Sunday, January 17, 2021 - Sloan's Progress in the CICU

1am-ish Dr Das told Mama that even with the fluid, Sloan's oxygen levels are still decreasing. If this continues, Sloan will need more Precedex to relax him and get his heart rate down to the 110s. Sloan will also need another IV just in case because his veins are so small the IV inserted in the ER could go bad so they need a back up IV.

Sloan will likely need a central line. The central line will be better to get blood for labs and meds into him since the IVs can go bad. He will also need an artery line to monitor his blood pressure.

If his oxygen levels do not get better, they will need to intubate him and have a ventilator help him get the oxygen he needs. 

Due to a possibility of infection, surgery would not be an option today, but there could be talk of Sloan having surgery later this week.

Dr Das has Sloan on PGE to open the pulmonary duct. Hopefully this will help with the pulmonary flow, but it may affect his oxygen.

5am-ish Looks like the PGE is helping with his stats stable with a heart rate of around 110, oxygen mid 70s, no fever, and a good pulse reading. So far, no infections detected from the infection group, but we are still waiting on the results for the cultures and spinal tap. 

Another echo was ordered to see if the PGE opened up the pulmonary duct. Abdominal and head ultrasound ordered as normal preoperative procedures. 

All of Sloan's blood work came back normal. 

8:20am-ish They will wean Sloan off Precedex to see if the PGE opened his pulmonary duct. 

Dr Manzuri reviewed 3 possible procedures for Sloan, dependent on his vitals, how he responds to the meds, and the discussions with the other cardiologist, cardiology surgeons, etc. 
1. Catheter which is the least invasive and it's non-surgical. 
2. BTU Shunt - surgical
3. Full Tet Repair - surgical 

1:55pm-ish No more Precedex 

2:45pm-ish Oxygen Saturation dropping

5:20pm-ish Art line in

5:50pm-ish Talk of intubation 

6:30pm-ish Echo

6:50pm-ish He will need surgery, but first we need to make sure there's no infection. If there is no risk of infection, Sloan will go to surgery and will need time in the hospital to recover from surgery. Estimated timeline is 3-4 weeks. 

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