Monday, May 19, 2014

CO2 Trend

This morning, Roscoe had his 3rd CO2 measurement since he's been back on more breathing support with the bubble CPAP. His first two measurements (64 and 68) were taken from the small capillary veins in his foot, so they can tend to be higher than the actual value. This morning's measurement was taken from his arteries, so it is more accurate. We were hoping for a lower value. I specifically prayed for "58", but the measurement came back at 77. This is one of the higher readings he's had (higher is worse).

The pulmonologist gave us the chart below when we had a meeting about a week and a half ago. The chart shows his CO2 readings over time, correlated to changes in his breathing support.
I put "lightning bolt" markers where his breathing support was changed. For the start of the graph, he was primarily on bubble CPAP with some short periods on vapotherm (like he is right now). At the first lightning bolt, he was changed to vapotherm-only. At the second lightning bolt, he was changed to a non-pressurized nasal cannula to prepare for going home. At the third lightning bolt he was changed back to vapotherm when they learned he couldn't go home. Then at the solid line ending of the graph (the day we had the meeting), he was changed back to bubble CPAP. I added additional markers to show his readings since the chart was printed.

At this point we had hoped to see a downward trend starting, since he's receiving additional breathing support. The amount of oxygen being pushed into his lungs has been increased from 100mL/minute to 2100mL/minute (6L/min at 35% oxygen). What is extremely frustrating to Alisha and I is that he is on greatly elevated breathing support now, but his readings are indistinguishable from those in late March when he was on minimal nasal cannula preparing to come home. On Saturday the doctor on call said that if his numbers stay in the mid-60's then they are comfortable with that. I'm not sure if they'll react to this single reading of 77 and elevate his breathing support once again, or if they'll give him time to get another reading.

2 comments:

  1. To me it looks like his readings are the best and most steady when he (and you two) are the most happy, like when he was preparing to come home. I think he was on the least breathing support at that time, too. I will also pray for happiness, as well as breathing and lung growth : ) Hey, maybe play Pharrell William's song "Happy" and dance around as far as his cords will let you!!!

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