Thursday, November 6, 2008

Maggie's Heart and Breathing

From Brooke's dad tonight:

Our big concern about Maggie remains her lungs. Her lungs are not working efficiently. For her back surgery, Maggie was intubated. Even before then, she needed an oxygen tube to keep her level of blood oxygen sufficient. The ventilation tube she had initially turned out to be too small a diameter, so today they replaced that tube with a larger tube. Kind of a tricky procedure with a child that produces a whole lot of mucous. Since they put in the new tube, her respiration has improved and she is now supplying about half of her breaths and the ventilator supplies the other half. Maggie is breathing at a reasonable pace, which indicates her brain is telling her lungs to work. That is good news, for a child with a Chiari malformation of the brain.

This afternoon Maggie had an echo-cardiogram. From this it was determined that her heart is generally functioning well. However, blood is flowing at a reduced level into the Pulmonary Artery, which leads to the lungs and then back to the heart before it is sent back around the body. The Pulmonary Artery takes the blood from the heart to the lungs where it receives and loads up on Oxygen. Instead of a normal function, much of Maggie’s blood is by-passing the lungs and slipping thru an opening, the PDA, which normally closes after birth. Before birth, blood by-passes the lungs, as it already has oxygen and goes thru the PDA back around into the body. Maggie’s Pulmonary Artery now has a very high level of pressure, too high. This is called Persistent Pulmonary Hypertension. The blood from the heart cannot force itself into that artery. Instead it is slipping back around into the body, before it is oxygenated. It is likely doing this for one of two reasons: either the lungs are insufficiently developed and she is exhibiting Respiratory Distress Syndrome or she has a mild case of pneumonia. While they are giving her antibiotics to protect against pneumonia, the suspect Maggie’s lungs are just not sufficiently developed. Because she was delivered prematurely, her body has not yet begun producing Surfactant, which it normally does at a full term both. Surfactant promotes normal lung development.

So for the next few days Maggie will rest and have minimal stimulation. We are waiting for her to produce Surfactant and her lungs to develop and continue to expand. They may encourage her blood system to increase its pressure. This should help force blood flow into the Pulmonary Artery which in turn should help the lungs expand and develop. The doctors are concerned about this condition of hers. They told us children with this issue can get really sick and require more medication before they get better. Then she quickly said that Maggie is not anywhere near there at this time, but this should be a very interesting 72 hours. Once Maggie does get better, she said it will likely happen quickly.

Please continue to pray.


Hayley said...

Thanks for the continued updates.