Tough News: Episode 2

Today we had another rough day. Mr. Lucas struggled with his blood pressures most of the day. The doctor explained that though the baby seemed a little more stable today, he's actually more worried about the baby because we don't know what's causing the blood pressures to go so low. The blood pressure number we look for shows as a 26 on the monitor (red). 26 represents the gestetional age and where Lucas should be at or above. His blood pressures while I was here ranged from 19 to 28.  The doctor started to tell me how badly Lucas was doing. While doing this he pressed on Lucas's belly, putting pressure on his liver. Lucas instantly improved. This was because when getting fluids, the fluids built up around the liver and by pressing on his belly, the fluids were sent quickly to his heart and helped increase his pressure. But by the time I left at 3:50pm, his blood pressure was back to 22.

Options for increasing blood pressure: The NICU staff can give and have given blood transfusions and saline to try to boost the amount of fluids his heart has to pump. They gave the baby a steriod which also serves to increase pressure. Along with blood pressure medication, the nurses and doctors have used all these techniques and Lucas is currently looking good on all his stats...

But... Lucas has been on 90%+ oxygen most of the day (blue). What does this mean? When the baby requires so much oxygen to maintain his blood oxygen levels at 90+% it means that if the baby's blood oxygen levels go below 80%, there is little that the doctors/nurses can do to help the baby. At that point you can't give any more oxygen. As I write this post, he was brought back down to 49%. The other problem is that the treatments of steriods and increasing fluids are temporary solutions to the blood pressure issue. They temperarily treat the symptoms but aren't fixes to the problem. The problem is that the baby is premature and his heart can't handle having the PDA closed, but can't really handle having the PDA open either.

His blood pressure was better- 30; his blood oxygen was 87-94% and his heart rate was 176 at 7:35 PM.. His new arterial line was failing to give a proper reading for his blood pressure, so they're using the small blood pressure cuff to measure. They are looking at his heart every day to determine if having the PDA open will be beneficial or not. The doctor said he has never had to open a PDA back up when he's closed it on purpose. When he spoke to me this afternoon he thought the baby not make it through the afternoon. He said that every day that the baby is on a ventilator puts him at risk for long term problems. If his oxygen needs stay the same or get better- we'll be happy for now, but if he spends a lot of time at 90% or better, we may be facing the most difficult decision of our lives.

There are no answers, just waiting... We need those prayers.
~Kristen