Off ECMO

As of about 2:00 this afternoon, Elli has been off ECMO. Because of the increased bleeding from around her silo, the doctors were forced to speed up the weaning process, and the surgeons were called to decannulate at 1:30. It was a few rocky hours after coming off, her blood pressure dropped very low 30's/20's. The nurses had to give 2 normal saline boluses to try to keep Elli's pressures up while they waited for blood from the blood bank. Elli has gotten 2 blood transfusions and a unit of platelets since the surgery and her blood pressure is just now leveling out. It is not as high as it was before surgery but it should improve once her blood volume is back to where it needs to be.

As far as how well she has been doing oxygenating and ventilating, the oxygenation part is going well but the ventilation (blowing off carbon dioxide) is improving. Elli's blood gases have been pretty good, and are getting better. The last CO2 level was 65 down from 89 (normal range is 35-45) so they changed around the vent settings a little bit, and now are holding them where they are. Currently Elli is still on the conventional vent with nitric oxide, but the daunting "jet" vent has been pulled into the room in case it is needed. As for now, if her CO2 levels continue to decline, she will probably get to stay on the conventional vent. Elli is still pretty knocked out because of the amount of Fentnyl (pain med) that they gave her during her surgery, apparently little Elli didn't want to fall asleep for the procedure and they had to give her a couple extra doses to get her to cooperate. The nurse did end up having to put another IV in Elli's head because the surgeons were unable to place a Hickman central line during the decannulation, so we are still left with the midline placed earlier today and now a scalp IV. Super Brian (who got the midline earlier) is now attempting to put in a PICC line. X-Ray is here to verify placement, so hopefully it is in the correct spot. I guess that's all for now, will post later if there are any changes. We are praying for a quiet night, and that Elli will continue to prove how strong she is.