Baby Eagan - NICU Day 41 - Fifth Surgery

Baby Eagan is just having a rough go at life lately. Today was surgery number five. I am writing this from the hospital so I apologize in advance for formatting and typos. Numerous cups of coffee later, I have made it through the day. For the past few days, vein access has been a huge issue for Eagan. Today, the surgeons decided to place an interjugular line where is old central line was. Now he has three points of access, one at the central line, and two at the interjugular line. This still isn't really enough though for all of the numerous medications, titrated drips, and transfusions of blood and blood products that Eagan so desperately needs. Every incision or even needle stick is leaking fluid due to Eagan's incredible amount of swelling. He now weighs twice his actual weight. Can you imagine being two times your normal body weight just due to swelling? I just can't imagine how uncomfortable my little boy must be. They are trying to keep him as dry as possible to avoid infection and skin breakdown, but just from one incision, he leaked 38 grams of fluid in less that thirty minutes. Please pray that this will be Eagan's last surgery for a while and he can finally start to get better.

Here is a run-down of his current status:

Weight
Eagan was not weighed today or last night.
Length 
14" at last measurement
 
Breathing
Eagan is on the conventional ventilator. His settings are now 32 breaths per minute.  His oxygen rate is 21%-24%. The pressure that the ventilator puts in his lungs is still at 26.

 

Vitals
Eagan's blood pressure was low for most of the morning.

 

Vein and Artery Access
Eagan had an interjugular line placed in surgery today.

The arterial line is in his head.

 

The IV in his right arm blew so now he has no IVs.

 

A CVL, central venous line, was placed during surgery on the left side.

Medications

Sodium bicarbonate is being given for acidic ph levels.

Calcium gluconate is being given since his levels were low in his blood work.

Hydrocortisone, for blood pressure and stress response, was increased again today.

His Dopamine is down to 8 micrograms.

 

Eagan is on Vancomycin and Meropenum - both antibiotics, and Synthroid for low thyroid levels.

His Morphine was previously given every two hours but now his is on the same dose, but as a constant drip.

Caffeine has been started as a diuretic to try to speed up his kidney function.

Nutrition
Eagan's only sources of nutrition right now are his TPN fluids and lipids.

 

Output

Eagan has a foley catheter in place. His urine output was better today.

Transfusions

May 20 - Transfusion #21