Uneventful Night, But Drama In The AM!

Overnight, Benjamin did well. They kept his O2 sats, blood pressure, and other vitals very stable on the ventilator. After his code, he had only made 6 ml of urine in over 6 hours. They want at minimum for him to make about 4 ml per hour. They had to put a foley in, and they had to get a urology resident to place it. For all of you OB's out there, do you remember in residency how much you loved that consult at 2 am? Anyway, over the evening, his urine output started to increase, and he was making at least the minimum.

Then, the excitement started. Xray came around 5 am to get another Xray of his belly. While they were manipulating him, something happened, and his O2 sats dropped, his heart rate dropped, and they had to extubate him. The doctor thinks he had a mucous plug in his tube. We think (as does the CT surgeon) that the tube probably moved during the manipulation. Either way, it was very scary. They have since reintubated him, and his labs again have improved. Immediately after the event, everything had looked worse again. But now he is back to stable.

Most likely he is presently suffering from what is called acute tubular necrosis; basically kidney failure. Hopefully it is an acute event, a combination of the low perfusion caused by his failing heart, and antibiotics he had to receive after the NEC last week. They are hopeful that if this is the case, this acute event is reversible, his kidneys will improve, and he will then stabilize. While his kidney function is abnormal, he could not undergo surgery, so again the transplant is on hold until he improves. This is so very discouraging, as a new heart is really the only thing that can help him, and all these set backs eliminates the only medical option. I am not used to dealing with issues that are not fixable - it is a very helpless feeling.

We will keep everyone updated as things evolve. Please pray that he continues to remain stable and that his kidney function improves.