I can see the status bar

Chapter 1017 D+3 day (1)

"The fourth trial version of the diagnosis and treatment plan has come out." Sun Lien was eating breakfast in the restaurant, and Professor Li Chengping took his job bowl to the table next to him.In order to talk to Sun Lien without violating the relevant prevention and control regulations, Professor Li spent a lot of effort, "Director Sun, have you read it?"

"I saw someone posted it in the work group." Sun Li'en nodded, took a sip of porridge and said, "But I haven't looked at it carefully yet, I plan to look at it when I go back."

"The changes in the fourth edition are quite big." Professor Li pulled off his mask, took a sip of the soy milk in his bowl, and said, "The move of the gate that we have been advocating has also been reflected this time-the patient has not been ventilated for two hours after non-invasive mechanical ventilation. If it is improved, direct invasive ventilation should be considered.”

"So radical?" Sun Li'en was startled when he heard this.In North Fifth District, the current treatment strategy is to consider tracheostomy for invasive mechanical ventilation if the blood oxygen saturation is lower than 12% within 94 hours of using non-invasive mechanical ventilation.However, the fourth edition directly relaxes the conditions to the level of "if there is no improvement, it will be gas cut".

"What should I do if I'm not radical?" Professor Li shook his head and sighed, "I led the team for a few days, and the biggest feeling is that my previous experience seems to be useless. Get worse."

"The vital signs are almost uncountable now." Sun Lien also sighed, "Director Huang sent a patient away yesterday. It is said that it is a rare silent hypoxemia."

"I've never heard of that." Professor Li himself is also a doctor of respiratory medicine. After thinking about it for a while, he asked, "Is it asymptomatic hypoxemia?"

Sun Li'en checked his phone and said, "It seems to be."

"Some people are naturally more tolerant to hypoxemia?" Sun Lien's answer made Professor Li curious. In his opinion, although it is rare in clinical practice, patients who can tolerate hypoxemia and have no symptoms are actually not considered. Too little, "How did this silent hypoxemia come about?"

"Director Huang's team sent two patients away, all like this." Sun Lien replied, "The blood oxygen saturation of the patients is only 80%, but they hardly have any uncomfortable symptoms. They can even play in bed Mobile phone, clear consciousness, and no dizziness or other problems—they once thought it was a problem with the instrument for monitoring finger pulse oxygen."

Asymptomatic hypoxemia is not absent, but it is indeed rare.According to Professor Li's experience, such patients are more likely to have obstructive sleep apnea hypopnea syndrome.During sleep apnea, the patient's blood oxygen saturation will drop to 60% or even lower.After waking up, the blood oxygen saturation of some patients also rose slowly.But such patients have basically no other problems except fatigue.The other part has underlying diseases and has tolerated hypoxemia—in the inpatient department of the affiliated hospital, Professor Li has seen many patients whose blood oxygen saturation is only over 70%, and they can still act like normal people. Talk and talk, it's time to play with your mobile phone.

But because of the new coronavirus infection, this silent hypoxemia... is really an example that has never been seen before.A patient with normal blood oxygen, whose blood oxygen saturation has dropped rapidly due to viral pneumonia, has reached more than 80% and is still asymptomatic...it doesn't make sense.

"Ms. Li, if you are interested, I will ask Director Huang to send the patient's case." Sun Lien finished the porridge in front of him in two or three gulps, and began to nibble on the bread. "Director Huang is quite serious about this situation. She I feel that this situation may be related to the infection of the new coronavirus."

"I've never heard of it before. When Yunhe came here, I met two at once. It's not surprising to have this guess." Li Chengping nodded and said, "I'll contact Director Huang later and ask if we can get a case."

"I hope this symptom is not common." Professor Li stopped his hands and frowned, "Dyspnea is one of the most common complaints of our respiratory medicine patients. Patients subjectively think that it is dyspnea... But if there is no dyspnea, many people may not know that they are infected."

Sun Li'en also became nervous. He put down the bread in his hand and was silent for a while, then shook his head, "It's useless for us to have a headache, and it's useless even if we want to do scientific research now."

When it comes to scientific research, Professor Li Chengping suddenly became energetic, "I heard that Xiao Sun, your laboratory is the first in our province to produce a high-precision PCR kit?"

"The main reason is that my supervisor is more reliable." Sun Lien replied very honestly, "Apart from giving orders and asking for money, I act as if I don't exist."

"Awesome." Professor Li directly regarded Sun Lien's honesty as modesty, and he gave a thumbs up and sighed, "You are a lucky general." He blinked and asked, "Yesterday the Xiangbei Provincial Health Commission Someone called me and asked me about tocilizumab."

"They agreed?" Sun Li'en suddenly became energetic.Tocilizumab appears to be one of the most promising drugs currently available to improve conditions in critically ill patients.

"The report has been submitted to the National Health and Medical Commission, and it is estimated that it will be approved today. I personally think that the possibility of passing it is very high." Li Chengping said with a smile, "Tocilizumab is an old drug, and our understanding of it is considered It is quite sufficient. At least its drug safety is recognized-however, I think the higher authorities may not immediately agree to carry out widespread clinical application."

The word "extensive" woke up Sun Lien, "Then... can we at least conduct a pilot study in the North Fifth District?"

"Anyway, I support you." Li Chengping nodded, "Old Li, I have one idea now, as long as it can improve the condition of critically ill patients, I can do anything. Anyway, I feel that Chinese medicine has been included in the plan. Tocilizumab is okay!"

Sun Lien’s views on traditional Chinese medicine are more open, “Anyway, I used traditional Chinese medicine injection when I was sick. Who hasn’t drunk traditional Chinese medicine since childhood? Can have medicine for patients, they will feel more comfortable, and we can feel it too. Feel better."

"No wonder Dean Song wants you to be the team leader. You have a very high level of ideological awareness!" Professor Li chuckled a few times, "I heard that there are already experts who specialize in Chinese medicine from the capital."

"My greatest hope now is not to let us boil Chinese medicine." Sun Lien was very interested in the news, but at the same time he was also a little anxious, "You all started moving the oxygen tanks yesterday, if you have to move the Chinese medicine tanks, then we have to live Tired."

　The last chapter is temporarily invisible due to some factors. I will strengthen the communication with the editor and release the last chapter as soon as possible.

　　
　
(End of this chapter)