Robots are called robots. One of the reasons is that they don't know how to be flexible and are too harsh.
Xie Wanying immersed herself in research on the patient's medical records, but did not raise her head and did not notice anyone coming. She said, "The analysis of serum creatinine and urine output is not enough for acute kidney injury, and biological markers are usually needed. Now the patient's urine is brown, and acute kidney injury should be considered. The possibility of renal tubular necrosis. The influencing factors in surgery are no longer discussed in the past. Judging from other indicators of today's patients, I personally think the most critical place is blood transfusion."
"Blood transfusion?" Xia Dongxian was surprised.
Kidney problems, not taking medicine, just thinking about blood transfusion?
"To restore the kidney after surgery, it must return to adequate renal perfusion, so that the patient's kidney has the conditions to repair itself."
(end of this chapter)