A Horse of a Different Color

Today they switched Andrew to a new ventilator that combines the qualities of the hi-fi and the conventional ventilators. It gives pulses just like the high frequency one, then pauses for a normal breath. The machine looks like it was pulled out of a World War II bunker (old and clunky), but it's dependable and apparently pretty useful. It's not quite as efficient as the newer hi-fi vents, so they only use it for children that are stable on low settings. He's weaned quite a bit over the last week, so he definitely qualifies. This new vent gives the nurses the capability to change from one style to the other with the flip of a switch...so they can try out the conventional vent without having to roll over another machine. In fact, he's been on purely conventional ventilation (without the hi-fi portion) since 7pm. His numbers have been good, so let's hope he can stay that way for a while.

He got pretty anxious when we were there earlier today. His blood pressure went up a bit, his oxygen saturation went down a bit, and he looked a little out of sorts. Compared to earlier freak-outs we have seen, this was almost nothing...but I think it may have concerned the nurse. In the end, a changed (disgusting) diaper, a breathing treatment, and a little rest seemed to do him good. An extra dose of Ativan and morphine may have helped as well. By the time they took his next blood gas, his numbers were good enough to wean him. They've already turned the ventilator settings down twice, because his test results have come back positive.

They've continued the feedings with the same frequency and volume, and overall they've been going well. He's had residuals of half his volume a couple of times, and all of it once or twice, but they've now been going with this strategy for a day and a half, and I think a few failed attempts are par for the course. Hopefully they'll keep giving him additional chances to prove himself, instead of stopping the process entirely.