Senior Brother Luo next to him wanted to share with her his views on the expert lecture.

Xie Wanying said: "The intensive care unit is very important, but it is not the most important thing for surgery now."

Her statement always makes people surprised.

Everything should be paid attention to evidence, and it is best to be statistical data in medicine. Statistics from both domestic and foreign countries show that regardless of adults or children, the proportion of patients after surgical operations in the intensive care unit is relatively small.

The biggest benefit of surgery is surgery. If the surgery cannot be performed, it is basically a hope and requirement for the patient to be transferred to the internal medicine department. So looking at the two, it shows that the intensive care unit may not be the most important thing for surgery.

What is specifically reflected in? Look at the various surgical departments. I heard that even the external neurosurgery is planning to build an intensive care unit with a special area for neurosurgery similar to the external heart area, and place it in a newly built surgical building. Setting up an intensive care unit in your own department means that the proportion of intensive care after surgery is not high, the number of bed requirements is not large, and there are even no special IICU doctors.

In this case, each department takes the maximum benefit as the premise, and the money is not distributed to the intensive care unit to earn. Moreover, most of the patients admitted to the intensive care unit are acute patients who come in from the emergency department. Even if this kind of patient cannot say whether he can undergo surgery before the operation, he may not be classified as surgical patients. In fact, some patients are like this. After entering the ICU directly, they die and cannot survive the surgery.

Xie Wanying once again gave an example: "The first critically ill children admitted to PICU are respiratory diseases. Then there are neurological diseases and postoperative children. Among them, children who are involved in the field of surgery, probably only some of which are cardiogenic. If pulmonary, most of them belong to internal medicine treatment. The two major diseases of cardiogenic respiratory diseases and neurological diseases are both major specialties in surgery, cardiac surgery and neurosurgery. The pediatric surgery department of our hospital should be based on pediatric generals. This is not long in hospitalization in the intensive care unit and has a high bed turnover rate. If the preoperative assessment is done well and the surgical risk is controlled well, I believe the hospital's judgment is that it only needs to establish several intensive care beds similar to the cardiac special area in the pediatric external ward."

In this way, if you listen to what Expert Li said on stage, if you don’t think about it carefully, you may be biased. Judging from the data, the significance of PICU is of great significance to children with critical illness, but it is not necessarily of great significance to pediatric surgery.

"For surgery, the most important thing is to do a good job in preoperative assessment, prevent postoperative risks, and do a good job in the operation. It will be too late to repair the dead after the operation." Xie Wanying expressed her basic understanding of surgery.

In addition, the intensive care unit is now equivalent to a big basket, and patients who cannot handle any department will be sent there to stay there for a few days. But in fact, many medical technologies in the intensive care unit require support from specialists. The simplest example is that intubation of the ventilator requires anesthesiologists. Thoracic drainage requires external cardiothoracic. Peritoneal dialysis is required, and ECMO requires the assistance of surgeons. Bronchoscopy can be treated with endoscopy. Some ICU doctors cannot do it and have to ask doctors from the respiratory department and other departments to do it.
Chapter completed!