Kaitlyn's lungs were still clear this morning. Tim and I had gone home for the night, there was nothing that we could have done. She was sedated with Rocuronium and Fentanyl and any lingering anesthetic. She was getting manual chest physio every four hours followed by suctioning the endotracheal tube. The plan was to have her wake up in the morning and then try some cough-assist through the endotracheal tube, see how she did, and possibly extubate her today or tomorrow morning at the latest. Through the night her nurse tried coughing her through the tube with pressures of +10 ,-10 and she didn't tolerate this very well! I say no wonder she didn't tolerate it! I don't know any details as to how the coughing was done (how many seconds, rounds, breaths and suctioning) but I think that they should have waited until she was a little less sedated and used higher inspiratory/expiratory pressures. I need to find out exactly how the coughing is done through the endotracheal tube. It's one thing to read the peri-operative protocol of Dr. Schroth and another to see it in action!
Kaitlyn received her last dose of Rocuronium at 5:00am and her Fentanyl was cut in half at about 11:00 am. We went for some lunch around noon and we returned at about 1:00pm, Kaitlyn was beginning to open her eyes. She remained pretty groggy for the afternoon, but started taking some breaths above the back-up rate of the vent. Back-up rate of the vent was turned back to 10 from 20 breaths/min, but she kept her rate usually at 15 or above. She had a wake period from 5:30 pm to about 8:00pm and from 10 - 11:00 pm during physio. Cough assist was used after this physio. It went well, but there was nothing to come up. Her lungs are still doing very well.
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