"The fourth trial version of the diagnosis and treatment plan has come out." Sun Lien was having breakfast in the restaurant, and Professor Li Chengping held his bowl and put it on the table next to him. In order to talk to Sun Lien without violating the relevant prevention and control regulations, Professor Li took a lot of effort, "Director Sun, have you seen it?"

"I saw someone posted it in the work group." Sun Lien nodded, took a sip of white porridge and said, "But I haven't looked carefully yet. I plan to take a look after it after I go back."

"The fourth version has changed a lot." Professor Li pulled down his mask, took a sip of the soy milk in his bowl and said, "The forward movement of the barrier we have always advocated has also been reflected this time - if patients have not improved non-invasive mechanical ventilation for two hours, they should consider directly using invasive ventilation."

"So radical?" Sun Lien was shocked when he heard this. In the North Five District, the current treatment strategy is for patients to use non-invasive mechanical ventilation within 12 hours, and the blood oxygen saturation is lower than 94% to consider air-stomaching for invasive mechanical ventilation. The fourth edition directly relaxed the conditions to the level of "air-stomaching without improvement".

"What should I do if I'm not radical?" Professor Li shook his head and sighed, "I have led the team for a few days. My biggest feeling is that my past experience seems to be useless. Many patients clearly see that their physical signs are pretty good, but they suddenly worsen."

"The vital signs are almost impossible to count now." Sun Lien sighed, "Director Huang sent a patient away yesterday, which is said to be a rare silent hypoxemia."

"I haven't heard this." Professor Li himself is also a respiratory medicine doctor. After thinking about it for a while, he asked, "Is it asymptomatic hypoxic blood?"

Sun Lien flipped through his phone and confirmed it, "It seems to be."

"Some people are naturally tolerant of hypoxemia, right?" Sun Lien's answer made Professor Li curious. In his opinion, although clinically rare, there are not many patients who can tolerate hypoxemia and have no symptoms. "How did this silent hypoxemia come about?"

"Director Huang's team sent away two patients, all of which were like this." Sun Lien replied, "The patients' blood oxygen saturation is only 80%, but they have almost no discomfort symptoms. They can even lie in bed and play with their mobile phones, have a clear awareness, and have no problems such as dizziness - they once thought there was something wrong with the instrument monitoring pulse oxygen."

Asymptomatic hypoxemia is not lacking, but the number is indeed very small. According to Professor Li's experience, such patients are more likely to appear in obstructive sleep apnea hypopnea syndrome. During sleep, the patient's blood oxygen saturation will drop to 60% or even lower. After awakening, some patients' blood oxygen saturation will rebound slowly. However, such patients have basically no other problems except fatigue. In the hospitalization department of an affiliated hospital, Professor Li has seen many patients with blood oxygen saturation of only more than 70%, and they can still talk and talk like those who are fine and play with their mobile phones.

But the silent hypoxemia that occurs due to the novel coronavirus infection... is really an example I have never seen before. A patient with normal blood oxygen has fallen rapidly due to viral pneumonia due to viral pneumonia and still has no symptoms at more than 80%... This makes no sense.

"Teacher Li, if you are interested, I will ask Director Huang to send the patient's case?" Sun Lien drank the white porridge in front of him in a few sips and began to chew bread. "Director Huang attaches great importance to this situation. She feels that this situation may be related to the infection of the new coronavirus."

"I have never heard of it before. When Yunhe came, he met two in one breath. It's not surprising that he had this guess." Li Chengping nodded and said, "I'll turn around and contact Director Huang and ask if I can get a case."

"I hope this symptom is not a common situation." Professor Li stopped the movements in his hand and frowned. "Difficult breathing is one of the most common complaints that our respiratory patients come to see the doctor. Chest tightness, shortness of breath and asthma, and when they reach a certain level, they will be subjectively considered by the patients to be dyspnea... But if there is no dyspnea, many people may not know that they are infected."

Sun Lien also became nervous. He put down the bread in his hand and was silent for a while before shook his head, "It's useless for us to have a headache. Even if we want to do scientific research now, it's useless."

Speaking of scientific research, Professor Li Chengping suddenly felt enlightened, "I heard that Xiao Sun, is the first in our province to create a high-precision PCR kit?"

"The main reason is that my supervisor is more reliable." Sun Lien replied very honestly, "I usually do not exist except for orders and asking for money."

"Awesome." Professor Li directly regarded Sun Lien's honesty as modesty. He gave a thumbs up and sighed, "You have a lucky general." He blinked and asked, "Yesterday, someone from the Hunan Provincial Health Commission called me and asked me about to tucizumab."

"Did they agree?" Sun Lien immediately felt energetic. Tocilizumab seemed to be one of the most promising drugs to improve the condition of severe patients.

"The report has been submitted to the National Health Commission, and it is estimated that there will be a reply today. I personally think it is very likely to pass it." Li Chengping said with a smile, "Tocilizumab is an old drug, and we have a relatively sufficient understanding of it. At least its drug safety is recognized - but I think the superiors may not immediately agree to carry out extensive clinical applications."

The three words "wide" reminded Sun Lien, "Then... can we at least conduct a pilot study in the North Five Districts first?"

"I support you anyway." Li Chengping nodded, "Old Li, I have only one idea now. As long as it can improve the situation of critically ill patients, I can do anything. Anyway, I feel that Chinese medicine has been introduced, so it doesn't matter if I use tocilizumab!"

Sun Lien's view on traditional Chinese medicine is more open, "Anyway, I used traditional Chinese medicine injections when I was sick when I was a child. Who has never taken traditional Chinese medicine and patent medicine since I was a child? If you can use medicine for patients, they will feel more comfortable and we can feel better."

"No wonder Dean Song had to let you be the team leader, and his ideological awareness was very high!" Professor Li laughed twice, "I heard that there are experts who specialize in traditional Chinese medicine coming from the capital."

"My biggest hope now is not to let us boil Chinese medicine." Sun Lien was quite interested in the news, but at the same time he was a little anxious. "You all started moving oxygen tanks yesterday. If you still have to carry Chinese medicine tanks, then we will be exhausted."
Chapter completed!