Two Goals

They were able to wean Ayden to the nasal cannula (at 2 liters) overnight; however, his chest x-ray this morning showed right lung atelectasis and edema (again). They are going to try a few respiratory therapies, such as CPPD and Pulmozyme, to see if they can open up and clear out his right lung. They are taking an afternoon chest x-ray. If the x-ray looks good, they will probably keep him on the nasal cannula; if it doesn't, they will either be more aggressive with respiratory treatments or put him back on Vapotherm. They removed his chest tube because it was no longer helping to remove fluid. (Ayden has been unhappy with everyone ever since the chest tube removal; removing a chest tube is supposed to be one of the most painful experiences in a hospital.)

Ayden was also able to tolerate his feeds, so they are working him toward full feeds today. If he does well, they will work toward bolus feeds tomorrow. They have moved all of his medications to the feeding tube (except for Milrinone), rather than through the PICC or IV. This is safer for Ayden because it means that they will access the line less often. I found out how much Methadone Ayden will be tapering... it's going to be a LONG taper. They are also weaning his Milrinone with the hopes of having him off that by this evening.

There are rumblings of going to the floor, but two things have to happen before that is possible: Ayden's right lung has to show improvement while on the nasal cannula, and Ayden needs to continue to tolerate his feeds.