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Wei Shi Liang
Intensive Care Unit
About me
Graduated from Shanxi Medical University with a degree in Clinical Medicine in 2006, and has been working in the field of Critical Care Medicine ever since.
Proficient in diseases
Treatment of severe infections, ARDS, severe trauma, MODS, and other diseases.
Voices
Can arrhythmia be cured?
Arrhythmias come in many types, most of which are curable. Once arrhythmia occurs clinically, an electrocardiogram should be performed as soon as possible to determine the type of arrhythmia. Common arrhythmias can be classified into tachyarrhythmias and bradyarrhythmias, and based on the location of occurrence, into supraventricular arrhythmias and ventricular arrhythmias. Clinically common are supraventricular arrhythmias, such as sinus tachycardia, junctional tachycardia, along with atrial tachycardia, atrial fibrillation, and atrial flutter. These generally do not affect the stability of hemodynamics and are relatively easy to treat. On the other hand, ventricular arrhythmias such as ventricular fibrillation, ventricular tachycardia, and sinus arrest are clinically challenging to cure and require aggressive resuscitation.
Hypokalemia can cause
Hypokalemia can manifest as weakness, a bitter taste in the mouth, lack of appetite, irritability, or mood swings. In severe cases, symptoms like nausea, vomiting, drowsiness, reduced orientation ability, and confusion may occur. In terms of muscle and nerve effects, hypokalemia leads to decreased neuromuscular excitability, and when blood potassium levels fall below 2.5mmol/L, clinical symptoms of muscle weakness appear. If blood potassium levels drop below 2.0mmol/L, flaccid paralysis and disappearance or weakening of tendon reflexes may occur. In severe cases, paralysis of the respiratory muscles and even respiratory failure might develop. For the gastrointestinal tract, common symptoms include lack of appetite, nausea, and vomiting, with severe cases leading to intestinal paralysis. Hypokalemia can cause an increase in heart rate and even ventricular fibrillation, which can be fatal. Additionally, it can result in metabolic alkalosis. Hypokalemia can cause metabolic alkalosis, and vice versa, with each condition potentially leading to the other, often coexisting simultaneously.
What medicine should be taken for hypokalemia?
The treatment of hypokalemia primarily involves addressing the underlying disease. Symptomatic treatment should avoid excessive potassium supplementation, which can lead to hyperkalemia. The principle of potassium supplementation is as follows: for mild hypokalemia, such as in patients showing clinical signs, oral potassium can be administered at 40-80 millimoles per day. For patients with severe hypokalemia, or those whose gastrointestinal tract cannot utilize potassium, with potassium levels less than 2.0 millimoles per liter, intravenous potassium can be provided. An initial supplementation rate of 10-20 millimoles per hour is relatively safe. In cases of severe hypokalemia with life-threatening clinical signs, a rapid increase to 40-80 millimoles can be achieved in a short period, but close monitoring is necessary.
How to deal with hypertensive emergencies
Hypertensive emergency is characterized by a significant increase in blood pressure, often with diastolic pressure greater than 130 mmHg. Target organs including the brain, eyes, heart, and kidneys are severely compromised or fail. Hypertensive emergencies require admission to the CCU for cardiac monitoring and the use of intravenous antihypertensives. In the initial one to two hours, the reduction in blood pressure should not exceed 25% of the peak value. Control blood pressure within two to six hours and stabilize it at 160/100 mmHg. Commonly used antihypertensive drugs include sodium nitroprusside and nitroglycerin, while avoiding the use of nifedipine-like drugs for blood pressure reduction.
Can bronchial asthma be treated with nebulization?
Patients with bronchial asthma can undergo nebulization, especially pediatric asthma patients who are more suited for nebulizer therapy. Nebulization inhalation is currently a safe and effective method for treating childhood asthma and is listed by the World Health Organization as the first choice for global asthma prevention and treatment. For severe asthma during acute exacerbations and attack periods, nebulization therapy is not recommended. When using nebulization therapy, it is important to regularly disinfect the nebulizer and replace it periodically. During severe bronchospasm, it is important to avoid using excessive doses of receptor agonists, and care should be taken to avoid too low drug concentrations during nebulization, as it is not conducive to the effectiveness of the treatment.
Symptoms and signs of subarachnoid hemorrhage
The typical symptoms of subarachnoid hemorrhage include headache, vomiting, and sudden severe pain, accompanied by vomiting, pale complexion, and whole-body cold sweats. Additionally, there may be disturbances in consciousness and psychiatric symptoms. Most patients do not experience disturbances in consciousness, but may exhibit restlessness and agitation. Severe cases can show varying degrees of clouded consciousness, and even coma, with a few instances displaying seizures and psychiatric symptoms. Furthermore, signs of meningeal irritation are also present, particularly common and pronounced in young and middle-aged patients, characterized by neck stiffness, headaches, and vomiting.
Can severe pancreatitis be cured?
Severe pancreatitis can be cured, but because its complications are severe, it may be life-threatening. Severe pancreatitis is caused by a variety of etiologies leading to local inflammation, necrosis, and infection of the pancreas, accompanied by systemic inflammatory responses and persistent organ failure. Currently, comprehensive treatment for severe pancreatitis has become very mature, but its mortality rate is still as high as 17%. Currently, with a deeper understanding of the pathology, physiology, and disease progression of severe pancreatitis, there have been advances in treatment modalities, treatment concepts, and means of organ function support for severe pancreatitis. However, the mortality rate for severe pancreatitis remains high, though it can still be cured.
Two major signs of severe pancreatitis
In patients with severe pancreatitis, physical examination may reveal abdominal distension with tympanic percussion sounds, prominent tenderness in the upper middle abdomen, and potentially widespread abdominal pain centered in the upper middle area. Some may exhibit rebound tenderness, moderate muscle tension is common, and a few cases may demonstrate shifting dullness. Occasionally, a mass in the upper middle abdomen can be palpated, possibly due to fluid in the lesser sac. Auscultation may reveal diminished or absent bowel sounds, accompanied by cessation of passing gas or stool, indicating features of paralytic ileus.
Symptoms of severe pancreatitis
The main symptom of severe pancreatitis is abdominal pain. This type of abdominal pain manifests as intense pain in the upper-middle abdomen, which radiates to the back and both sides of the body. The pain is widespread and severe, with about 95% of patients experiencing abdominal pain. Onset often occurs following binge eating or excessive drinking, and the pain worsens after eating. Another symptom is abdominal distension, which is also a common symptom. It is caused by extensive effusion in the abdominal cavity and retroperitoneum, as well as intestinal paralysis. Fever in the early stage of the disease is also a common symptom, resulting from the absorption of a large amount of necrotic tissue. Fever occurring in the later stages is often caused by infections triggered within the abdominal cavity.
Prevention and Treatment of Bronchial Asthma
The prevention and treatment of bronchial asthma mainly involve the following aspects: First, eliminating the causes and triggers of the disease; second, preventing diseases and pests such as allergic rhinitis and gastroesophageal reflux disease; third, immunomodulation; fourth, routinely checking if inhaled medications are used correctly; fifth, education and management of asthma patients, mainly allowing them through long-term, appropriate, and sufficient treatment to fully and effectively control asthma attacks. Additionally, understanding individual differences in asthma triggers to avoid occurrences, learning patient self-monitoring of disease progression, mastering the use of inhalers and peak flow meters, and educating patients on simple self-help methods are essential. It's important for patients and doctors to jointly develop a plan to prevent asthma attacks and maintain long-term stability. These are the basic elements of the prevention and treatment of bronchial asthma.