Following last week’s trial extubation, Olivia returned to her usual self (and settings) in a matter of days. However since then, she’s experienced a handful of respiratory events, beginning overnight Monday. An x-ray yesterday afternoon revealed signs of atelectasis in her right lung (again), so sprinting has been put on pause while we work to get both lungs fully recruited.
This morning in rounds, the team increased her rate on the ventilator from 15 to 20 to give her a bit more support. A follow up x-ray will be taken tomorrow to see how her lungs look.
Initially a team member suggested that the atelectasis was a result of her sprint on Tuesday, but after reminding the team (some of whom are new to her case this week) that her events started before Tuesday’s sprint, and that prior to extubation she was sprinting more hours a day than not – we all agreed that the sprint was not the culprit, but most likely didn’t help her out any. The best explanation as to why she started derecruiting again this week (after she had looked so good prior to her extubation trial) is that she’s growing, she’s getting bigger, and her “baseline settings” may no longer be sufficient.
It makes sense. The ventilator is helping provide a certain amount of volume and pressuer to her lungs. If the volume and pressure stays the same, but her body and lungs are getting bigger, that volume and pressure may no longer be enough.
So we’ll continue tweaking settings, bit by bit, to try to find the optimal support she needs.