February 10th, 2010

Kierson was extubated 2 days ago with much apprehension on our part. Her oxygen requirement was erratic over the weekend prior to the extubation and her CXR appeared to be moderately worse. Following the extubation, she was put immediately on CPAP (continuous positive airway pressure) to help her continue to ventilate (roll down your window at highway speeds, stick your head out the window allowing the wind up your nose, now breathe...this is like CPAP). She didn't tolerate this very well and they removed this after about 2 hours.

They then placed her on high-flow nasal cannula with 8 liters of oxygen/minute and an FiO2 of 80% (this is pretty high flow and very high percentage of oxygenation - we breathe 21% oxygen). This was concerning as she wasn't on such high settings prior to her apneic episode. She still continued to have major retractions and oxygen desaturations throughout the evening, night and following morning. Her neonatologist sat Deitre down (I was working in the ED) and discussed the possibility of re-intubation if Kierson continued to work so hard to breathe. She began to stabilize the following day and remained with less severe desaturations yesterday and today.
Her tube feeds continue to be increased and there is no sign of any bowel issues at this time. This is the best news so far. We need her to grow and put on weight as this is the only way her lung condition is going to improve. Her neonatologist is increasing her tube feeds very slowly as he wants to be certain Kierson continues to not have any bowel issues.
We continue to do what we can to pass the time. Deitre has been making preemie clothes for Kierson. They are pretty impressive. I have been working. Emmie is continuing to grow up, cutting some bottom teeth and doing lots of talking. She is not interested in crawling but loves to stand up (with some assistance). She continues to be a very good-natured little baby, never fussin' and goes to sleep when you put her down to bed (and wakes up giggling). She has been a real blessing in our lives.
Thanks for your continued prayers for Kierson and for us. Pictures to come soon.