No extubation today so far, and probably not until tomorrow. No extubation means no allowing her to come out of sedation completely. She is mostly doing well, but they are concerned about how hard she is working to breathe on her own. She breathes rapidly and shallow, and her chest is working very vigorously with each breath.
She has still been spiking fevers, so they are going to run another blood culture on her. Her breathing is starting to sound ragged and liquidy. People are on ventilators for a long time run an increased risk of complications and infection from the liquid that collects and cannot be expelled by customary coughing and throat clearing.
The issue is that if she doesn't do well off the ventilator, they don't really have the option of putting her on a C-PAP machine to help her breathe as it requires that she wear a tight strap around her head to keep it on. Neurosurgery nixed that idea because it would put too much pressure on her tender skull and brain.
Without the option of a C-PAP machine then, if she were to fail breathing on her own, they would have to intubate her again. They can't be guaranteed that it will go as smoothly as a couple nights ago when they had to intubate her after she extubated herself. Again, the longer one is on a ventilator, the more complications can arise.
They want to wait until it is pretty clear that she will succeed with extubation and breathing on her own before they proceed.
They aren't acutely worried at the present. But, I'm not so sanguine. I'm impatient and stretched and cranky and have an ever growing hair trigger that Jeff steps on more and more often (unfortunately for him). My mind wants to latch onto anything it can worry about.
Somebody take me out back and shoot me.
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