His IV for blood transfusion failed about 15 minutes into it last night. So they had to give him a new IV. The wonderful nurse was able to get it back into the same vane.

He was requiring higher oxygen percent last night and had been trending towards more de-sat so they did an X-ray. He wasn’t liking the peep being lower. Fluid was moving in around is lungs.

So they they can’t pull him off vent yet.

0530 They decided to extubate anyways to switch out his tube. It was covered in secretions and absolutely horrible looking after being down his throat for three weeks. Running culture on secretions.  We don’t need him getting pneumonia.

They tried putting a 3.0 down but unfortunately it was still too big and he was to swollen. So they ended up put a 2.5 down again. Unfortunately there is no 2.75. But it’s fresh, clean, and healthier.  Only a small amount of blood from extubateion and re-intubation, went away over the course of the day.

Still a large leak and requiring around 40% oxygen. They started giving him a different medication to try and get rid of fluid around lungs. And a vibration massage on his chest to help dissipate the fluids. They also bumped his peep up. Nava level is up to 2.5.

They did a 2nd X-ray to check depth of breathing tube. Medication appears to be helping get rid of fluid around lungs.

Feedings restarted at 0800 9cc.

Stopped caffeine and is now instead on a different medication every 6 hours that will hopefully open his throat and lungs up and get rid of fluid.

He handled it all fairly well. It was a Long night for little RT and his nurses.

Throughout the day he has been on backup more trying to recuperate.  But he has been quite a bit more stable.

Slowly we have been able to bring his oxygen needs down over the day.

It was my turn for skin to skin yesterday but he was not stable enough, so my turn today! While we were doing skin to skin he only de-Sat 3 times, and to me it seemed to be because of his leak and him getting wiggly,  not because of his PDA.

During our wonderful skin to skin time the nurses swapped out his incubator/isolette for a different one and fresh linens.

Unfortunately the IV that was installed last night had to be removed.  So hopefully he can not require a blood transfusion for a few days,  and just medications that can all go through his PICC line.

He pooed all by his handsome self without needing medications!

Weighed in tonight at 1220 grams!

We brought a blanket up to cover his new isolette.

Eat, grow, pee, sleep, poo. repeat.

Keep being you RT!

Fingers crossed,  prayers said.

Long day, time for bed.