Tuesday, October 24, 2006

10/24/06 - NICU Day #22

Nurse: Maria, Didith
  • Overnight the epinephrine was weaned to off. His dopamine is also being weaned off. Dobutamine will be the last to go. Hopefully, dobutamine will come off quickly as its theoretical effect on the blood pressure (in his case) is minimal.
  • He continues to put out urine. 58 mL over the last 24 hours. His potassium is down to 5.3. His insulin is off. He's leaking urine around the catheter in his bladder so they've pulled the catheter and are now just weighing the diapers for volumes.
  • His 1 AM hematocrit was up to 34.7 (from 27 at 6 PM). He got another transfusion this morning and the labs will be repeated at 1 PM. He seems to be bleeding much less than last night. The output from the chest tube is also less bloody.
  • The team will continue to follow his I's and O's and monitor his glucose level. If everything continues in the right direction they'll consider restarting intravenous nutrition tomorrow.
  • The concern for NEC is rather low. On today's X-ray, gas appears to be moving through the gut normally. Barring any changes, the team is going to stop antibiotics tomorrow (Day #5).
  • The biggest problem continues to be Daniel's lungs. One of his chest tubes stopped draining last night at around 10 PM. He again developed a tension pneumothorax and his saturation dropped without recovering. The fellow took the dressing off the chest tube and the bubbling started again in the Pneumovac and his saturation shot right back up. This morning's CXR showed no pneumothorax. He is on the Jet ventilator with significant support. His FiO2 has been weaned to 75% and last night, his attending added Nitric Oxide (NO) to his mix. This is a somewhat experimental therapy with few side effects that may help reduce any effect that pulmonary hypertension has on his difficulty with oxygenation. They'll follow him on this for a day or so to see if he is responsive otherwise they'll just turn it off.
  • We hope Daniel continues to surprise us.


Michael said...

Daniel...you continue to amaze us. Your tiny body seems to be stronger than Hercules. Share your strength with your parents...their love for you is endless. Your family is with (all of) you with each step you take!!!
Love Rebecca, Michael, Jessica and Lizzie

uncle richard said...

Wow Daniel you are keeping all of us (all family and friends)....glued to this INFORMATION SUPER HIGHWAY...we watch with such keen interest on your progress...your dad doesn't want to jinx anything....and I agree...conservative optimism is always good...but boy do you put up the fight of all fights...not a single wrestling match I was ever in could ever match your strength and power of survival.
You are my inspiration to be better in my life.

Kimberly said...

Fitz and Jackie here-
You are keeping us glued to the computer. We are constantly checking on you. We want you to feel good. Keep up the fight Hercules. we love you. xoxox

Jackie and Fitz, Kimberly and Michael