I can see the status bar

Chapter 1068 Lupus Erythematosus
To be honest, Sun Lien himself has never been on duty in the ICU.Even when he was in the fourth hospital before, because Liu Tangchun changed the regular training plan in the second month of the regular training in the emergency department, Sun Lien never completed a department rotation in the end.If the original training plan was followed, he should enter the ICU in March of the second year after starting the training, and study in this department for two months.

In the end, not only was Sun Lien not on duty in the ICU, he was even blacklisted in the ICU of the Fourth Hospital—the doctors in the Department of Critical Care Medicine have always believed that Sun Lien should be kept as far away from the ward as possible.As long as this guy enters the ICU, he will be as busy at night as if he drank Wangzai milk and ate mangoes for supper. Everyone has to keep their feet on the ground.

It's okay if it's just that the newly admitted patients have problems. After all, it makes sense for the newly admitted patients to be in unstable conditions.However, as long as Sun Lien has been in the ICU, the symptoms of many patients in the ward who have been treated for more than ten days or even dozens of days will suddenly change.

The intensivists, who were puzzled by this "spiritual phenomenon", finally made a decision, regardless of whether he had any scientific basis or evidence-based medical proof, in short, just throw Sun Lien out.

So, Sun Li'en was on the blacklist of the Fourth Central Hospital together with Mango and Wangzai Milk.However, Mango and Wangzai Milk can be avoided, but as a doctor, Sun Lien cannot avoid going to the ICU for consultation.Especially after he became the director of the Comprehensive Diagnostic Center, there were more such tasks.

If they couldn't avoid the consultation, the intensive care physicians of the Fourth Hospital could only choose a more flexible workaround—such as inviting Sun Lien to come for a consultation, but not allowing him to enter the ward.

After being reprimanded several times by Sun Lien, "I'm afraid you have some serious illness", the doctors in the intensive care department finally made concessions.They decided to transfer all patients who needed Sun Lien's consultation to the separate ward closest to the door in advance.

All in all, it is enough to treat Sun Li'en as a plague god.

When he decided to take over the ICU ward of the two-day infectious disease hospital, Sun Lien was actually a little nervous.After all, it is impossible for my own critical care medicine department to treat me as a plague god, so I don't have any thoughts in my heart.But...Thinking about the temporary ICU, Sun Lien suddenly regained his confidence.

The temporary ICU in the North Fifth District created a miracle.Ten patients were treated in eight beds within a week, and two of them died due to the rapid deterioration of their condition.But none of the remaining eight patients died—Mr. Shen, who was the most seriously ill, got off ECMO safely and was transferred to an ordinary hospital bed for treatment.Of the seven other patients, only one is currently in a situation requiring intubation for mechanical ventilation.

Under the careful care of the Song'an Provincial Medical Team, the vital signs and other conditions of the patients are very satisfactory.Especially after using the triple therapy, the severe inflammatory storm was basically pushed back.After the inflammatory storm is lifted, the main thing doctors have to do is to maintain the vital signs of the patients, and to strengthen and encourage their immune system—in any case, there is no need to worry about the inflammatory storm due to too strong immunity.

This reassuring feeling is like giving pain medication to an elderly patient on advanced airway support.Anyway, with ventilator support, there is no need to worry about respiratory depression caused by opioids.

After having at least seven successful cases, Sun Li'en has a lot more confidence in his heart.But when he stepped into the ICU ward full of confidence, he realized that things seemed to be different from what he had expected at the beginning.

"This patient...has lupus?" Sun Lien and the nurse on shift confirmed the situation again and again, then put on protective clothing, and stood there blankly for a long time without moving.

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Zhang Min, 35, is a native of Yunhe.Her home is only one street away from the seafood market that was first suspected to be closely related to the new coronavirus. Beginning on December 12, Zhang Min began to feel a little hot.But at that time, she only felt that it was a low-grade fever, and the problem should not be too big.

Because of her history of systemic lupus erythematosus, on December 12th, Zhang Min deliberately went to a tertiary hospital near her home for regular rheumatic and immune-related examinations about a week earlier.At that time she was positive for anti-ds-NDA antibodies, strongly positive for anti-Sm antibodies, positive for antinuclear antibodies, and normal complement C18/C3 levels.

一个月后，也就是1月20日，由于低热一直没有消失，张敏再次前往医院就诊。当时的血常规提示她的白细胞计数为12.73*10^9/L，淋巴细胞计数1.11*10^9/L，淋巴细胞百分比8.7%，血小板计数250*10^9/L。

Because the percentage of lymphocytes decreased and the white blood cell count increased, the local doctor thought that Zhang Min might have a bacterial infection.And empirically prescribed moxifloxacin for anti-infection treatment.

Two days later, on January 1, Zhang Min's symptoms still did not improve.When she went to the local hospital for the third time, the doctor prescribed a CT scan of her lungs.This time, the CT examination results showed that she had multiple patchy ground-glass opacities in her lungs, some of which were fused and consolidated, and air bronchial signs could be seen in them.For this result, the doctor revised the diagnosis to "viral pneumonia?" and prescribed ganciclovir for treatment.

Three days later, on January 1, Zhang Min's symptoms began to worsen.She developed shortness of breath, shortness of breath which worsened with activity...she was unable to get out of bed.After going to the hospital for the fourth time within a week, she was admitted to Yunhe Third Central Hospital.At that time, without oxygen support, her finger pulse oxygen saturation was only 25%.

From the day of admission on the 25th to the 29th, Zhang Min received continuous intravenous infusions of moxifloxacin, ganciclovir, and doxofylline while continuously inhaling oxygen.Her dyspnea has improved significantly, and her body temperature has returned to 36.7 degrees Celsius.

On the 30th, Zhang Min's throat swab nucleic acid test results were released, and she was officially diagnosed as a pneumonia patient infected by the new coronavirus.

On February 2, Zhang Min was transferred from the Third Central Hospital to Yunhe Infectious Disease Hospital, and was sent directly to the ICU for treatment—although her classification was severe rather than critical, considering the systemic Lupus erythematosus is the underlying disease, and Zhang Min, who is only 4 years old, still needs to be sent to the ICU for close monitoring of vital signs.

Then, she became the first patient who needed special attention when Sun Lien took over the ICU of Yunhe Infectious Disease Hospital.

In fact, as a patient in the ICU, Zhang Min's symptoms are the lightest among all the patients.Her body temperature is now only 36 degrees Celsius, and she is almost the same as a healthy person except for three to four times a day of mild diarrhea, and finger pulse oxygen is 91% when not inhaling oxygen.But Sun Lien's first reaction when he saw Zhang Min was to scratch his head - systemic lupus erythematosus is a very troublesome basic disease.Usually due to the long-term use of methylprednisolone, hydroxychloroquine phosphate and total glucosides of paeony for immunosuppression, she is susceptible to various infectious diseases.

The immune system has been suppressed for a long time, and Sun Li'en doesn't even know when Zhang Min's body will produce enough IgG antibodies to clear the virus.

Although it is a headache to treat patients with new coronavirus infection with systemic lupus erythematosus, Sun Lien is still very active and encourages himself deep in his heart.

Being under immunosuppression for a long time, at least there is no need to worry about the sudden immune storm killing Zhang Min... right?

(End of this chapter)