Chapter 411 Let’s get started
Under the guidance of fighter jets, the plane entered the sky over Alaska, made contact with the Fairbanks Airport tower, and landed smoothly.
The manager of the airport boarded the plane with several staff members, expressed his intention to Yang Ping, and led Yang Ping to transfer to the prepared special plane, which would fly directly to Houston.
They were very warm and considerate. I heard that there were three of them and they prepared three coats for Yang Ping and the others to temporarily avoid the cold. It was still quite a distance from one plane to another. They had coats to keep them warm on the way so that they would not suddenly feel too cold.
Fairbanks is close to the North Pole, and the average air temperature throughout the year is relatively low. It is indeed very cold when you get off the plane.
International space emergencies are now the hottest news in the United States. Even as far away as Fairbanks, no one knows about it.
After learning that Yang Ping would go to Houston to participate in the rescue of Steven on the International Space Station, the black manager told Yang Ping that after completing the mission, he would definitely come to Fairbanks to play. He would take everyone to see the Northern Lights and treat everyone to red wine. Venison and king crab, and enthusiastically left Yang Ping his phone number.
The sky was already getting a little dusky, so everyone was racing against time, not daring to waste time, and immediately boarded the special plane and rushed to Houston.
When we arrived in Houston, it was already late at night. Jim Bartha took Johannessen and several officials waiting at the airport.
This is the world's top expert recommended by Mayo Johannesson. He is even better than Johannessen. The person whom Johannessen regards as his teacher is not as well-known as meeting him. He really has an extraordinary temperament.
With Johannesson's status in neurosurgery in the United States and his strong recommendation of Yang Ping, Jim Barsa dared to rely on Yang Ping to give it a try.
The commercial vehicle drove them quickly to Space City, the ground control center of the Johnson Space Center, where lights were on all night.
The emergency rescue team has set up camp beds here. If you want to rest, you can lie down for a while. Everyone takes turns to work around the clock.
Yang Ping walked into the lobby of the ground control center. The large and small screens, busy staff, and the sound of typing on the keyboard all reminded that this was the communication center between the United States and the International Space Station.
I heard that Dr. Yang had arrived, nearly a hundred people including doctors, engineers, and ground control center staff.
Finally I saw this expert whom Johannesson highly praised, but he was much younger than expected.
In extraordinary times, no time was wasted on introducing each other, and the condition was communicated many times. Johannesson got straight to the point and brought Yang Ping to a screen, and the doctors gathered around him.
"The blood pressure is 85/40mmHg, and the heart rate is 38 beats/min. Currently, nifedipine is used for controlled blood pressure reduction, and an ice cap is used to cool the head." Johannesson said the most important thing.
As soon as Yang Ping sat down, he got into the mood. He had already reviewed Steven's medical records on the plane, and now he was just reviewing them.
On the special plane to Houston, Yang Ping had already copied Steven's experimental body in the system space and performed simulated surgery. The powerful copying ability of the system space could not only copy the case, but also the surgical equipment and environment.
Yang Ping has simulated two scenarios, using telemedicine surgical equipment and performing surgery directly on the space station.
It was also the first time for Yang Ping to encounter such a strange case. In the history of mankind, Steven was probably the first astronaut to require surgery in space. There were many things to explore.
"This is a whole-brain DSA done by our astronaut Dr. Susan on Steven on the space station. The imaging quality is not very good." Johannesson opened the DSA picture.
"The image quality is too poor, but it is enough to diagnose a small aneurysm. This artery is too dangerous. It passes through the heartbeat center of the medulla oblongata. Once it explodes, it will be fatal immediately. Interventional surgery must be performed immediately to embolize the aneurysm." Everyone is a doctor, or A first-class doctor, Yang Ping goes straight to the point without making any detours.
"The physical examination on the ground, MRI and CT cerebral angiography, found no abnormalities. It should be an occult cerebral aneurysm. The first symptom was a slowed heart rate. Only a few days ago, I had headaches, dizziness, and a feeling of hypoxia and suffocation." Johanne Sen continued to describe the condition.
"Yes, occult cerebral aneurysm. In a microgravity environment, the normal gravity on the earth is lost, and the venous return of the head becomes difficult, causing relative venous stasis and arterial congestion. Occult aneurysms appear under higher blood pressure. , it interferes with the heartbeat center and causes myocardial depression. This is central myocardial depression. Surgery must be arranged as soon as possible. What drugs, equipment and medical conditions are available on your space station? Give me a detailed list, hurry up!" Steven couldn't wait for the lecture.
Interventional surgery is necessary. It would be better if there are drug-loaded microspheres in this regard, especially flexible stent drug-loaded microspheres, which absorb coagulation drugs and deliver them to the location of the hemangioma. The coagulation drugs carried by the microspheres gradually trigger the coagulation mechanism locally. When a thrombus is formed and there is no blood flow through it, the aneurysm will naturally not be impacted by the blood flow, and there will be no rupture. After two weeks, the thrombus will become an old thrombus and its stability will increase. It can withstand the high-speed fall zone when returning to Earth. The impact comes.
Companies with relatively mature drug-loaded microsphere technology include British Biocompatibles, American BioSphere, and Chinese Hengrui. Their embolization microspheres DCBead, HepaSphere, and CalliSpheres are all used to treat liver cancer through ionic bonds (mainly) and hydrogen bonds. The effect is combined with anthracyclines and can be accurately quantified. After reaching the lesion, the drug is slowly released through the ion exchange mechanism.
If the microspheres can carry coagulation drugs such as thrombin, they do not need to be released, allowing them to act locally at the target site.
Some companies' laboratories are currently studying such microspheres, but Yang Ping does not know whether they can be developed for clinical use.
Without such microsphere products, embolization can only be performed using traditional coils.
Metal spring coil embolism has subsequent risks. After the aneurysm crisis is resolved, Steven will always return to Earth and cannot stay on the space station for the rest of his life. Falling at high speed when returning to Earth, once the spring coil moves in the brain, it is also life-threatening.
Therefore, the second method, coil embolization, after controlling the condition, in order to successfully survive the high-speed fall, a craniotomy is required to ligate the artery.
Whether to perform a craniotomy or brainstem surgery on the space station is simply a fantasy.
After Yang Ping introduced his idea, he hoped to use the first method to get it done in one go, which is simple, safe and minimally invasive. "No matter which method, I want to know the success rate?"
Professor Massimo remained silent. He was disgusted with Yang Ping's confidence.
"This is Professor Massimo, director of the Interventional Department at Johns Hopkins." Johannessen acted according to the situation and introduced someone who needed to be introduced.
"Hello, Professor Massimo!"
Many of the classic interventions that Yang Ping has seen in the system space are his works, and the latest micro spring coils that are currently leading the industry are also designed by him.
But now Yang Ping is in no mood and has no time to praise him.
"Success rate? If there must be a definite number, it would be more than 80%." Yang Ping could only give a rough estimate.
"Eighty percent?" Massimo almost couldn't help but laugh on the spot. Even a magician didn't dare to brag like that. Whoever Johannesson hired was a magician, even if it was said to be thirty or forty percent, Massimo was willing to listen.
"What's wrong? Professor, what did I say wrong?" Yang Ping thought his expression was too exaggerated.
"You're right, maybe I heard wrongly. How many intervention cases has Dr. Yang performed on this type of patient?" Massimo asked in a questioning tone.
At this time, every second counts. The aneurysm in the sky might explode at any time, and you are still arguing with me.
"Professor Massimo! Are you doubting my surgical ability? I don't have time to accept your questioning. You invited me to come to Houston to accept your questioning? Or to help deal with the crisis. If it is the former, I don't have the leisure. I believe You don't either. Now you either have to listen to me or you can solve the problem on your own and help me buy a ticket. I will go back to China immediately. "Yang Ping is a little impatient. It's a life and death situation, so I don't have time to talk nonsense to you.
Jim Basa felt that although Massimo's entanglement was reasonable, it was meaningless and inconsistent with the emergency scene at this time. With the endorsement of Johanathan and Mayo, there was no need for any suspicion, otherwise he would not be hired.
"The technical implementation of medical rescue must follow Dr. Yang Ping's command and does not accept refutation or debate." Jim Basa stabilized the situation.
"We immediately contacted BioSphere and asked if there were drug-loaded microspheres for coagulation drugs." Alpha, NASA's chief medical officer, took immediate action.
The emergency rescue team is directly appointed by the president, with Jim Bassa as the team leader. In extraordinary times, all resources can be dispatched.
This kind of flat crisis management, where resources are directly dispatched by the rescue team, is very efficient.
After a few phone calls, it was quickly confirmed that the drug-loaded microspheres for coagulation drugs studied by BioSphere have not yet been successful and cannot meet clinical requirements. Currently, they only have microspheres for the treatment of liver cancer.
Then, you can only use spring coil embolization to solve the most urgent problem first, and then study the subsequent problems.
"Professor Massimo has more sophisticated intracranial interventional equipment." Dr. Eugene reminded everyone.
"If necessary, we can launch another rocket to send the equipment up, but it will take eight hours." Richard felt that rockets could be launched at a high density.
"Eight hours is too long. Steven can't last that long." Yang Ping rejected this plan. His simulated surgery and pathological anatomy were very accurate in judging Steven's condition.
"The Russians can send it up in three hours."
"The stuff is in the United States, their rockets are in Kazakhstan."
"Let's get started! For direct surgery, use your existing instruments and prepare to open the remote surgery system." Yang Ping prepared to operate overnight.
Once it's tomorrow morning, Steven won't need resuscitation and the aneurysm will rupture.
An 80 percent success rate, Yang Ping was referring to using a remote surgical system.
All the doctors were stunned. The remote surgery system had uncertain communication delays and interruptions. The space station also made the surgical objects unstable for various reasons.
In this case, intervention is required, involving the small arteries of the brainstem. Not to mention interruption of communication, any delay will cause the blood vessel to be pierced, leading to immediate death.
But now he is the only one who has confidence, and there is no other way.
(End of chapter)