Another Rough Night

Early in the evening last night, Andrew decided that he wanted to get upset, even though he's still sedated and paralyzed. His heart rate went up, his blood pressure went up, and his oxygen saturation went down into the 80s. It appeared as if perhaps the sedatives were wearing off, giving him the opportunity to feel uncomfortable or get cranky. They raised his dosage by a little bit, and that seemed to be effective. He had also just gotten weaned to an amplitude of 28 on the hi-fi ventilator, perhaps making him work a little harder, so they upped his oxygen for a while until he settled down, then turned it back down to 35%.

A few hours later, he had a similar desaturation, this time falling into the high 70s. He also had a bit of a runny nose, making the doctors worry a bit about infection. He's on an antibiotic, but they're concerned that it might be something unaffected by that particular antibiotic....either a different bacteria, or a viral infection. It also appeared that he may have spit up, and some may have gotten into his lungs (aspirated). They turned his amplitude back up to 30, but he eventually required even more support. By the morning, he was at an amplitude of 45 and oxygen around 66%. I haven't gotten any particularly good answers, but infection, aspiration, and airway issues are all possible concerns. A chest x-ray showed that his right lung was okay, but his left was retaining some fluid. As they want that lung to collapse anyway, they aren't too concerned at the moment.

He's having a better morning, and they're weaning his amplitude back down slowly, but the level of support is still quite high. They're waiting on blood and lung infection results, and they're getting a belly x-ray to make sure his feeding tube is still in the right place. For now, they've stopped his feeds, and will start back up later tonight with a very minimal amount. If none of these results show any obvious issues, then they might be a bit stumped. Unexplained instability is never a happy thing, but calling in for a before-bed checkup and hearing bad news is particularly rough. No one should ever have to experience the feeling that they can't fall asleep because they don't know if their child will survive the night.