Chapter 352 Beriberi Is Not a Disease

"Vitamins, have you checked?" Zheng Ren asked.

"Vitamins?" Su Yun was taken aback.

ICU, the habit of emergency rescue, there is no such thing as vitamin inspection, except for some special diseases.

Trauma is not a special disease.

"Vitamin B1 deficiency, I'm thinking about it now." Zheng Ren said: "Stop the patient's sedative."

"..." Su Yun was slightly taken aback.

"I want to see if the patient has symptoms of oculomotor nerve paralysis when he is agitated."

The extraocular muscles innervated by the oculomotor nerve are paralyzed, and symptoms such as abnormal eye position and dilated pupils and loss of light response will appear.

Just as Su Yun wanted to refute, he suddenly recalled the scene of Yang Lili's trembling eyes when she was awake. It was precisely because of this that Su Yun had the feeling that Yang Lili had seen a ghost.

He pondered for a few minutes, then suddenly raised his head, his eyes lit up, "Boss, I think you're right."

Director Qian and the other consultation directors were stunned.

Are these two young men joking?

The city is still waiting for today's condition report, they...

If it weren't for Su Yun's extraordinary emergency first-aid skills in the ICU, and Zheng Ren's extremely high surgical skills in previous emergency operations, he would have been sprayed with saliva.

Vitamin B1 deficiency?

What a joke.

"Xiao Zheng, Xiao Su, don't be joking." Director Qian said in a deep voice, expressing his dissatisfaction.

"Director Qian, I'm not joking." Su Yun smiled.

Zheng Ren's words cleared away the fog in front of him, and there was a clear sky.

Sometimes, the difference is just a little bit. Once the layer of window paper is pierced, it is actually nothing to look back.

"What does the patient's symptoms have to do with vitamin B1 deficiency!" The chief of the medical affairs department said angrily, "Beriberi?! Nonsense!"

"Pathology and physiology, you have learned it all." Su Yun looked around, with a sneering smile hanging from the corner of his mouth, "This vitamin B1 deficiency is commonly known as beriberi, which is correct."

As he said that, the smile on the corner of his mouth became more intense, and the starlight in the eyes of many nurses in the ICU was shining.

"Vitamin B1 is also known as thiamine, and thiamine is phosphorylated by enzymes after intestinal absorption to produce thiamine pyrophosphate.

Thiamine pyrophosphate is an important coenzyme for the decarboxylation of pyruvate and a-ketoglutarate in the tricarboxylic acid cycle, and is also a coenzyme for erythrocyte ketol transferase. "

A series of professional terms, like thunder billowing, emerged from the void and fell on the heads of everyone present.

Director Qian pondered, what Xiao Su said seemed to be a train of thought.

The chief of the medical affairs department had an ugly expression on his face, because...he couldn't understand at all.

His position is very important, he is responsible for the integration of various rescue links, handling medical disputes, and controlling the quality of medical care.

But the time away from the clinic is too long, and the pathophysiology and other things have almost been forgotten.

Su Yun didn't pay attention to the thoughts of the great people present, and continued: "In the brain tissue and myocardial tissue with vigorous metabolism, there must be enough vitamin B1 to participate in the metabolism of glucose and pyruvate, otherwise, due to the lack of thiamine pyrophosphate, it will be difficult for pyruvate to enter the tricarboxylic acid cycle.

A large amount of pyruvate stays in the blood, resulting in dilation of peripheral arterioles, decreased peripheral resistance, increased venous flow, and increased cardiac output and cardiac workload. "

Huh? Finally talking about RV output and cardiac load?

The chief of the medical department pretended to be thinking, and at this time he couldn't let people see that he didn't understand.

But... this hateful guy, can't it be simpler?

"So, I..." Su Yun's smooth tone froze for a moment, "My boss said that considering Yang Lili's restlessness and psychological symptoms, it should be a complication caused by vitamin B1 deficiency."

After speaking, Su Yun glanced at Zheng Ren.

"I'm right, boss."

"Basically that's what it means." Zheng Ren was not polite, and then said, "It is recommended to inject 100mg vitamin B1 intramuscularly, but the body absorbs the intramuscular drug slowly. You can try to inject 20ml normal saline + 50mg vitamin B1 intravenously at the same time as the intramuscular injection."

"The first dose is higher on the first day, no problem." Zheng Ren said.

All the directors present and the director of the medical affairs department looked at each other in bewilderment, but in each other's eyes, they were all in a daze.

Although not everyone agrees with what Zheng Ren and Su Yun said, if they want to complain, they have to have a reason not to.

People explain things and judgments clearly in one, two, three, four, five, and explain clearly from the perspective of biochemistry.

Although I can't understand it, I feel that it is very powerful.

What to do then?

What else can I do?

"Try it, there is no other good way." Director Qian said.

He has had the longest contact with Su Yun and knows Su Yun well. Generally speaking, once Su Yun has that kind of expression on his face, it means that what he said is right.

Don't refute at this time, even the chief director will be slapped in the face in the face of a well-founded illness.

Besides, the intake of tens of milligrams of vitamin B1 will definitely not have a negative impact on Yang Lili's condition.

"After half an hour, stop the sedative." Zheng Ren got up and said the last sentence.

"Okay, boss." Su Yun went to give the doctor's order.

Seeing the back of Zheng Ren leaving, Director Qian felt a little emotional.

This is a young tiger that has grown up.

As far as this kind of momentum is concerned, the senior director who has been there for many years does not have it.

Medical treatment, there is no absolute certainty, who dares to say such a certain thing? Whatever you say, you will be slapped in the face soon, or the kind of slap left, right slap, and a few slaps.

Director Qian has only seen this kind of temperament in a few professors in the imperial capital and magic capital, but the city's first hospital... has never had such a person.

Su Yun gave the doctor's order, and some nurses rushed to carry it out. Afterwards, he injected vitamin B1 intravenously, and then gave a muscle injection.

Glancing at the time, Su Yun sat down on the chair beside the bed and stared at Yang Lili intently.

Half an hour, the time the boss said should be fine. At that time, the dose of the sedative will be reduced, and when the sedative in Yang Lili's body is almost metabolized, it should be 2 hours later.

If it is really the oculomotor symptoms and cardiovascular symptoms caused by vitamin B1 deficiency, they will definitely improve.

This diagnosis is really interesting.

...

At the same time, in the operating room, orthopedic surgery to remove the vertebral body was in progress.

"Xiao Zhou, was the embolism confirmed yesterday?" Professor Tian from the Department of Orthopedics in Imperial Capital asked while opening the skin.

Dr. Zhou said: "The embolization takes a long time, because we only have one doctor in the interventional department here. I can't tell whether it is successful or not. But he has embolized patients with peritoneal hematoma after pelvic fracture before, and the effect is very good."

"Well, there are few interventional doctors, so it would be nice to have one." Professor Tian began to bluntly separate the muscle tissue, carefully avoiding a place where capillaries are densely packed.