A Slight Step Backwards

The goal for Lynnea this morning during rounds was to wean her ventilator settings so that they could extubate her tomorrow. This went fine for awhile, and they managed to get her rate down to 12 without major problems, but then they started trying to turn down the amount of pressure support (PEEP) that the ventilator was giving her. It started out at 7, and the goal was to get it down to 5 by the end of the day. They turned it down to 6, and initially she did OK, but about an hour after they turned it down, she had an episode of respiratory distress, which in turn dropped her blood-oxygen saturation levels to the low 50's, and when they did a lab draw to check her blood gasses, they looked really bad, so they ended up turning the pressure back up to 7, and turning the rate back up to 20. And they haven't tried to wean her since then (this happened while I was getting lunch). So, the plan is no longer to try to extubate her tomorrow because she is not ready. Other than that, her day hasn't been too bad. Her feeds are now up to 12 mL's per hour, and her temp is now 101.3. They switched her antibiotics around again today because the ones she was on didn't seem to be super effective.