2 steps forward, 1 step back

It was confirmed that little Lalo has a bacterial infection in his blood. It is believed that it started at his central line going into his chest. This was placed during surgery and very soon after it looked pretty red. We questioned it, but it was not a huge concern because that is a natural reaction anytime you have a foreign object going into your skin. They were just watching it closely to make sure it didn't get any worse. Ironically, I mentioned to the nurse yesterday that it looked better. Well when the nurse put him back on his bed after I held him yesterday she mentioned he was warm. About an hour later after a change in position, she noticed puss from the central line. Not long after he developed a fever. So it began...

Overnight, he started struggling more with breathing. They decided to switch from nasal cannulas to CPAP, which is a little mask going over his nose to provide oxygen. This is the middle step before being intubated (back on the ventilator). He seemed much more comfortable. His fever came down slightly today, which is also good. He is on 2 antibiotics now, and after 48 hours they should be able to more specifically identify the bacteria to make sure they don't need to change medications. In the meantime, they decided to sample his spinal fluid to determine if the infection had spread that far. That would change how long he required antibiotics. They do this by taking a sample of spinal fluid from his lower back aka a spinal tap. They weren't able to get enough fluid from the first injection, but Lalo got too upset and started desating from the poor positioning of the CPAP while they had him in the position they needed. They decided to let him have a break and they will attempt again later. Poor baby!

Since they have a confirmed infection, they need to figure out what to do with that iv line. They are investigating a method of cleaning the line, where they run something into the line to break down the bacteria and then pull it back out. This is not commonly done in the nicu because most nicu patients don't have these lines, so there is no protocol on doing it. Therefore, they are still researching whether it's the best option and who should be doing it. It is fairly common and successful in older chemotherapy patient kids that frequently have these lines (Erin C. - if you are still following our blog and have any helpful info on this, email me sfrank218@gmail.com - I don't have your contact info and am not usually here nights). Unfortunately, they really need that access line because he is receiving all of his nutrition and medication intravenously. Hope this all resolves itself quickly so we can get back to move forward and closer to getting him home!

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