It’s a new week… Ventilator support was increased over night & Emerson continues to let it do all the work – she is not spontaneously initiating breath, even when awake and agitated.
They were able to get some urine by titrating a drip overnight, but output is trending down again this morning. She has a lot of fluid building up in her little body, and it will be difficult to improve her breathing status until we eliminate the pressure it’s creating and drain it from her lungs.
The plan for today is fluid management. There will be no breathing trials and Emerson will not extubate. Instead, they’ll keep her comfortable on the vent and work towards gently correcting her fluid status. It’s a delicate balance with her DI issues, as overshooting means trouble maintaining critical electrolyte levels.
Infection markers are heading in the right direction with the exception of lactate, which has been elevated and fluctuating for a few days. All signs, though, are that we have a handle on the infection and now just need to support her through the fallout of septic shock. It could be a challenge, but she’s done it before and will do it again – in her own perfect way and time…