10/22/06 - NICU Day #20

Nurse: Ebony

• Daniel has not made any urine in four-and-a-half days. In the neonatologist's opinion, recovery of renal function after this long state of anuria is very unlikely. Daniel's potassium and acid levels continue to slowly, inexorably rise. They will eventually reach a critical level and Daniel's heart will no longer be able to function normally. Peritoneal dialysis may delay this outcome but it has many risks and, sadly, a dysrhythmia probably cannot be avoided.
• In an attempt to give Daniel's kidneys the best possible chance of healing, his blood pressure is being maintained with dopamine, dobutamine, and epinephrine. Attempts were made today to lower the levels of these medications because they come with their own risks but they have all proved necessary.
• The most improvement today was seen in Daniel's lungs. His right pneumothorax almost completely cleared and the left lung shows much better expansion. He is oxygenating and ventilating well.
• He is still resting comfortably.