Day 76 - Lingo Review & BPD

Tuesday, March 16, 2021

Review: We are going to take today to review James and the medical lingo that’s been being used, along with an update on James. However, PLEASE know how the search feature on the blog works. If there’s ever a word or lingo you’re not familiar with, it was probably explained in a previous post. Simply go to the search bar and type that word in. All of the previous posts will appear and you can then get our explanation on that topic. (Google is also a great tool 😊)

- FIO2 = Oxygen % that James is requiring to breathe. The higher this number is, the more concerning it is. Why? Because that means James is not breathing enough on his own. The concentration of oxygen at room air is 21% (what we breathe). James is requiring 61%. The closer he gets to 21% the better! Additionally, for babies who are born very prematurely, too much oxygen in the blood may also lead to problems in the brain and eyes. This is a balance.

- CO2 = Carbon Dioxide levels for a normal human is in the mid to high 20’s. This is the gas waste the body eliminates. When they do a blood gas on James, they see what his CO2 level is at. When it’s higher than 70-80, this means there’s a lot of gas built up in his lungs that needs to be released. The longer that stays inside his lungs, the harder it is for James to use his lungs properly. The lower the CO2, the better!
- PEEP = Pressure at the end of a breath. The higher this number is, the larger the collapse of the exhale is. Normal humans are around 6-8, the lowest James got to was 10. Sometimes this higher PEEP is needed to open his lungs up more, but too large of PEEP has potential consequences. The consequence could be that the alveoli are opening and collapsing much more than they would normally and will also be subject to pressures that are higher in order to reopen them with each breath. This combination will damage the alveoli further and creating even more lung damage and possibly cardiac issues.
Rate, Peak, Leakage, and other words can be searched in the blog using the instructions above. Just wanted to take a moment and discuss the main lingo we use daily.

Update: James has severe BPD.

What is BPD? Click Here for a Detailed Breakdown

Google says:Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that affects newborns. Most infants who develop BPD have been born prematurely and need oxygen therapy. Most infants recover from BPD, but some may have long-term breathing difficulties.
Doctor says:Severe lung disease, which is the under development of the lungs due to being born prematurely.

What’s the potential consequences of BPD?
Google Says: Further studies have identified that BPD and prematurity have long-term impacts on pulmonary function and may increase risk of late pulmonary morbidity, raising concerns that newborn intensive care unit (NICU) survivors represent an emerging burden and future challenge for health systems and adult providers.
Doctor Says: Due to being on the machine, the tissue in the lungs are damaged permanently and cannot be repaired. His lungs must grow and mature to develop more alveoli on his own. This damage can cause the best case scenario of getting asthma and needing an inhaler to start childhood and eventually ween off. Worst case, James gets a tracheostomy and will have that permantly placed, which could lead to James not being able to speak or swallow for an uncertain amount of time.

What’s happening now?
We wait patiently, pray, be present, and hope that during the next 3 weeks as James approaches his 100th day in the NICU and his original due date, somehow Baby James can begin responding even better to the steroids and the ventilator settings to help reduce the irritation in his lungs, while also giving him the oxygen that he needs to survive. It’s catch 22 we are in ... the machines are saving his life, but they are also causing damage. So the goal is to get him off the support soon, which is why a trechostomy is an option.

Afternoon: Mom got to hold James for 2 hours today. He tolerated it extremely well. He’s looking good and especially loves getting touch time and kisses when he can.