Once Eric was intubated last night, we discovered he needed the vent for more than a low pH and high PCO2. They started suctioning Eric and got tons of secretions out of his lungs. "Neverending" the nurse said. He was drowning in copious amounts of thick purulent sputum. We won't get the cultures back for a couple days, but they're calling it pneumonia and have already started across the board antibiotics. Eric responded to conventional ventilation well. Prior to knowing that, the doctors said they would "try" a regular ventilator, and at the same time were talking about the "oscillator" (we called it a "jet" ventilator in Pgh) and if that didn't work, ECMO (don't ask if you're not in the medical field). But he surprised them all and his pH quickly went from 7.13 to 7.39. And we've been able to ventilate Eric with low pressures, which is key in his case to not do furthur damage to his lungs. And once they got the vast majority of sputum out of his lungs, and they continue to do so, his oxygen level has also greatly improved.
Speaking of Eric's damaged lungs, the surgeon stopped by tonight. He's a "straight-shooter" and told us if he doesn't do surgery soon and fixes those leaks, Eric is "going to die." We dread the thought of Eric going to surgery again; he hasn't recovered from the last surgery almost two weeks ago. But it doesn't sound like we have a choice. Eric's going to CAT scan again today. Not real sure when this surgery might happen, possibly Monday or Tuesday, unless this pneumonia holds things up. They tell us his lungs are so devastated, and indeed they are, but it occured to me . . . the fact that, at one point yesterday, when on a simple face mask, Eric had a PaO2 of 225 (which was too much and caused his PCO2 to rise, called CO2 narcosis), and then his PCO2 responded so well to mechanical ventilation, tells me that surely there's some very viable lung tissue in there. If the lungs weren't working, we could ventilate him all we want and nothing would happen. So if the primary problems are mechanical, if the surgeons can close the leaks and get the lungs re-expanded . . . maybe it will work. I'm ever hopeful.
As of this AM, Eric is stable. He and Bob even watched Steve Martin's movie The Jerk earlier. Current vent settings; Pressure-limited 18, SIMV 18, FiO2 .60, PEEP 5.