No Need To Vent

Edward took a tremendous step forward today and was extubated!  Upon delivery, Edward was immediately intubated (placed on a breathing machine) due to the immaturity of his lungs.  He was initially on a 'conventional vent' but was quickly switched to 'the oscillator' - a type of ventilator that allows for hundreds of small breaths per minute instead of larger (and slightly more forceful) breaths at a much slower rate on the conventional vent.  In the adult medical world, the oscillator is a relatively rare form of ventilation and typically not the best prognostic indicator.  However, in the NICU the oscillator is much more common and is considered a 'gentler' form of ventilation.

For two weeks, Edward was on the oscillator, but was fortunately maintained of relatively minimal ventilatory settings.  He was actually able to make the switch back to the conventional vent last week and for the past seven to ten days, Edward's team of doctors have re-evaluated his need for ventilatory support on a daily basis.  Due to repeated concern for possible infection and the desire to advance his feeds to maximize his nutritional status, extubation was delayed day after day.

Initially, Katie was quite hesitant to have Edward extubated.   Everyone (including me) had explained to her that the ventilator was "a machine that is helping him breathe because he is too small to breathe on his own."  Now, this same group of people was talking (and excited) about removing this vital and seemingly irreplaceable part of Edward's physiology.  But after some more discussion with Edward's docs, Katie came around to the belief that 'any time off the ventilator is good time.'

Today was that day.  Finally.  Katie and I huddled around his isolette (incubator), nervously holding each others hand as Edward's nurse and respiratory therapist removed a complicated arrangement of tape, tubes and stabilizers and its in place, fitted Edward with his very own CPAP (continuous positive airway pressure) mask over his nose.  CPAP is still a mode of ventilatory support, but is much less invasive and is a big step in the right direction.  Given his young age, it is quite likely Edward will have to be intubated again, whether it be in 2 hours, 2 days or 2 weeks.  In fact, he already had to be switched to BiPAP (bilevel positive airway pressure) from CPAP this afternoon due to his arterial blood gas results which revealed he has not breathing regularly enough on his own.  Regardless of when that re-intubation occurs, Katie and I are both thrilled to have come this far with little Eddie.

Katie and I hope this blog will serve as a way to keep friends and family updated with Edward's progress without filling your inboxes or hijacking facebook as well as a way to post photos and the occasional video.  Future posts to include quick recaps of Week 1, Week 2 and Week 3 as well as smaller updates of Edward's daily progress.   We hope you enjoy following along with us and continue to ask for your prayers as they definitely seem to be working.  Though many of you have seen this, here is Edward's YouYube debut.