SeaStar
Rough_Rock
- Joined
- May 24, 2009
- Messages
- 97
He has been in ICU for a week for a GI bleed/increased liver failure/septicemia and they kept him there all week to run more tests and get him bumped up on the transplant list. Yesterday he had a procedure done to drain what they thought was an encapsulated abscess on his liver. The doctor thinks the IR physician accidentally created a fistula from his liver to his lung when they drained it because his right lung is completely whited out on x-ray and the drainage is much worse. He was really agitated yesterday after the procedure and the ICU nurse told me he started randomly telling her thank you for the great care he received and that he appreciated everything everyone did for him. The ICU nurse thought he was stable enough to be given to an acute care nurse that was floating to the ICU, but didn''t like what he said and decided to change the assignment for him to have an ICU nurse. Around 6:30 he had severe respiratory distress and his PH was 7.0...he was intubated and on 100% with 10 of PEEP and without 0.4 of Levophed he doesn''t have a sustainable BP. He bradied down with wide complexes and they came very close to coding him but he stabilized after intubation. He''s down to 70% and his PH is 7.4, but he has only put out 30 MLs of urine since 7pm last night...they''re going to fluid challenge him today before talking about a renal dose of dopamine. They''re giving him a 40% chance...he grew out MRSA in his blood, sputum, ascites and liver abscess, so he really has overwhelming sepsis. 2 grams of vanco BID....they can''t get an arterial line on him and are concerned about his true blood pressure but are doing the best they can. They are using Fentanyl/Versed and trying to avoid continuous sedation since it makes it really difficult to come off the vent. Knowing what I know as a nurse I really in my heart of hearts do not think he''s going to make it...even if he''s extubated he probably will not be able to leave the hospital without a transplant, and it takes an average of two years to be matched. He''s not a candidate for a living donor. He was a DNR prior to being on the transplant list because he absolutely didn''t want to live like this...we''re giving it at least a few days to see if his lungs can clear and to give the vancomycin a chance to work before we make any decisions. I want to say we did everything we could but I also want to respect his wishes about not wanting to live on a ventilator. He''s having a bronchoscopy and CT scan of his chest/abdomen today and the ICU nurse said the x-rays are showing slight improvement, but that he''s very sick. He''s young, only 60, and has beaten the odds before when he lost double his blood volume from a burst varice, but he''s never been intubated before. I just want good thoughts/prayers that regardless he won''t suffer and that God will do what''s best for him. I don''t want to be selfish and pray he makes it because it won''t be fair if there''s no quality of life for him. Thanks for listening.
300x240.png)