How to Resuscitate Patients with Colon Cancer Multiple Organ Failure?

  The patient, Mr. Yue, 60 years old, was discharged from the hospital with complete obstruction of colon cancer with ileal rupture, diffuse peritonitis, infectious toxic shock, ARDS, DIC, etc. Our general surgery department, together with gastroenterology, manual anesthesiology, intensive care unit (ICU), blood transfusion department and pharmacy department, overcame many difficulties and finally overcame every obstacle, and the patient was discharged from general surgery recently. The family sent 5 banners to express their gratitude to the relevant departments of our hospital! The successful treatment of this patient shows that the level of critical care in our hospital has reached a new level, reflecting the team spirit of unity and cooperation among multiple departments and the doctor’s heart of saving lives and helping the injured without fearing difficulties and taking risks.  The patient’s illness coincided with the November holiday and her condition was extremely critical, she could barely maintain her blood pressure of 70/50mmHg and heart rate of 180 beats/min under the condition of almost extreme amount of two elevating drugs, so she was actually in a terminal state. The patient’s condition was extremely critical secondary to multi-organ failure, and surgery was the only way to save the patient’s life, but the risk was huge. After thorough and brief preoperative preparation, we decided to save the patient’s life by emergency surgery. With the consent of the family, the operation was started at 1:55 a.m. on October 8, 2013. 5000 ml of foul-smelling pus was found in the abdominal cavity during the operation, and the cecum cancer caused complete obstruction and rupture of the ileum, and a radical right hemicolectomy with one-stage anastomosis and abdominal drainage was performed. During the operation, the patient’s condition was extremely critical. Under the maintenance of antihypertensive drugs such as dopamine and norepinephrine, the heart rate continued to be 180-200 beats per minute and the blood pressure could only be maintained between 50-70/30-50 mmHg. The patient passed the surgical anesthesia level smoothly with high level of comprehensive anesthesia technology and dedication.  The patient was in severe infectious toxic shock, ARDS, DIC, and the platelet count dropped to 70,000 (normal 1 million to 3 million). Director Geng Yingjie, Dr. Shan Haifeng and all the medical and nursing staff of the department attached great importance to and carefully arranged the treatment and care plan, and successively passed the hurdles of maintaining body circulation (the daily intake was as high as 25,000ml), maintaining and restoring respiratory and cardiac functions, treating DIC and controlling infection, etc. The patient was successfully discharged from the ventilator 2 weeks after the operation, reflecting the strong professionalism and high comprehensive treatment level of critical illness. After returning to the general surgery ward, the whole department was able to provide a comprehensive treatment for the patient. After returning to the general surgery ward, all medical and nursing staff of the department paid great attention to the treatment and care plan, and solved the problems related to the subsequent thoraco-abdominal fluid, residual infection, bacterial resistance, dysbiosis, nutrition and incision healing one after another. Doctors such as Liu Zhixian, Zhang Qingde and Gao Qiang were highly responsible, reflecting a high level of responsibility and medical technology.  Director Saren of the Blood Transfusion Department paid great attention to the clinical urgency and, under the extremely tight blood supply, tried every possible way to provide the clinic with 1800ml of suspended red blood cells, 1400ml of platelets and 3600ml of plasma, which were crucial to the successful treatment of the patient. Zhang Yan’e, director of the pharmacy department, overcame difficulties and actively cooperated to provide strong drug security for this patient.  The successful rescue of this patient is the result of the unity and cooperation of many departments in our hospital, and is the result of the hard work and wisdom of countless medical and nursing staff, representing the continuous improvement of our comprehensive medical technology level.