Day 20

Day 20

Day 20: 930 grams or 2lbs 1oz. Rough night, rough day. No cuddles for mom and dad today. We had to intubate Jax last night. He was having a lot of A's and B's to the point they called them death spells so they needed to intubate to help him breathe because his brain is just not mature enough to breathe consistently for him. The intubation tube plugged off with lung secretions (could not suction) that caused him to not get air so they had to pull the tube and replace it. The tube would not set properly due to inflamation so they had to run another smaller tube. Due to the plugging his right lung collapsed and increasing the need for oxygen (high 90's %), high rate of 50 bpm, and a higher peep. His oxygen saturation level would not come over the low 80's even with this intervention. Dr. Nold indicated that he is in Persistent Pulmonary Hypertension of the Newborn (PPHN).  This causes the blood vessels in the lungs to revert to a recessed size (she compared it to blood flowing through a 1/2 inch hose then constricting it to a 1/4" hose). This was likely triggered by the collapsed lung resulting in his body panicking and reverting to the constricted vessel size. This is an internal function in babies that are in the womb, the vessels of the lungs are constricted forcing blood to flow through the PDA instead of the lungs. The doctor opted to change ventilators and now he is on an oscillator that gives him up to 900 oscillations per min. It removes the need for him to breathe by "vibrating" the oxygen in and out of his lungs. It makes him vibrate from his shoulders to his waist. While he is on this he does not breathe on his own at all. No chest rise at all but his stats are much better. He started at 100% O2 and is now down to 55% O2. If the oscillator does not snap him out of this then he will be transported to another hospital to have nitric oxide (different than nitrous oxide) treatments. His right lung was showing signs that it was inflating on the last x-ray. We are about to take the fifth x-ray today at 1pm we are looking for open clear lungs. They gave him morphine to relax him. His white blood cell count is very high 60k but could be caused by many factors other than infection but he may get a few doses of antibiotics as a precaution after further review. They actively stopped feedings to help him focus on breathing only. He is tough. Everyone in the NICU is very supportive and attentive to Jackson's needs and they are doing a great job. FOJSP!