Chapter 1058 A gamble, living towards death!
Although the most dangerous shock stage has been seen, the patient's body temperature fluctuated several times and was still in a low fever this morning.
During the major dressing change, sepsis was found on the burn wound.
This is a manifestation of bacteria multiplying and growing on the necrotic tissue of the burn wound, rapidly expanding and invading the deep skin. Although thorough debridement has been done before, how can a burn of Tian Ling's degree be cleaned?
After further examination, it was confirmed that the amount of bacteria per gram of tissue exceeded 100... This shows that the systemic infection is very serious. The blood culture is negative, and the burn wound sepsis can be confirmed!
But this is not over yet!
In addition to systemic sepsis, the patient has a local infection of Pseudomonas aeruginosa. This morning, the positive result of Pseudomonas aeruginosa blood culture was just found... Proving that the patient has Pseudomonas aeruginosa sepsis!
"..."
Seeing this result, the people who were originally somewhat excited immediately felt like being hit hard on the head by a heavy hammer, and felt unreal.
Wound sepsis is difficult to deal with, and there is also a local infection of Pseudomonas aeruginosa?
Is it really that extreme!
At this moment, Kong Lan and Cheng Pingsheng are the most confused.
The current situation is much worse than the worst condition they estimated!
With so many debuffs stacked together, the person should be dead, and he can't even survive the shock period... How on earth can this patient hold on!
They both looked at Xu Qiu at the same time.
But they found that there was no extra expression on Xu Qiu's face, which made Kong Lan and others even more shocked. Obviously, the current situation still did not exceed Xu Qiu's expectations.
How many plans did Academician Xu prepare... No, as long as brain death has not been confirmed, it can still be saved.
No, with Xu Qiu's medical skills, patients who are considered brain dead should be caught and electrocuted twice...
"Doctor Xu, what do you think?" Kong Lan has given up thinking at this moment.
It's not that she's not good enough, but Tian Ling's situation is beyond expectations.
Cheng Pingsheng looked at Xu Qiu silently, but his hands under the table clenched unconsciously.
I didn't expect that as the director of the burn hospital, I would start to hug other people's thighs...
But even Academician Kong doesn't care, what's the point of me being a director?
The others looked at Xu Qiu at the same time.
A steady voice sounded at this time: "In fact, whether it's sepsis or septicemia on the wound, prevention is the priority. Tian Ling has a deep and large area of burns. During the peak period of wound exudation, we used targeted antibiotics against wound bacteria..."
Xu Qiu narrated lightly.
In theory, such a full set of antibiotic coverage can avoid infection as much as possible, allowing the antibiotic protection barrier to form in the extracellular fluid under the scab, and play a certain protective role on the infected wound.
This kind of protection is better than nothing for ordinary people, but it is the last straw for burn patients who have lost their skin protection barrier and whose first line of defense is almost collapsed.
Of course, the theory is good, but in reality, Tian Ling eventually suffered a large area of serious infection.
However, this does not mean that Xu Qiu's plan has failed, because if this method is not used, Tian Ling will not be able to survive the shock period, and may have died early in various surging infection outbreaks.
And now, at least there is still a chance to further control the infection!
"Earlier today, I consulted some literature and tested more than 60 antibiotics on Tian Ling." Xu Qiu suddenly said.
Hearing this, everyone was stunned.
Kong Lan and Cheng Pingsheng were even more shocked... When did this happen!
In contrast, the people in the emergency department of Linyi were not so surprised, but they were the most shocked - Director Xu's body was really strong. He worked late at night and could continue the operation the next day without being affected at all.
Is this a cheat?
But thinking that Xu Qiu has always been like this, they are used to it.
And Xu Qiu seemed not to see the shocked expressions of others, and continued: "In the end, it was found that only polymyxin can be used."
Other drugs have basically developed drug resistance.
Polymyxin is Tian Ling's life-saving medicine.
However, at this moment, everyone's expressions are not good.
The reason is very simple... The use of this drug is very restricted!
It causes serious damage to kidney function and can only be used for 1 day at most, otherwise the kidney failure will be irreparable!
Whether to let the infection develop or use polymyxin to fight the infection, both are close to a road to death for Tian Ling.
However, the most critical thing is not this!
The problem is that polymyxin is only "more effective for patients than other antibiotics", only "more effective", not miraculous!
This means that even if polymyxin is really used at risk, the patient may not be able to survive this infection.
If it doesn't work, then Tian Ling is really beyond the reach of ghosts and gods... The infection that has not been contained is coupled with kidney failure. Even if Xu Qiu really opens the "Hua Tuo Experience Card", it is difficult to save the patient.
The discussion in the conference room instantly came to a deadlock.
Use it or not?
No matter which choice you make, you may regret it.
In the end, Xu Qiu took on this responsibility. He knocked on the table and said decisively: "Let's not talk about whether it can be saved or not. The only effective drug at present is polymyxin.
Although this drug may cause kidney damage, it can at least buy more time for the patient and for us! "
No, the infection will break out and the patient will die on the spot.
If you take a risk, you may be able to overcome the serious drug-resistant bacterial infection. If you can reverse the bacterial infection index, everything will be fine. If not... then it will buy time for the doctor.
However, Xu Qiu dared to say this.
After all, for most doctors, the so-called treatment and saving lives is just to deal with the condition according to the established rules. This is no different from repairing machines in factories and assembling parts on assembly lines. Just follow the rules and regulations.
For this group of people, there is no difference between giving them five days and five years.
But, it is completely different for Xu Qiu!
Stop the patient's life and hold on for another five days. Maybe within these five days he can think of a treatment plan to replace polymyxin, or give a better backup method after the treatment fails!
After finalizing this treatment policy, other measures will be taken next.
There is nothing to discuss about nutrition, support, wound treatment, etc., and they are supplemented according to the daily calorie deficit of 4,000 kcal.
For the others, intramuscular injection of immunoglobulin, subcutaneous injection of transfer factor, and transfusion of Pseudomonas aeruginosa immune plasma for Pseudomonas aeruginosa infection, etc.
The only good news in this serious condition is that the treatment of sepsis and septicemia is probably the same, both can be treated by external debridement and internal anti-infection, and there is no need to give two completely different treatment plans based on the two.
However, this is just good news.
Because on the fifth day of the application of polymyxin, the patient's kidney indicators have deteriorated to the point where it is difficult to support it. Creatinine, urea nitrogen, uric acid, etc. all show that the patient's renal failure is about to reach a dangerous critical point!
And a more suffocating news was heard by Xu Qiu at this time.
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