Coming Off ECMO Tomorrow

So, as indicated in our last post from this afternoon, Jude's trial on low ECMO settings was cut short not long after it began because his body demonstrated continued difficulty in removing carbon dioxide from his bloodstream. This was a little disappointing, although it wasn't wholly unexpected. The good news is that despite the results of the low flow trial, Jude is still scheduled for decannulation (i.e. disconnection/removal from the ECMO circuit) tomorrow.

This afternoon, Jude was given his first of six doses of dexamethasone, a steroid that should effect short-term improvement of his lung function, which, in turn, should help him prepare to come off ECMO. He'll receive two doses of the steroid each day for three days, and the size of the dosage will progressively decrease.

Tomorrow morning, Jude will be put on a different type of ventilator that is better suited to meeting his present needs: It's a high frequency ventilator called the oscillator. I won't endeavor to explain all the ins and outs of how this is different from a conventional ventilator right now, but it works a little bit differently and, in a sense, provides a little more support. It should hopefully help Jude get rid of some of his excess carbon dioxide as well.

After Jude is put on the oscillator tomorrow, shortly thereafter he will have another trial on low ECMO settings, although that trial may have a slightly different purpose than the one from this morning, i.e. it should afford the medical staff an opportunity to adjust the settings on the oscillator in response to Jude's "performance" at low ECMO settings. After the second trial tomorrow, the pediatric surgeons will decannulate and Jude will be off ECMO.

Right now, I don't know when Jude will receive his surgical repair. His surgeon came by his bedside today when Rose and I were out of the NICU, so we didn't speak to him personally, but we later learned that he would like to see Jude move down to the conventional ventilator before undergoing surgery, if possible. Being on the conventional ventilator may offer some surgical advantage(s), but it would also allow some latitude to move back up to the oscillator or the jet ventilator (another type of high frequency vent) if that's necessary to support Jude.

Here are a few things we're thankful for today:

• Jude's low flow trial this morning gave the doctors information that they needed to formulate a plan for his care over the next day or two.
• Jude continued to urinate reasonably well today. Hooray for pee! :)
• Rose was feeling well enough to come into the NICU with a mask. So glad that she's back alongside me and able to see our baby boy again.
• Rose and I were able to look into our little boy's eyes today, as he was awake a bit more and seemed rather alert.

In addition to general prayers for God's mercy and daily provision to all involved in Jude's situation, please pray with us about these specific things over the coming days:

• That the oscillator vent will be very effective in stabilizing Jude and getting his carbon dioxide levels in his blood down to a lower level.
• That tomorrow morning's ECMO trial and subsequent decannulation will go as smoothly as possible.
• That the dexamethasone being administered to Jude will easy his inflammation around his belly and significantly improve his lung function.

Thanks for your prayers and patience with me as I cobble together posts about Jude, folks. The Lord has continued to minister healing to Jude in His time, and He has sustained our family in ways that can only be explained by His mercy and grace. Please keep the prayers coming! Good night!

    The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.
(Philippians 4:5-7)