You ever just have one of those days where you just want to crawl in a cave, escape from the world, cry, scream, cry and scream some more, then do it all over again? Well, we're having one of those months it seems. Colby has ever so slowly been decompensating since extubation this past Friday. In order to stabilize his heart rate and oxygen, we've had to up his pressures and backup rate, and switch to a full face mask in order to hold in the pressures. Then slowly over time, Colby's C02 has been getting worse and worse. The normal range for C02 is 35-45. Colby's started to go over 50, even 60, but I was thinking he'd be okay, just tweak the settings and give him some more time. Since he was starting to act up a bit, we put him on TPN, total parental nutrition, through IV instead of belly feeds. If you looked at him clinically he looked great, holding his oxygen level in the high 90's. Heart rate nice and low around 100-120. He looked comfortable and his chest x-ray looked good too. But he did have some destat episodes yesterday. We were having to do another set of cough assist treatments within 20 minutes or so of his scheduled cough tmts. But if you looked at Colby overall and took out the Co2 number, he looked okay. But by 5:30 this morning his C02 was almost 90. After much discussion with the docs and RT, we had no choice but to re-intubate Colby this morning. That's right, I'm so sorry to say that Colby is back on the vent. Shit!
So that's the latest shitty news for now. Totally sucks. As soon as I get some time, I'll update again. We've had shift change and I want to help get Colby settled in for the day. They have ordered a broncoscopy for today so that will give us a better idea of what we're dealing with, because right now we're kind of scratching our heads saying WTH?! This is not Colby's typical pattern. We'll figure it out though.
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