Monday, November 14, 2011

Tentative Game Plan: 22 Days On ECMO

Jordan continues to make progress today. His urine output has continued to increase and he has lost pretty much all of the inflammation. His right and left lung are both open, but we are waiting on the left lung to really pop open like it did before his repair.

This morning, they placed a bronchial cuff in the endotracheal tube. Jordan's endotracheal tube was leaking. At times, it actually sounded like he was snoring. It was important to make sure that they could control the amount of air volume they were giving Jordan because they are trying different methods of opening his lungs. The "cuff" can be inflated to create a seal in the airway which will prevent the leak. The team decided to move Jordan to very low settings on the oscillator, rather than the conventional ventilator, as well. This is another trick to try and open those lungs.

To make things more interesting, they sent lab work in this afternoon to see if Jordan has a respiratory bug. The ECMO technician and our nurse are both required to wear a mask and gown. They have also blocked off our space so that other teams members cannot enter our room. This seems a little ridiculous to us, but is required for the safety of the other patients. The test is just a precaution to ensure that Jordan is not having trouble opening his lungs as a result of being sick. It may take 24 hours or more to get the test results back.

The goal is to get Jordan off of ECMO. The game plan is to try one method at a time to get his lungs to completely open up. Once they like what they see on x-ray, they will try turning down the support settings on ECMO. Depending on how Jordan responds, they can actually clamp the circuit and have Jordan breathe on a ventilator. If everything looks good, they will take the opportunity to remove Jordan from ECMO. That will be a very important milestone for Jordan that will bring on a whole new set of ups and downs. The transition off ECMO may occur as early as tomorrow or Wednesday.

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