Daily update: Post-surgery Day 1

Today, Wren was largely stable on his dose of 10 (mg?) dopamine which the neonatology team described as a "moderate" dose. They would like him to be on a dose of 5 post surgery and ascribe the higher dose required to maintain BP, his cold feet and legs to his left heart having some trouble maintaining adequate circulation.

He has also been running a low fever (100ish) and has blood cultures taken today.

On the plus side he is a lot less sick than expected. His lactates are low, urine output is high, upper BPs are okay, he is overbreathing the ventilator and both his morphine and the vent were stepped down to half-dose and 15 BPM respectively. His fever fell over the day on a dose of tylenol.

He is often slightly responsive and the team were very encouraged that he has a circulatory response to stimulus. For example when they suctioned his lungs to remove mucus which builds up since he can't really cough, his heartrate rose, BPs rose and he moved and wriggled. This shows his heart is managing, not just hanging on ok. A lack of response would be a lot more serious.

Tomorrow we are hoping his BPs rise.

The surgical team felt he could be extubated but the intensivists preferred him to remain on the vent and lines until the dopamine is down and he is holding his stats up.

Some Stats:
Upper BPs around: 68/32
Lower BPs around: 55/31
Sats: 98%
Temp: 37.7

Apparently the lower BPs are indicative of the heart having some trouble maintaining circulation because in these instances the arteries ?? in the extremities clamp down reducing flow. However, flow to his hands is good and his kidneys are doing well.

We spend a lot of time with Wren today. Josh sang to him and his BP seemed to rise a bit when he was singing. We also warm his little feet and stroke his head. He is very sweet and lovely even with all the tubes in and we love him very much.