Chapter 2172: Chapter 2172: Maintaining Balance
While thinking, she walked to the ward.
At the entrance of the ward, there was a chair, and after finishing his meal, Dr. Yuh sat on it with his arms crossed, his head like a chick pecking at rice, tapping his forehead against his folded arms.
After a busy day, the young resident doctor was exhausted beyond relief, so he took a nap whenever he wasn’t working.
Anyway, there was another person in the ward.
Contrary to others, after resting up and recharging, Geng Yongzhe guarded the instruments showing the numbers and graphs, bright-eyed and not showing any fatigue.
Hearing footsteps behind him, Geng Yongzhe turned around and saw her, asking, "Why did you come back? I said I’d notify you if anything happened."
"I ate too much, just checking the patient’s condition before going back to sleep," Xie Wanying said.
Indeed, it’s hard to sleep when overly full. Shouldering with her, Geng Yongzhe began discussing: "The patient’s vital signs are relatively stable now."
Hearing this, Xie Wanying asked, "How is the patient’s clotting situation?"
Clotting situation?
Some surgical issues might not be viewed the same by outsiders. One point, likely unforeseen by the general public, is that doctors not only fear excessive bleeding during and after surgery but also worry about high coagulopathy and thrombosis during and after. A patient’s death can sometimes be due not to hemorrhagic shock but to conditions like DIC disseminated intravascular coagulation or a thrombosis suddenly blocking a vital organ location.
During pre-surgical team discussions for this patient, doctors generally perceived him as being in a hypercoagulable state, causing artificial valve thrombosis, so heparinized large doses of anticoagulants were used during surgery to try to balance anticoagulation and hypercoagulation. These anticoagulants’ efficacy and post-surgery duration need consideration. Whether additional anticoagulation is required—all crucial points to consider.
Having not done rounds in cardiothoracic surgery, never witnessing a heart surgery first-hand, Geng Yongzhe was unfamiliar with such operations and upon hearing her pointed out issues, he pondered, saying: "I remember reading that extracorporeal circulation in heart surgery can cause a hyperactive fibrinolytic system in the blood, leading to postoperative bleeding and thrombosis."
Student Geng is an excellent medical student who studies diligently and remembers everything he can, quickly relating back to relevant knowledge.
"Yes, yes," Xie Wanying nodded, saying, "Generally speaking, after heart surgery, antifibrinolytic drugs are administered on the same day."
Geng Yongzhe was puzzled: "Yingying, you said antifibrinolytic drugs are used on the day of heart surgery—is this a common strategy post-heart surgery?" This knowledge point seems not mentioned in textbooks.
Having been to Guoxie’s cardiothoracic department observing such scenes and witnessing her cousin operate in Guo Zhi Hospital, Xie Wanying had some personal conjectures and thoughts, saying: "Whether it’s a standard departmental treatment plan, I’m not sure since I haven’t communicated much with cardiothoracic teachers. But I’ve witnessed its use in their department."
Such ward scenes hadn’t been observed by Geng Yongzhe before, suddenly surprised by how she attuned herself to discovering problems everywhere. Medical students usually learn in the ward by being guided into whatever the teacher says. Independent critical thinking to pinpoint issues is difficult for medical students due to a lack of clinical experience and knowing where to focus.
Of course, having a different perspective than other medical students is because Xie Wanying is reborn. Whenever it involves laboratory blood tests and related aspects, this was her domain before rebirth, making it hard for her not to notice.
