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Li Qiang
Intensive Care Unit
About me
Graduated from the Department of Clinical Medicine at Peking University Health Science Center in 1996 with a bachelor's degree. Appointed as an attending physician in the Beijing Health Bureau system in 2001. In 2011, became the chief physician and associate professor in the Critical Care Medicine Department at Peking University Third Hospital. Pursued a master's degree in Surgery at Peking Union Medical College from 2002 to 2005. Published over thirty papers as the lead author in domestic core journals, including three articles in SCI journals.
Proficient in diseases
Proficient in the diagnosis and treatment of critical illnesses such as severe cervical spinal cord injury, various types of shock, severe infections, multiple severe traumas, acute respiratory distress syndrome, acute severe pancreatitis, multiple organ dysfunction syndrome, and critical obstetrics and gynecology pathologies. Skilled in techniques such as cardiopulmonary resuscitation, tracheal intubation, tracheotomy, central venous catheterization, fiberoptic bronchoscopy, hemodynamic monitoring (Swan-Ganz catheter, PICCO hemodynamic monitoring), and blood purification. Able to proficiently handle the rescue and treatment of critically ill patients in departments such as general surgery, orthopedics, urology, obstetrics and gynecology, cardiovascular surgery, gastroenterology, neurology, hematology, and emergency medicine.
Voices
Is it necessary to perform a tracheotomy in the late stages of ALS?
Patients in the late stages of amyotrophic lateral sclerosis (ALS) must undergo a tracheotomy because, by this stage, they have completely lost their motor abilities, including the muscle strength needed for breathing. Consequently, they lack the strength to breathe on their own, leaving them unable to survive without a ventilator. They must rely continuously on a ventilator to breathe as they cannot do it themselves. Therefore, if a ventilator is needed over the long term, a tracheotomy is necessary. This is because other methods, such as inserting tubes through the mouth or nose into the trachea to connect to the ventilator, are quite uncomfortable. Comparatively, tracheotomy offers a bit more comfort, making it a necessary procedure for connecting to a ventilator for long-term use and achieving greater comfort.
Why does pulmonary embolism cause cardiac arrest?
The mechanisms causing cardiac arrest due to acute pulmonary embolism mainly encompass several aspects. One is a large-scale acute extensive pulmonary embolism, which prevents the blood from being ejected from the right heart, potentially leading to acute right heart failure. At this time, the entire body's blood circulation will encounter issues. Another scenario is that following the pulmonary embolism, it causes severe hypoxia. This hypoxia can lead to oxygen deficiency in all organs of the body, including the heart. The coronary arteries that supply nutrients to the heart can also become ischemic. Both of these factors can cause the heartbeat to lead to sudden cardiac arrest. These are the primary mechanisms that can cause a sudden stop in the heartbeat.
What to do with respiratory failure in the late stage of amyotrophic lateral sclerosis?
Amyotrophic Lateral Sclerosis (ALS) is an irreversible disease, also known as motor neuron disease. Its motor function deteriorates progressively and irreversibly. Therefore, in the advanced stages, respiratory failure can only be managed with the help of a ventilator, which assists the patient's breathing mechanically. Consequently, patients typically require a tracheotomy in the late stages of the disease. Once connected to a ventilator via a tracheotomy, the ventilator becomes a permanent necessity. If at any point the ventilator is stopped, the patient would die due to lack of oxygen and the accumulation of carbon dioxide in the body. Therefore, they must wear the ventilator for life. Inevitably, this leads to respiratory-related complications, such as lung infections.
Can pulmonary embolism result in a vegetative state?
After a pulmonary embolism, if it is an acute and extensive embolism and not treated promptly, it can lead to severe hypoxemia. If hypoxemia is not addressed quickly and persists, it will affect the oxygen supply to vital organs throughout the body, including the brain. The brain is the organ most vulnerable to oxygen deprivation. If there is complete lack of oxygen for just four minutes, irreversible damage occurs to the cerebral cortex, and the patient will not wake up, leading to a vegetative state. Therefore, in cases of acute extensive pulmonary embolism, if treatment is delayed, there is a significant risk of the patient entering a vegetative state, and the mortality rate is also very high. Many patients may experience sudden death.