Chapter 1058 A Gamble, Living Towards Death!
Although the most dangerous shock stage has been seen, the patient's body temperature is still in a low fever state this morning after several fluctuations.
During the major dressing change, burn wound sepsis was discovered.
This is the 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, and the blood culture is also negative, which can confirm the burn wound sepsis!
But this is not over yet!
In addition to systemic sepsis, the patient also had a local infection of Pseudomonas aeruginosa. This morning, the positive result of Pseudomonas aeruginosa blood culture was just found... Proving that the patient had 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?
Do you have to be so extreme!
At this moment, Kong Lan and Cheng Pingsheng were the most confused.
The current situation is much worse than the worst condition they expected!
With so many debuffs stacked together, the person should have died, and he couldn't even survive the shock period... How did this patient survive until now!
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 shocked Kong Lan and others. Obviously, the current situation still did not exceed Xu Qiu's expectations.
How many plans did this Academician Xu prepare... As long as brain death has not been confirmed, can it still be saved?
No, with Xu Qiu's medical skills, even brain-dead patients have to be caught and shocked twice...
"Doctor Xu, what do you think?" Kong Lan has given up thinking at this moment.
It's not that her level is not good, but Tian Ling's situation is really beyond expectations.
Cheng Pingsheng also looked at Xu Qiu silently, but his hands under the table clenched unconsciously.
Unexpectedly, as the director of the burn hospital, I actually started to cling to other people's thighs...
But even Academician Kong doesn't care, so what's a small director like me?
The others also looked at Xu Qiu at the same time.
A steady voice also sounded at this time: "In fact, whether it is sepsis or septicemia on the wound surface, prevention is the main thing. Tian Ling has a deep and large-area burn. At the peak 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 formation of an antibiotic protective barrier in the extracellular fluid under the scab, which plays a certain protective role against the infected wound.
This kind of protection is better than nothing for ordinary people, but for burn patients who have lost their skin protective barrier and whose first line of defense is almost collapsed, it is tantamount to the last straw.
Of course, the theory is good, but the reality is that Tian Ling eventually suffered a large-area serious infection.
However, this does not mean that Xu Qiu's plan failed, because if this method was not used, Tian Ling would not have survived the shock period and might have died in the outbreak of various surging infections.
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 it happen!
In contrast, the people in the emergency department of Linyi were not so surprised, but they were the most shocked - their own Director Xu's body was really resistant. He stayed up late to work 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 surprised 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 has become Tian Ling's life-saving magic medicine.
However, at this moment, everyone's expression was not good.
The reason is very simple... The use of this drug is very restricted!
It has serious damage to kidney function and can only be used for seven days at most, otherwise the kidney failure will be irreparable!
Whether it is to let the infection develop or to use polymyxin to fight the infection, both are almost 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", just "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 hard to save... 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 fell into a deadlock.
Use it or not?
No matter which choice you make, you may regret it.
In the end, it was Xu Qiu who took on the responsibility. He knocked on the table and said decisively, "Let's not talk about whether he can be saved or not. The only thing that works right now 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 he will die on the spot.
If you take a risk, you may be able to overcome serious drug-resistant bacterial infections. If you can reverse the bacterial infection indicators, everything will be fine. If not... then it will buy time for the doctor.
However, only Xu Qiu dared to say this.
After all, for most doctors, the so-called treatment and saving lives is to deal with the disease 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 follow the procedures.
For this part 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 a better backup method after the treatment fails!
After finalizing this treatment policy, the next step is other measures.
There is nothing to discuss about nutrition, support, wound treatment, etc. Just fill in the 4,000 kcal daily calorie deficit.
For the others, intramuscular injection of immunoglobulin, subcutaneous injection of transfer factor, and infusion 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 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 use of polymyxin, the patient's kidney indicators were so poor that they could no longer be supported. Creatinine, urea nitrogen, uric acid, etc. all showed that the patient's renal failure was about to reach a dangerous critical point!
And a more suffocating news also reached Xu Qiu's ears at this time.
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