We called the NICU just a few minutes ago for an update. They were able to wean the pressure on the oscillator which makes it a little easier on her lungs. Her oxygen level is set to 82% but is constantly being adjusted by the nurse depending on how she is doing. In the last 24 hours it has varied from 54% to 100%. Juliana was a little too excited yesterday and pulled her breathing tube out on her own! They quickly fixed it and took the opportunity to rotate her in the isolette. She is getting a little more fentanyl now so that she doesn’t get as agitated. When she moves around too much, it can cause her blood oxygenation to desaturate. Her dopamine has been turned down even further and they are hoping to wean her completely soon. As long as her blood pressure stays steady, they will be able to take her off it. The exciting news is once she is off the dopamine they can begin to feed her small amounts of milk! They start out at 0.5 ml per hour to get her stomach primed and ready. It is such a tiny amount, just a few drops, but we are excited that she will soon be able to do it. Jen and I will be heading back down to Baltimore for a few days later today. All the grandparents and relatives left this morning. I’ll have another update after we see her today.
Update: We spent a few hours with Juliana this evening. Since I’ve had some requests to get a little more technical, I’ll try to keep up. Her dopamine was turned down from 3 to 2.2 when we first arrived. Her oscillator settings were turned down from 13 Hertz to 11 Hertz with a 13.5 pressure. They had a chest x-ray on order just to make sure that her breathing tube was placed correctly in her trachea. When she had the chest x-ray, she didn’t really like it. She desaturated her oxygen for about 45 minutes while the nurse checked through a list of possible adjustments. She went as low as 55 at one point, but by the time we left it was in the low 90s. She had really good “wiggle” throughout, which is kind of an indication of how she is shaking from the oscillator and shows whether it is working properly. Just for fun, here are some of the things the staff can do with your baby while she is desat’ing:
- Suction her breathing tube.
- Check her O2 sensor on her foot and switch it to a hand to check if it is working properly.
- Turn up her oxygen levels to 100%.
- Take her off the oscillator briefly, bag her, and manually respirate her.
- Check her x-ray for positioning of the breathing tube (might just be perfectly placed).
- Make a small adjustment to the oscillator.
She resaturated after all of that and was doing fine as we left. Some new parents in the NICU that we met earlier looked terrified as they watched. They will soon learn about the roller coaster ride that is the NICU.