32 weeks

A new attending is now on service this has some benefits as well as draw backs.  A new attending often brings a new set of ideas as well as a new plan of care.  One of the draw backs is that they are unfamiliar with the infant's prior behavior and his likes and dislikes. As an example Zane likes a crit around 32 and a normalize chloride level.   To over come that problem Zane has a great set of parents who can give accurate information and a grandmother who is familiar with Zane's "medical"  course over the last eight weeks as well as a great set of primary nurses who will speak up for Zane when we are not around. The attending and I spoke about what the short term goals for Zane, as well as the plan for the next few weeks.  One of my concerns was that he was still intubated and that this was causing him additional damage to his lungs. A plan was made to  wean the vent daily and to extubate before Zane needed to be transfused again.  Apparently Zane was listening to the conversation as he was very cooperative and he was extubated to CPAP on Tueseday.

 

Zane is not happy with CPAP (most people would not enjoy air being forcefully blown up your nose ) but we hope that by next week he will be on a nasal cannula which is gentler to the nose.  CPAP is beneficial for Zane right now as it helps to keep his lungs open.  He is also on 100ml/kg/d of mother breast milk along with TPN (paternal) nutrition to help boost his calories.  His current weight is .711 grams, the goal is to gain 20-30 grams a day.
The NNP's have also remarked that Zane seems to have a attitude problem, if he doesn't like how you do an assessment, or the mask on his face, he lets you know, that must be the Yankee in him!