Bump in the Road

Lauren has had a rougher couple of days. She was placed back on the ventilator on Sunday morning @ 3am. She was getting more tired from working so hard on the CPAP and needed another break. She was having more apnea & bradycardia (A's & B's for the NICU shorthand) all day Sunday and as she got more tired the spells got longer, so they decided they needed to re-intubate. We had a feeling that this may happen, so it wasn't much of a surprise when the phone rang @ 3:30 in the morning. They think that these episodes are due mostly to her age and being so small, but sometimes can be due to an infection in the bloodstream so they did a blood culture which take 3 days. They do get a preliminary report daily and so far it is negative which is a good sign. They put her on prophylactic antibiotics for 48 hours just in case however. Just after being re-intubated her blood sugar shot very high up and this could have been due to stress from re-intubating, working so hard to breathe or from an infection. Her blood sugars are starting to come down now which is good. She continues to tolerate her breast milk feedings well which is encouraging. Her urinary output also decreased a lot Sunday & Monday so she is on Dopamine to help increase it. We've also learned that Lauren also has a PDA. I am going to copy & paste some info about it now...easier than me trying to explain it:

*The ductus arteriosus is a blood vessel that connects a baby's aorta and pulmonary artery while the baby is in the womb. This connection allows blood to be pumped from the right side of the heart straight to the aorta without stopping at the lungs for oxygen. In the womb, only a small amount of a baby's blood needs to go to the lungs because the baby gets oxygen from the mother's bloodstream. The baby's pulmonary artery, which carries blood to the lungs, is not needed at this time.
After birth, the baby is no longer connected to the mother's bloodstream. The baby's blood must now go to his or her own lungs to get oxygen. Normally, as the baby begins to breathe on his or her own, the pulmonary artery opens to allow blood into the lungs, and the ductus arteriosus closes. Once the ductus arteriosus closes, blood leaving the right side of the heart no longer goes straight to the aorta. First, it goes through the pulmonary arteries and stops at the lungs to pick up oxygen. Then, blood carrying oxygen returns to the left side of the heart and is pumped out to the rest of the body.
If the ductus arteriosus does not close after birth as it should, it is called a patent ductus arteriosus (PDA). A PDA allows blood to flow directly from the aorta into the pulmonary artery and from there to the lungs. This extra amount of blood flowing into the lungs strains the heart and increases the blood pressure in the arteries of the lungs.*

The doctors don't believe Lauren's PDA is too large or causing much of a problem so they are not going to treat it as of now. There is much controversy over treating them or not and this group of doctors is more conservative, unless there is a big problem. For the most part, PDA's usually close over time and need no intervention.
I just called the NICU to get our nightly update and the nurse said she opened her right eye! Blood culture is still negative, tolerating feedings well and blood gases were better than this afternoon so the plan is to start weening her off the ventilator. Her urinary output has greatly increased and they are going to stop the Dopamine after the current IV is done. We will be going up tomorrow and try to get some new pictures to post. Still taking it day by day...