ICU Day 21 – Setback

Last evening Rachana was battling a few issues; she had a fever that was almost at 103, had a bloated stomach, and her hemoglobin was at 6.8. The stomach situation got a little better when she had a bowel movement as she was probably gassy. They also stopped the feeding tube last night and changed it to suction this morning to relieve the pressure. The fever has stumped the doctors all this while, they continue to do tests and blood cultures but cannot find anything, which is maybe a good sign, but the fever and its frequency jumped up yesterday so they are no thinking there is something out there that they are unable to zero in on. They gave a unit of blood last night and that probably will give her some energy for the next 1-2 days.

The blood gas test this morning at 4am showed her O2 level in the blood at 40, they want it between 80-100. So this translated to them bumping up the ventilator’s O2 setting to 60% to push more O2. They had to cancel the breathing test as the O2 setting needs to be at or under 50% and Peep at 8 for the test to occur. So she remains on the ventilator for now.

She threw up a little last night and a good amount this morning and has been coughing all day. The doctors think she might have swallowed some of the vomit down into her lungs and that is irritating her. They hooked her again to pain meds and a sedative drip to keep her comfortable. Not sure how she felt but her coughing looked pretty uncomfortable.

This evening they did a Bronchoscopy i.e. sent a camera down her airways to see if some fluid is stuck causing the cough. Her airways looked clean, pink and healthy. There was no blockage, ruptures or pus. I was in the room when they did it I was pleasantly surprised to see how clean it all looked. They did spray some fluid and pulled fluid back to test for infections. Her xrays looked worse than yesterday so there is definitely an issue in her lungs but her airways looked clean.

Overall a day where she had a few setbacks. I guess the optimistic view is that it’s good that they didn’t pull out the tubes yesterday after she passed the breathing test, as today would have been much worse without the ventilator.