Question

sandra · #1 09-22-2004, 02:58 PM

Brian has been doing great with vent weaning. He is on the O-ring for about 13 hours a day now and it was an effortless transition. He has not desatted once while on the O- ring. He also started tolerating the PMV as soon as we started putting it at the end of the O-ring versus right at his neck. He loves it now. He is going crazy making noise.

Here is my question. Do I call the doctor and ask about adding nights? Currently, he gets CPAP at night. He does desat some with CPAP. He is doing great with the O-ring during naps. I know I am excited and don't want to stress Brian, but he gets mad when we put him back on CPAP. Just curious, he just seems ready. It seems like almost overnight, I know, but just wondering what others think.

abby · #2 09-22-2004, 03:38 PM

It sounds like he is ready for nights free of cpap. I would ask. Jared went pretty quickly to being off 24/7 once he tolerated being off all day. Great news!!

akabot · #3 09-23-2004, 09:07 AM

I would definitely ask. I got frusterated with our doctor weaning slowly, so I asked him to speed it up. Come to find out that he was going slow because he felt like he needed to wean us as parents from the vent and was afraid that we would get too nervous. When I found out that I wasn't nervous, Corey quickly was done with the vent. So, I would go for it and see what the doctor says. I'm glad to hear that he is doing well.

Amy

christyw · #4 09-23-2004, 05:22 PM

We weren't using CPAP, we were using the LTV 950 in its pressure control/support mode, and when it got down to having nothing else to wean other than nights, I went ahead at the same speed we were weaning days. Gaithy had been 24/7 vent support for over a year when we started daytime weaning and then the nighttime weaning ensued about six months after that.

It was SO HARD to get an appt in our pulm's office (due to all appointments were overbooks because he was so backlogged) and unless I could get a hold of this one particular specialty nurse, I had no luck, and she was going thru the illness/death of a loved one and was out for awhile. I wasn't going to put Gaithy's great progress on hold just because I couldn't get into the office, we wanted the vent gone!! Â*

The main thing, I knew Gaithy was doing just fine, and had no reasons to even think about not continuing. She did fine during naps, and we used the pulse ox at night. We started off by letting her go to sleep for a couple hours and then putting the vent on for the night. The next week we'd give her another hour off, and so on each week until finally I was getting up at 5-6am to put her on and since she'd been asleep most of the night already this would wake her up. So, I stopped at that point and just let her be vent-free. I later TOLD the pulm about my methods, and what could he do? Her blood gases were perfect and she was doing fine, so the vent was d/c'd. (well, he made us do a sleep study in order to "officially" d/c the vent)

I wouldn't personally wean all at once for nights...after several hours of sleep his lungs could start to lose the upperhand. Maybe you could try a version of our nighttime weaning..? Just a thought. Â*I'm so happy he's doing SO WELL! It's very, very exciting to see him almost off the CPAP.

Christy

#5 09-23-2004, 10:20 PM

We are also in the process of weaning Kayla off the LTV 950 c-pap right now. She weaned very quickly with the days but we are still trying to get her off at night. It didn't help that she had RSV and in the PICU this July. She is still recovering from that. She is at 2 hours into sleep but tonight her end tidals went too high so she had to go back on. We call each MOnday to check in. I would gauge it by weight loss/gain, secretions, end tidals, heart rate increases, respitory rate, and your doctor's comfort levels with his destats. It's exciting that he is making such wonderful progress. I hope that the nighttime wean goes quickly for you. We have to get Kayla off by Feb. for her reconstruction so we are in a hurry! Let me know how it is going. Take care and good luck, Lisa

Kayla 25 weeker-1.13oz
trached at 5 months due to severe bronchotrachial malasia, severe subglottic stenosis, aretnoid prolapsing and BPD.