25 6/7 24 hours post op

Zane was off the epi. by the morning and his blood pressures remain stable, they are looking for a goal of 25-30 on his maps.  Usually they like the map to be greater than gestational age anything 25 and above is good. His dopamine has been anywhere from 8-20mcq.  He did receive another blood transfusion today, which is interesting as their are some theories that blood transfusions can increase the risk of NEC., was it the neoprofen, prematurity or blood transfusions that lead this to happen?
His belly looks dusky and dark to me and is firm and tender, he still has drainage coming out of the site, it will be a few days before the surgeon can tell whether the drain fixed the problem or if a lap. is required. The encouraging sign is that his blood gases are not acidotic, if they were acidotic you would think he might have dead bowel also his lactates are low, this is all encouraging and perhaps Zane only had an isolated perforate bowel.  A PIV was placed even with his UAC still in place they needed another form of access to run his blood through.
Zane was started on Zosyn last night and fluconazole today, his platelets keep dropping so the thought is he might have a fungal infection. His fluids are at 150ml/kg as he appears to be dry based upon his labs. His sodium is low and his BUN is 60 and creatine is 2.0 (indicated kidney failure) The attending came and spoke with us today and he answers all our questions, it is also interesting to me to hear the reasons why they start a new drug or increase fluids as each attending wants to do the best for the infant but they all have their own focuses.