Today we came in and his oxygen percent was 32%.(Room air is 21%) Peep down to 6 from 7, and NAVA level down to 2.2. From 2.5.

Positive End Expiratory Pressure (PEEP)

Essentially a constant pressure applied to the lungs to keep them from collapsing.  

The NAVA level is the factor by which the Edi signal is multiplied to adjust the amount of assist delivered to the patient. This assist is thus proportional to the patient’s Edi and as such, it follows a physiological pattern

Essentially he doesn’t have to think as hard to breath because it is more sensitive to the signals being sent to his diaphragm.                                               If he is sending good signal we can lower the amount we multiply it by.

Feeds are up to 12cc! He is tolerating them well.

Low amounts of fluid coming out of his lungs during suction.

He continued to be more stable through the night.

Seems to be doing good!

Weight on the board now 1220 grams!

Swelling around his face maybe slightly down, still pretty puffy though.

His aminofilin that we started yesterday has been stopped because it requires a seperate IV, it interacts with with the fluids that he is receiving through his PICC line.

Caffeine started back up again it doesn’t interact badly with the other fluids going through PICC

He is running out of good veins. Only a few options left. One being one on his head. Hopefully it doesn’t come to that. We would rather postpone a new IV till its really needed,  hopefully his old IV sites can rest for a bit.

Dr. On duty came by bedside today. He says RT is doing pretty good. Talked about reason for switching back to caffeine. Adjusting peep and wanting to try NIV NAVA again in the future.

It is moms turn for skin to skin today, it went well. He wiggled up higher and higher until his head was resting under her chin. Then he explored her chin with his itty bitty hand. We had to adjust his ventilator tubes several times to accommodate him.

He already seems adventurous!

Nurse checked to see if the culture on his vent tube came back with anything. Turns out it’s positive for coliform.

Dr. has not perscribed antibiotics. Curious if they are not concerned because his white blood cell count is within a normal range… Or if it’s residual somehow from last extubation.

Night cares went well just pee this diaper change.

We weigh him. He is feeling slightly heavier when I pick him up now, still just as flappy though.

1235 grams! Only a 15 gram gain tonight. Hopefully this means his swelling is subsiding, while he puts on healthier weight.

Slightly larger circumference on his head,  sometimes different nurses get different measurements.  I won’t worry till we have a trend of quick growth with the same nurse.

We have several nurses that have volunteered to be more primary for him.  We appreciate the continuity of care! They get to learn him.

Plus it means they really like our little guy!
Keep learning the world around you RT!