Day 4 in the ICU - Thursday Update

Shirley rested well overnight.  Urine output is up, which is good, although it is going to take 4-5 days to net her back to the fluid level she should be at.  They have set a goal of two liters net output per day and they will continue Lasix to hit this target.  As of late afternoon, she was only down 430 cc's, so they were upping the Lasix dose.

I sat in again on rounds--and think I understood 80% this time.  They continue to treat her with three broad-spectrum antibiotics two for potential lung infection and one aimed at her gut. Still no identifiable cultures. They said today that she was on some antibiotics at the time the cultures were taken, so they may never have a definitive smoking gun.  They are going to keep her on the antibiotics for a 14-day course.

Her lungs are improving but are still not flexible enough. They did a test this morning where they changed the ventilator settings so that she was initiating the breaths and the vent was helping hold the pressure.  She was able to do it, but was uncomfortable for her.  They returned her to the former settings and will try this test again tomorrow.

Her BP is running high.  When she was hit with the sepsis, it was critically low and they had her on meds to bring it up. That issue has passed and they have resumed the beta blocker Metoprolol to control her pressure.

This afternoon, they decided to inset a Low Flow Tunneled Catheter instead of the PICC line. The insertion was done by the Interventional Radiology team in the IR unit instead of bedside.

The next few days are likely to be more of the same:  rest and attempt to get more liquid off. I've included a photo I took of her hand this evening. You can see how fuffy it is and shows the amount of fluid she is retaining.