Case In Point

Wednesday was not the day we were hoping it was going to be. The ECMO was turned off, as it was the night before, so that mum's blood still flowed through it but none of it was getting oxygenated. This meant that her lungs were doing all the work. On Tuesday evening this proved to be moderately successful and it was believed that Wednesday would be the day that the ECMO machine could be removed altogether. Unfortunately on Wednesday morning when the same procedure was followed, mum's oxygenation went into a tailspin and the machine had to be bumped back to 2.3 litres/min and 50% oxygenation. As well, the sedation had to be increased substantially. Nobody was sure why.

A CT scan was ordered for 2pm as well as blood tests. It was believed that there was a possibility of blot clots in the lungs or some sort of hemorrhaging was occuring. We also noticed that mum felt hotter even though her temperature remained normal. Her oxygenation started to improve during the day but we were kept on alert in the event that a decision needed to be made on how to continue.

Around 7pm mum was starting to get back to where she was the night before. The preliminary CT results showed no additional problems in the lungs or surrounding organs. The thought was that there was some blocking in her bronchial tubes that may have prevented her lungs from receiving the full compliment of oxygen. Additional suction and general movement had probably cleared things away during the day.

Yesterday morning the ECMO was turned off once again but the results were substantially better. The ventilator setting was increased to 55% oxygenation (from 50%) and mum was holding well at around 90% oxygenation. It was decided that the ECMO machine would be removed completely at 2pm.

The removal of the ECMO occurred with no complications. The surgeon was happy with the procedure and indicated to us that her oxygen levels were satisfactory. Apparently lots of secretions were removed from the lungs at the same time. After going in to see her we noticed that her sedation levels were back down and that her oxygen was running around 86. The ventilator was soon modified to deliver 70% oxygen content and it didn't take long for her oxygenation level to average around 91%.

We also noticed that the room looked a whole lot emptier without the additional machines. It was certainly a visual sign to us that we'd made it over a major hurdle.

Unfortunately the blood cultures came back and indicated what we had suspected. Mum is now infected with a gram negative septicaemia. Sepsis occurs in 1-2% of hospital patients and is especially prevalent in those who have ports and catheters will direct access to arteries and veins. She has already been given a cocktail of new antibiotics but they are awaiting the exact type of bacteria before they can determine the specific drugs to use. That information should be available this morning. We are hoping that it is something treatable like e coli as we don't need another nasty bug to complicate this any more.

So that is where things stand as of this morning. Although we knew that further infections were a possibility, we were hoping that we could avoid them. We'll have to wait and see what it turns out to be. As well, we are waiting to see whether mum's kidneys begin to function again. The dialysis machine has been removed for now in hope that the increased blood flow will trigger the kidneys to start working again.

I know a lot of you are following the blog and I thank you for your comments and support. I ask you to be patient as we enter a critical time in the recovery. Keep those positive thoughts going and we'll be sure to continue to pass your messages and well wishes onto her. She needs all the help she can get and I'm sure she is thankful for all the support she has received to date.