December 23 – 11:30 am NICU Rounds

This is a super technical update. tl;dr if you don’t want to read the whole thing: Things aren’t bad right now!

• NICU Nurse/Doctor rounds at 11:30AM
  • Becky and Max attended rounds!
  • It’s basically a meeting of:
    • 4 doctors/NPs
    • The attending nurse
    • Respiratory therapist
    • Nutritional specialist
    • (parents as desired)
  • It is a highly technical, data-driven update where Olivia’s status is shared, orders are reviewed, and new orders for the shift are established, and a care plan created.
  • This is a very shortened list of stats and updates
    • Advanced the positioning of the breathing tube by ½ cm (respiratory)
    • Chest ultrasound
      • showed no signs of heart murmur (good)
      • Confirmed Olivia has a PDA
        • Patent Ductus Arteriosis
        • All fetuses have this
        • It is a connection between the aorta and the pulmonary blood vessels
        • It usually closes in the first two days of life in term babies
        • Preterm babies can tolerate it for much longer
          • It causes respiratory distress in other preterm babies
        • It will go away with time
    • Heart rate steadily in 130s-140s
    • BP is 54/34 (normal)
    • Platelet level decreased by ~30%
      • Olivia will need a blood transfusion for platelets
      • All blood transfusions come from a single adult donor for the duration of their stay in the NICU
    • Weight increased by 15 grams overnight to 660 grams
      • Down from birth weight of 700 grams
      • Drop in weight expected over the first few days
      • Increases are not expected to be consistent yet. There will be a fluctuation before consistent increases
    • Total fluid intake increased
    • Brain ultrasound normal
      • Will be repeated early next week
    • Small abrasion near umbilicus
    • Chest X-ray showed minor lung collapse (normal)
    • Blood gas testing ordered for tomorrow 
    • Feeds are resuming today
      • Olivia will be given breastmilk at 10ml/kilo
        • This translates to about 6mL of milk
    • Blood sugars remain high
      • High blood sugars lead to higher urine output, which can dehydrate Olivia