Wyatt is still holding strong. He has his PICC line still in his arm and will most likely have it a few more days. They changed out his ventilator yesterday, more on that in a bit. He is still experiencing some pain associated with the trach. When his position is moved he get very upset, as would I. He is on Versed and Fentanyl for pain and sedation.
He is on a NAVA ventilator now that he really seems to like. I will attempt to explain the differences in the vent he is on versus the other types he has been on. While at Norman and the first two days here at Childrens he was on a vent that most patients that need a vent use. The Vent is either pressure or volume driven. When Wyatt's brain sends a signal to his diaphragm via the Phrenic nerve, his diaphragm drops creating a negative pressure in his lungs, which triggers a drop in pressure that the vent senses and provides a pressure of air and or volume via his et tube or trach. The main problem with this is if his diaphragm cant create enough negative pressure for the ventilator to sense then it was a wasted breath effort on his part. Thus causing him to fight the vent to some extent.
His new Vent (actually software in the vent) called NAVA uses a different way of triggering the vent to give a breath. They have an NG tube place down his nose to his stomach for feeding and along side the tube are electrical sensors. Quick anatomy lesson, the esophagus passes through the diaphragm to connect to the stomach. The NAVA system senses the electrical signal applied to the diaphragm from inside the esophagus and tells the vent that Wyatt want a breath the instant, there is far less mechanical delay and the breath is given as long as the signal is present. This allows Wyatt to be truly synchronous with the vent and breath when he wants. The conventional vents are great and work fine, he just cant always create enough negative pressure to tell the vent he wants to breath. Enough about all that...He is so stinking cute. We just love being able to see his face. Don't forget Pray for Wyatt and all sick babies.
-Dad