February 25, 2016 0900

Arlyn had a great night overnight and maintained her strong little self doing what they wanted, scott and I came to rounding this morning to find out the plan. Dr. Powers and the medical team were very pleased with Arlyns progress overnight. They decided to back off on ABGs to every two hours, her lactate has stayed consistently down currently 1.8. Her calcium drops almost every lab draw and she has been repeated about 10x since surgery (which is not an abnormal event for a cardiac surgery) but that being said they are adding calcium to her maintenance fluid. Her ventilator was continued to wean this morning with a lower respiratory rate. The line in her neck was a little bit deep so the cardiac surgeon, Dr. Gensini is pulling the line back at the moment. Her pulses in her feet have been difficult to find although her blood pressure and other signs of perfusion look good so they will reduce the EPI she is receiving and later today if all goes well the team had decided to back off on the paralytic and just use sedation. Arlyn is an amazing little fighter and mommy and daddy have been supportively sitting with her throughout the day and night. This morning she will received the rest of her cell saver (which is the left over blood from surgery) her hemoglobin was down to 11.2 from 12.4 and this will give her a little boost. If she tolerates this well the doctors who rounded this morning will decide this evening if she will receive diuretics and try to get fluid off. She will get the blood over 3 hours and we will watch. Otherwise we will start to get the fluid off, TPN and lipid tomorrow.