Returning to ’90s, She Became Famous in Major Surgical Fields

   Chapter 1987 [1987] As expected

  What's so scary about atelectasis?

   The alveoli are not open and there is no gas exchange, indicating that the patient is severely hypoxic and even suffocated to death. The symptoms of hypoxic asphyxia are called respiratory distress syndrome, or RDS in English. In adult patients, it is called adult RDS, or ARDS for short, plus an A. Neonatal respiratory distress syndrome is NRDS, plus an N. Why the two should be separated, because the causes of respiratory distress syndrome in adults and neonates are not the same.

  Adult ARDS, like the SARS that left a deep impression on us, is mainly caused by severe infection. In the lungs of patients with severe infection, the virus has inactivated a large number of alveolar surfactants referred to as PS, and the alveoli collapsed.

   At the same time, a large amount of mucus is produced, which can block the bronchus, causing mechanical obstruction of the bronchus that cannot be eliminated, and eventually leads to severe hypoxia and death of the patient.

  The treatment plan is definitely to fight infection first. In the absence of a specific drug for a certain virus, the effect of anti-infection can only be greatly reduced, and the doctor's method is only physical solutions such as bronchoscopy and back-patterning and expectoration. These last life-saving measures become especially important in the rescue of such patients. So this kind of ward needs a lot of nurses to assist in rescue. The rest, can only rely on the patient's own immune system to fight infection. However, relying on the patient's own immune system to fight infection has another fatality. It is the immune storm that we can hear from doctors, and it is also one of the important causes of death for such patients.

   It can be seen that for patients with ADDS, the current medical means are limited, which has always made clinicians very afraid. In the event of a new respiratory virus infection such as SARS, we can only resort to more distant and ancient means such as isolation. No way, no medicine.

  In addition to infection, adult respiratory distress syndrome can be caused by traumatic foreign body inhalation and other factors. The same process is more dangerous and the fatality rate is high.

   In contrast, NRDS, neonatal respiratory distress syndrome mainly occurs in premature infants. The etiology of this kind of children can be traced back to a relatively single, and it seems to be more treatable.

  To understand the source of neonatal respiratory distress syndrome, we must first understand the mechanism by which a normal baby leaves the mother. First, the fetus is in the womb without self-breathing and the lungs are atelectatic alveoli that are not inflated. After birth, the baby needs to rely on the alveolar surfactant given by the mother to make the baby's lungs inflate automatically. Due to the lack of this substance, the alveoli cannot be inflated and opened, resulting in difficulty in breathing.

Going back to the lung-stimulating acupuncture that Dr. Hu said at the beginning of the discussion, the most commonly used drugs in clinical practice are hormone drugs such as dexamethasone, which use this mechanism of action to induce fetal lung type 2 cells to produce alveolar surfactant PS, ultimately avoid white lung to avoid respiratory distress.

The current situation is an emergency. The doctor failed to give the mother a lung booster in advance. As a result, the baby who was born early has symptoms of respiratory distress, as Dr. Hu said, which is expected by medical staff. .

   Now that I know that the baby is in respiratory distress due to the lack of this thing, can I directly give the baby alveolar surfactant? of course can. The question is where does this kind of thing exist in a small hospital.

   This medicine is expensive. In general hospitals that do not have a special neonatal department will not have such specialized precious drugs.

   (end of this chapter)

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