182nd Day in the NICU

Today Drayke had a new ventilator tube put in. He has been having a lot of oral secretions and it has been causing an issue with his breathing. He has had a 4.0 tube in him since well before we left Centennial. We are talking it was either late July or early August when he had this particular tube installed.

They gave him a big dose of morphine & ativan so he would be calm as well as a paralytic to make sure he did not get to fiesty & beat the hell out of the respiratory therapist. We got back to his room just as they were finishing and they were very VERY pleased with the result. The extuabtion and re-intubation went very smoothly. He now has a larger, 4.5mm tube. He did not de-sat during the entire procedure. His peaks (inhale/exhale) are really good where they had been fairly weak on the exhale. He was very pink & looked so good.

I pulled his old tube out of the garbage and saw why there were so many problems. The inside of the tube had accumulated hardend gunk with just a pin hole for the air to be going thru (literally!This thing is NASTY looking). We are finally going to find out for certain how much pressure he really needs. We are predicting his pressures will be able to lowered signifgantly.

I made it to rounds this morning and a lot is going to be happening over the next two weeks. Dr C is wanting to get his nitric down to zero by the end of the week. Early next week they are going to scope his brochia to see is there is any damaged that has been caused by the tube and if he has bronchial malaysia (a floppy tube). Normally there is a stiffness to the air passages. If floppy then they are going to do the tracheostomy then & there. If they are firm then we may be able to bypass surgery & go to an alternative, less invasive method of O2 delivery called Vapotherm.

An ultrasound of his kidneys was done. He is going to be going on methodone to help wean him off of the morphine.

It is a very exciting time for our little man.