Monday, February 18, 2008


So Ananya has a fever. Her transplant was Tuesday night - She spiked Saturday early morning about 2:00 am. After extubation she's been doing these worrisome episodes where she breathes really really fast (tachypnea) about 60-80. Earlier this afternoon the team thought she was a little anxious and gave her some fentanyl/ativan which she responded to beautifully. My wife woke me up at about 1:30 am to say that Ishani was getting a cxr b/c she was working so hard - when I came down and saw her - she really did look like she was working hard - nasal flaring - some belly breaths, I listened to her lungs and she sounded junky and she was tachycardic to the 170's - so I did some chest thumping (chest pt) and when I was doing it thought she was a little warm. The Nurse said her axillary temp had been ok 37. something (anything over 38 (100.4) is considered a temp in hospitals) but when we got a rectal temp she was 39.1 (102.4). So that certainly explains the tachycardia and tachypnea. We're giving her some tylenol and she'll need some big gun antibiotics to cover hospital bugs. Her CXR looked unchanged from before - so hopefully its not in the lungs ( though that RUL still remains collapsed). Typically this early post transplant line and catheter (she has a central line - a large iv going into her jugular vein and a catheter in her bladder (foley)) related infections would predominate. though about 20% of these infections could be viral. Her belly is pretty soft and her output from the drains she has in her belly (JP drains) hasn't changed so I doubt she has anything brewing in her belly. The surgeons make lots of connections - one connection that may be prone to leakage and is a more serious complication is when the connection made between the donor livers bile duct and the recipients intestine breaks down. This would result in bile leaking into her abdominal cavity - which is one of the main reasons surgeons leave drains in the cavity. All right, more later! Keeping our fingers crossed that this is a minor bump....

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