One week

Today marks one week since we brought Elyse back to CHEO, and it seems like she is starting to get a reputation for being a little on the difficult side (if they only knew the half of it). You can tell the team is getting frustrated by the lack of marked improvement, and continue to try different things in the hopes that something will work better than the last.  All of her numbers are looking good, with the exception of her oxygen saturation which continues to hover in the 80's (ideally it should be in the mid- to high-90's).  One positive is that she is expelling carbon dioxide without issue, just not absorbing oxygen very well.

They decided to change the type of machine from high frequency oscillatory to high frequency jet ventilation yesterday, hoping that it may require less pressure and help to loosen the lung secretions.  So far she has not shown any real preference for one machine over the other, and her numbers remain the same if not a little worse.  Now they are talking about switching back to oscillatory, or even conventional ventilation, although also admit that it may just come down to giving her time.

          High frequency jet ventilator

In addition to the bronchiolitis and RSV, they have also found a few secondary infections which are being treated with antibiotics -- this poor kid just can't catch a break.  She keeps fighting the sedation and trying to wake up, which is great for a finger squeeze, but not great if she attempts to extubate herself.  For that reason they continue to adjust the sedation medications -- not just increasing the amounts, but also trying different ones too in order to try and minimize the severity of withdrawal she is going to experience when it comes time to wean off of them.