As you read yesterday things went really crazy really fast. Evan is now stable and relatively happy back in the PCTU. The echo, x-rays, blood gases, and cultures are not pointing to NEC which is great. Because he had some symptoms and because the doctors take NEC very seriously they are treating him with IV antibiotics and putting a hold on any feedings by mouth for at least a week. He will get nutrition through his IV but nothing can go into his stomach so he’ll be pretty irritable for the first 2-3 days. This will give his stomach and intestines time to calm down and heal if there was anything going on with them.
When he was moved to the PCTU he was under a lot of stress so he was sedated and intubated (put back on the ventilator). Additionally, the femoral arterial and central lines that had been removed for us to go to the floor were put back in so they would have access for delivering medications and fluids. His feeding tube (that daddy worked so hard to put in the night before) was replaced with a similar tube for removing gas from his stomach. He went back on Milrinone, was given potassium, and some other things. Through the course of only a couple hours his pH and lactate were brought back into the normal range and he’s been doing well since. His ventilator settings were reduced through the night and by 9AM they did a sprint and removed him from the ventilator. One of his femoral lines and the tube in his stomach for gas was also removed.
Dr. Mackie came by this morning and discussed another possibility with us that they are investigating. It’s called coronary ischemia and essentially means that there was not an adequate amount of blood being supplied by the coronary arteries to the heart. This possibility was brought to light during the echocardiogram done yesterday. Also during this echo they noticed a difference in his ventricular function (the beat of the ventricle) in comparison to the echo done a week ago. This could just be due to the stress he was under yesterday or because of the pacing being supplied by the pacemaker. They are still investigating whether or not this is an issue and what they might be able to do about it. They are monitoring it by testing the cardiac enzyme troponin. These levels are currently elevated but not at a remarkable level.
Since he’s unable to eat for at least a week and it’s going to take time for him to work back up to feeding once he’s allowed to eat again I suspect we’ll be here at least 2 more weeks. We don’t know what that means for us. We don’t expect them to keep us in the PCTU for that whole time if he’s stable, but I don’t really want to go back to general care unless they learn what happened and do something about it. We could go to moderate care or to the Holden NICU.
We appreciate everyone’s concerns and your thoughts and prayers during this difficult time.
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