Vent question. : My husband has been on a... - ICUsteps

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Vent question.

Nuet profile image
Nuet
14 Replies

My husband has been on a ventilator for 24 days now. His stats took a turn for the worse and he has become hypoxic and the doctors are telling me I’m prolonging his death.

Yesterday I went to visit him, and even though he was heavily sedated he began to breath on his own. The vent was set to 10 and for a good five minutes he brought his resp rate up to 15-17.

Then the nurse came in saw it, walked away and played with his sedation medicine and he stopped breathing.

Should I take him breathing on the machine as a good sign? Before he would buck against it, setting all the alarms off but he didn’t do that this time.

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Nuet profile image
Nuet
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14 Replies
Sepsur profile image
Sepsur

Hi Nuet

I’m sorry I don’t know how to answer your question- I was hand pumped at times because I couldn’t tolerate intubation - thankfully I had no hypoxia damage & I eventually weaned off machines

Rhyl1 profile image
Rhyl1PartnerModeratorICUsteps

Dear Nuet you haven’t said if your husband has any other organs being supported, such as needing dialysis. Does he have a tracheostomy? Having an oral endotracheal tube is very uncomfortable and many patients don’t tolerate it. A tracheostomy is a lot more comfortable and usually facilitates stopping sedation. Only then can you begin to access how someone is going to cope. It sounds like your husband has possibly developed an infection in his lungs. If that’s the case they should have started new antibiotics and breathing on his own would tire him. But the fact he tried may be positive.

Gooddaysunshine profile image
Gooddaysunshine

I am sorry I do not have an answer, but having been intubated myself it may be that the above answer is correct ie the patient is sedated because the pipe/tube is so uncomfortable that waking up causes distress.It may also be that they want his lungs to rest and/or repair for now, and let the ventilator do the heavy lifting.

However it sounds a potential positive sign that he was able to breathe himself for that short time.

Copse77 profile image
Copse77

I think it could be a mis communication or mis understanding but I would Please ask his doctors to explain this and how they are managing his treatment and care. It must be very distressing for you. It’s 4 years today when my brother became critically ill. I wish the best for you and your husband.

Nuet profile image
Nuet

Sorry everyone for my post being so vague, it’s a lot and I can never remember it all. My husband has Covid pneumonia/ARDS and is on ecmo as well, along with dialysis and has just started making urine but nurse told me that he’s still auric but I don’t know it’s the first time I’ve seen urine come out of him in 3 weeks.

He’s got multi organ failure along with suffering a cardiac arrest for five minutes and then several strokes, it’s been a hard ride for him and I’ve been told and pushed towards ending care.

But seeing him breath has given me a bit of hope even if it’s futile. They have to keep him under maximum sedation apparently due to him trying to go into seizures and now they’ve paralyzed him just to keep him partly stable.

It’s stressful beyond all imagination.

I’m just not ready to give up yet.

Nuet profile image
Nuet in reply toNuet

He also has the Trach.

AV8R profile image
AV8R

I am sorry. My wife was vented for 2 months and 2 weeks. Her oxygen was fantastic but CO2 was 140!!! Her blood turned acidic. Caused a lot of irreparable damage. We had to let her go. I have seen her good childhood friend close and actually had heart problems, now home. I would ask your pulmonologist for a better explanation. Also ask about CO2. I had no idea until it was too late. I’m sorry. Dewey

Sepsur profile image
Sepsur

Whilst it’s bad news that they are having to resort to ECMO, the criteria for being accepted is quite high, so they must believe he has every chance of surviving. If he is being proned, they will have to paralyse so that he synchs with the ventilator better.

A trachy is another good sign - a step towards them weaning him off meds, waking him & weaning off life support eventually.

Copse77 profile image
Copse77

ECMO allows the lungs to rest and recover, here is a link to the ECMO information from Wythenshawe Hospital. Also at the link are details of the ECMO family support group and stories of hope from other families. The first story is our family story written to provide hope of recovery. This time 4 years ago we were in the depths of despair when my younger brother became critically ill out of the blue. As Sepsur said the criteria for acceptance on ECMO are very high as there are only a few centres around the UK that offer this treatment. My brother was a father to two children the youngest age 6 and had never smoked so all these are taken into consideration along with the risk that patients can die during the ECMO procedure when the patient is being put in ECMO. My brother was given drugs to paralyse him which is we understood to stop the risk of any tubes and wires being pulled out. ecmofamilysupport.com/ecmo-...

Nuet profile image
Nuet

Copse77 how long was your brother on ecmo?

They’ve told me now that they no longer thinks he’s there and that it’s just the machine keeping him alive.

I’ve read all your stories and they give me hope and comfort and cause me to wonder if I just need to give my husband more time,

They’re are trying very hard to guilt me, saying I’m traumatizing the nurses by keeping him on there. They say his lungs have zero functionality basically concrete lung.

Thank you everyone for answering, you don’t know how much I appreciate your input.

Copse77 profile image
Copse77 in reply toNuet

My brother was on ECMO for a short time only around 3 days as first day is classed as day zero, as with the ventilator he started to breathe with that support. He remained unconscious and unresponsive for another month- it was 4 weeks before he started to wake up. It’s nothing like in the films where people are instantly awake and life is normal. He suffered ICU delerium and remained on a ventilator for those 4 weeks and on dialysis beyond then. He suffered bleeds to the brain as you will have read in the link. My brother was previously fit and healthy and a non smoker so that all helped but he had fluid in his lungs and various infections. Ask for an understanding of why they believe your husbandr has no chance of recovery. We were told that this may be it for my brother with no chance of recovery by one consultant who has looked at his MRI scans. It almost broke me. I asked him why he came to that and my DAd rang up and spoke to another dr who gave a different view and my Dad and that kind Dr were right. It took time. Keep talk to your brother

Copse77 profile image
Copse77 in reply toCopse77

Sorry my iPad malfunctioned and I almost lost my reply to you. I meant your husband

Sepsur profile image
Sepsur

Several times my family were told I wouldn’t survive the night, my heart failed, my kidneys failed & my respiratory system failed. I had severe ARDS - concrete lung - and these have largely repaired. I was given every chance to recover, which I did. Have they done an MRI? What number on the Glasgow Coma Scale does he sit ( the higher number is more positive, but there are individuals on this forum that have survived from GCS 3)

Copse77 profile image
Copse77

Sepsur is right ask for the MRI but keep talking to your husband. The smallest signs of a response like the kind consultant shouting loud my brothers name down my brothers ear when he was unconscious made his eyes blink open briefly in response. These wonderful small positive I noted and focused on these on bad days. I really hope your husband can improve.

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