ICU Day 11 – Getting worse

X-rays show a worsening picture of her lungs. They are getting filled with fluid from the pneumonia and that is increasing her reliance on the ventilator. The infection is not moving to other parts of the body and that’s good. Also positive is the fact that her BP is under control without any medicines.

The doctors are doing a Blood Gas Test every 12 hours by drawing blood from an artery to determine how much O2 is being passed from her lungs to the blood, which is then taken around by the blood for other organs to function properly. They want the O2 level in the blood gas test to be between 80 and 100. They are doing this test multiple times a day and based on its results they are changing the settings on the ventilator to support her body. They are primarily tweaking two settings on the ventilator to make sure she gets enough oxygen. 1) O2% being pushed from the ventilator into the lungs. This is currently at 70% and we want to see that go down to 50%. 2) PEEP which is now at 12 and we want it to go down to 5. Peep is basically pressure that allows the lungs to expand to let the blood absorb this oxygen. Basically the first number (50%) is how much O2 is being pushed  into her lungs and the second number (12) is how much the machine is expanding her lungs so this oxygen gets into her blood. At O2 around 50% and Peep around 5 is when they’ll consider waking her up and doing a respiratory test, before pulling the tubes from her mouth. The hope is we see these numbers go down in the next few days.

This YouTube Video is a good explanation of pneumonia, which is primarily what Rachana is fighting now. The bacteria that caused her pneumonia is MSSA.  Her condition is critical as she needs a lot of support from the ventilator and her current situation is called ARDS

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