Arlyn looked great this morning although her chest Xray looked absolutely the same, collapsed on the left side. They changed her from Bipap to Cpap this morning. Some of my nursing friends may ask like I asked why would Cpap be a better option because Bipap gives more support. It was explained to me this morning where Bipap gives 16 breath and doesn't take her breathing as a cue to breath at the same time, Cpap is more sensitive and will pick up on her breaths and she doesn't need the other components that Bipap uses. So the plan for today is to recheck and X-ray this afternoon and see if her left lung is still completely down. They turned off her breast milk tube feeding because it is likely that she will be re-intubated this afternoon. Even with the increased support she has not been able to pop that left lung open. She was increased to twice a day lasix to maintain a net negative on her fluid volume. Once she is intubated this afternoon she has done wonderfully tolerating her feeds so they will restart her dobhoff feedings that are post pyloric and they will place a NG (nasogastric) tube to decompress her stomach because she did have some air and when she was intubated before she had quite a bit of air. Although we are taking a step in the opposite direction I can understand the early intervention will help her open the left lung and get proficient oxygenation because eventually using only the right she will tire and then we would be facing a different situation with intubation.
If the left lung opens after intubation she will likely be on the vent for 3 to 4 days and then we would reevaluate the function of her diaphragm. Dr. Alfaris stopped today and it was apparent he was not convinced that her phrenic nerve was damaged and feels like the diaphragm is weak and to really get a good picture we need to re-inflate and re-evaluate.
We are taking the time today to really spend time cuddling Arlyn because after she is vented there is no more holding her again so daddy and mommy will be by arlyns side until this afternoon before she is re-sedated and paralyzed. Cuddles are a priority today!!
Daddy snuggles with baby
My baby astronot
Looking at mommy
So in Love with daddy
Sneaking my little arm out of the blanket to be close to my face
No comments:
Post a Comment