Tranqs on the wane

Sometime yesterday afternoon, Woody got the memo that the CPAP is, while annoying, a whole hell of a lot better than the ET tube, and decided to chill out. Which has made visiting him much more pleasant. In fact, it's been downright odd to visit him and have his O₂ needs be so low so consistently; he's right now at 34% oxygen, which is just unprecedented for him, and is a marked contrast from Extubation I, where his oxygen needs never got within twenty percent of his pre-extubation numbers. His average oxygen needs then averaged in the 60s, but he's running averages in the 30s this time, and we're very stoked.

Not that we don't anticipate it going up, at least a little bit. He's still on his steroid burst right now, which can tend to make things look a little better than they may actually be. This is another reason that, as I alluded to yesterday, his real time of trial on this begins this weekend, when the flush of extubation begins to fade, his pulmonary reserve that was built up over the last few weeks of tubelife is tapped, and he shows us how sustainable he can maintain this time of not being on the ventilator.

Since Woody has been a lot more comfortable now, they haven't had to give him the sedation that was necessary yesterday to keep him from thrashing; he was knocking off that CPAP so much at first that they were drugging him just to make sure he stayed stable. Now, however, he's kind of worn himself out with the crying and the wiggling, and he's resting comfortably. Grammie reminds me that her mother (Woody's Great grandmother) has a theory that babies need to cry to develop their lungs, and if this is true, then Woody's doing his level best to recover.

The blood gas taken this morning was up slightly in the CO₂, but it's still in the good range, so we're not that worried about it. We just don't want it to trend upward, and it will be watched pretty closely. Also, he had an x-ray that shows, except for one area of localized "collapse" (a soon-to-be-banned word, I have no doubt-- I rather liked how the NP described it, instead-- 'schmutz'), his lungs were looking overall a bit better than past shots. All in all, Extubation II (Electric Boogaloo*) is going quite well.


*For the squares. I've learned that sometimes my cultural references just aren't gotten by key parts of my audience (my mom).