And Again

Andrew's extubation has been postponed again, to either Monday or Tuesday. The reasons were less clear this time, but mainly I think they want to give him a chance to rest after going through the arterial line trauma yesterday. I mentioned the base excess value in the last post...even on lower settings, that number went down...oh well. There's certainly no danger inherent to a low base content, it just may not provide as much of a reserve if he has acidity issues after extubation.

They've continued with twice-a-day sprints, and he's passed them all with flying colors. He stayed at 100% saturation through most of them, and slept quite a bit. He's still on twelve breaths per minute for the other 22 hours of the day, and doing well as long as he isn't too fussy. When he is, turning up his oxygen temporarily is usually enough to keep him from desaturating.

Andrew was pretty boring today, sleeping most of the time I was there. He was all bundled up to prevent him from pulling his own tube out...apparently he was grabbing at his tubes and pulling this morning. He likes being swaddled and falls asleep pretty quickly.

The one new complication for today is that one of his cultures came back positive. They took the entire vacuum container, which collects everything they've suctioned out of his tube in the last few days, and sent it off for a culture...it was about a cup of liquid. Out of that entire container, there was one nasty bacterium. It's a bacteria that doesn't affect adults, but can be dangerous to immuno-compromised or lung-diseased children. They are not at all worried about Andrew, as it was only one cell and he is showing no signs of infection or lung issues. However, protocol says that they have to put him in isolation, which means we have to put on gowns and gloves before touching him. It's not a big deal...just one more hoop to jump through. They've also put him on a new antibiotic, Bactrim, which should clear up any remaining bacteria.

Hopefully I'll be able to provide an extubation story one of these days. I think the last day of rest was probably pretty helpful for him, but I'm ready for them to give him an opportunity to breathe on his own again.