Ambrose is vent-free!

Today when I stopped by to see Ambrose after work a few nurses were gathered around his bed. They told me I came at a great time, because they were just getting ready to take his breathing tube out. The doctor said that Ambrose has been doing wonderful on his blood gas draws and they think he could be ready to have the tube removed. They let me know that he may not be able to tolerate not being on the vent and that this was only a trial run. The Respiratory Therapist took the tube out and told me I could take a picture of Ambrose, since we haven't seen him without any tubes in his mouth since the first few minutes after he was born. I only had by phone with me, so the picture isn't as great as it could have been. It was great to see him without any tubes in his mouth. He did have a piece of tape above his upper lip, but it was left in place, because he was then put on a CPAP*. He still requires some pressure, but once the CPAP mask was placed he did really well. One thing that was funny was that he didn't know what to do with his mouth! It had been open with tubes stuffed in it since the first day he was born. The nurse pushed his bottom lip up to close his mouth and he practiced opening and closing it on his own. It was really cute.

He may or may not remain off the vent. There are a few factors involved. He will need to have low CO2 levels in his blood and be able to keep his oxygen saturation levels high. His O2 concentration was at 37% when I left and if he needed to go to 50%, then they would take another blood gas and see if he should go back on the vent. Breathing on his own will take a lot of effort for him and he will tire much easier than before. Overall, though, he looked really good for the hour I was there after he was extubated.

Gina will put up more pictures as soon as we have some. Right now he is wearing a soft mask around his head with straps in the front to hold the prongs in his nose.

-Ryan

***When infants are disconnected from a mechanical ventilator, they often require a form of assisted breathing called nasal continuous positive airway pressure (CPAP). A nasal CPAP device consists of a large tube with tiny prongs that fit into the baby's nose, which is hooked to a machine that provides oxygenated air into the air passages and lungs. The pressure from the CPAP machine helps keep a preemie's lungs open so he or she can breathe. However, the machine does not provide breaths for the baby, so the baby breathes on his or her own. (http://kidshealth.org/parent/medical/lungs/aop.html)