Showing posts with label dobutamine. Show all posts
Showing posts with label dobutamine. Show all posts

Saturday, May 25, 2013

It Was a Good Day in Transplant Land

It was a good day.  Things are looking as they should.  When I walked in he was much more alert than yesterday.  I figured since he was a captive audience with no ability to grab the remote, I'd chatter away at him.  He responded with nods to questions and was just more engaged than your average unconscious patient :-)

He saw the PT and OT ladies.  They did some range of motion and he showed off.  They were asking if he had a cane or walker at home.  I looked at them like they were crazy.  I told them he had been going to the gym up until the day prior to The Call.  They were surprised.  I told them, we don't play around.  We've got a volleyball dynasty to grow!  We discussed any potential issues once he goes home...like stairs, etc.  Fortunately our bedroom is on the first floor so he won't have any issues there.

They did start the thymoglobulin but at a much slower rate.  He tolerated that fine.  The plan was too extubate if he passed RT's tests once the med was done.  It took a little longer to make it happen and in fact, I thought the ICU intensivist was going to not order it.  But when I got back into the room he was off the vent with just a little oxygen nasal cannula, smiling at me :-).  Oh happy days.  I can always handle just about anything as long as he can talk to me.  Him being heavily sedated and on a vent are just not things I tolerate well.  Anyway, I didn't have to lay the smack down so all is well...lol. 

So kidneys are improving with creatinine at 1.8  and good output.  Minimal drainage from the chest tubes.  They say those stay in an average of 3-5 days.  Still no need for the pacing wires and the dobutamine is being weaned down.  The epinephrine was shut off much earlier today and he has kept his blood pressure up.  He's been getting his anti-rejection and anti-infection meds by IV but tomorrow they will start transitioning to oral medication.  He will start to get up tomorrow and move around a bit as well.

Friday, February 10, 2012

More Good News

Carlos is finally getting his act together and listening to my lectures on behavior.  Maybe he figures it is the only way to shut me up -lol :)

So he did well through the night.  They decreased his oxygen on the vent to 50%.  The stopped the ativan and replaced it with precedex, which is a sedative also but makes it easier for the patient to wake up.  They added dobutamine  because he continues to have periods of ectopy and NSVT.  So they continue to titrate the medications.  He is getting another unit of pRBCs, as he likely will every day for awhile.   He's starting to diurese a bit more, which is good as he has gained 18 pounds since his admission....although 5 of it might be hanging out in his bowels :p They plan to work on that today.  The critical care doctor (one of several)

I guess he misbehaved a bit this morning but straightened his ass out by the time I got here.  I have some pictures to post but am having trouble uploading them on my tablet. I'll put them on Facebook. Possible extubation by tomorrow morning.