Rewind

I wish I could report some improvement, but I can't. Instead, Andrew is back on the high frequency ventilator, which is a significant step back. He had an okay morning, but in the afternoon he spiked another fever and had an elevated pulse, blood pressure, and CO2. Even with additional sedatives, there didn't seem to be any abatement. After two bad blood gases (high CO2, but more importantly, low pH), they decided to try the hi-fi. They also put him on a constant sedative drip, which we have been expecting ever since they started him on the paralytic. Without appropriate sedation, he could be awake and distressed, but not able to show it through the paralysis; having the drip makes sure he's comfortable at all times.

Generally, Andrew responds pretty well to the hi-fi, and his CO2 quickly drops. This time, however, he wasn't as quick to improve. He had another bad gas, and they turned up the settings. After a breathing treatment, an airway suction, and a while on the new settings, he had much better results. Since we left, his heart rate and blood pressure have been relatively calm, likely due to the increased sedation. His gases have been up and down....not as high as they were today, but higher than they should be.

All the signs of infection are present, though it's still hard to pinpoint the source. His urine, blood, and airway seem to be clean, which rules out quite a bit. The thought is still that his digestive tract is the issue, but multiple x-rays haven't shown any perforation of his bowels. It's obviously affecting his respiratory status, but there's no known pneumonia or other specific lung ailment. At the moment, we're in wait-and-see mode....nothing seems to have gotten obviously worse, but it certainly hasn't gotten better, either.

A lot will depend on which direction the infection decides to go. If his fever (which is gone for the moment) comes back, it could cause further problems. If the infection subsides, we can turn off the sedation and return the focus to ventilator weaning again. The last few days have been incredibly emotional and stressful, and it may not get better any time soon. Though we hope for the best, we would not be surprised by a call from the NICU that says he's taken a turn for the worse.

Needless to say, we'll be checking in with the nurse quite often....at the last few checks, he has been nice and stable. Unfortunately, I can't update the blog after every call, so rest assured that everything is relatively calm unless I post otherwise.