Dec 26 & 27 – NICU – Olivia Hope Maybury

12/26 6:30PM NICU

Digestive
- Olivia Weighs 680 grams (up 10?)
- Blood sugar in 110s
- Triglycerides higher, so nutrition is being modified (nothing to be worried about)
- Feedings are being auto-pushed rather than hand pushed with a feeding tube syringe because amount has increased
- As Olivia gets more breastmilk and her stomach expands, it may take up space needed by her lungs so feedings may need to slow down again
Other
- Blue lights have been removed as Bilirubin levels continue to decline
  - These levels may go up again
- She is on a higher sedation dose now to keep her calm, requiring fewer bullouses (sp?)

Lowering oxygen more and more
Advancing feeds, but will need to drop for PDA treatment
Feeds got up to 50/kilo
PDA – Patent Ductus Arteriosus
- Doctors did a chest ultrasound for duct check
- Discovered that there is now a PDA flow reversal – blood running from heart to lungs, which causes lungs to work harder than they should
- Treatment is three IV doses of indomethacin – 9pm/9am/9pm is one course; they may need to do more than one, but this should close the duct
- Another chest ultrasound to occur on Thursday
Will keep an eye on kidney function
Head ultrasound taken – it’s normal again!!!

PICC line placement was unsuccessful
Olivia tolerated the procedure well, but the NP on call was unable to do it. She said she has “fragile veins”, and another NP is going to try this afternoon/evening
They may have radiology be involved to better get an idea of her veins before attempt number two
The three doses of indomethacin for treating the PDA were started, and should be completed this evening