intensive care

[monty0703]

I have a relative in intensive care who is doing fine apart from still being on a ventilator. They say that she is unlikely to come off but I can't believe with all the technology there is that something can't be done. She is fine apart from that and I can't get my head around them wanting to stop treatment when they try to get her off and it doesn't work. Any advice would be really appreciated. I don't know where or who to turn to. I can't lose her, I just can't.

[Sqad]

boxtops ....good morning my darling.

This is not an uncommon problem and as already been said, one cannot keep her on a ventilator for ever and the decision to take her off artificial ventilation will be taken by a group of doctors and staff at an ICU meeting.

[monty0703]

Sqad, she's had a tracheostomy and was doing brilliant when capped off. they said that they fear her lungs are too weak. are there no machines that can help with this? when she's capped off she's breathing fine and breathing entirely on her own so i can't get my head around it all. are there no breathing type devices to help strengthen lungs?

[Sqad]

monty.....if she is "capped off" I presume you mean that she is taken off the ventilator.

If she is doing well, there would be no reason to put her back on the ventilator.

The fact that she is put back on the ventilator would indicate that she is "not doing well" and cannot breath on her own.

Other machines less effective MIGHT be available, but could they and her, be managed at home..............I doubt it.

You still haven't answered my question.......what operation did she have and for what condition and how old is she?

[monty0703]

she had a successful aneurism op and is 75. she had a lot of tests done before which showed what we all knew, that she was fit and healthy. they took the trachy tube out and her co2 levels built up so they put it back in again and they are saying that they will try again but if her co2 levels creep up then there's nothing they can do and won't put the tube back in. i can't believe this is happening - she was literally a couple of days away from being transferred to a ward.

[Sqad]

Was this a cerebral aneurysm or an abdominal aneurysm.

Important to know.

[monty0703]

abdominal

[Sqad]

Big problem and is a "big deal".

They will certainly try again, perhaps twice to get her off the ventilator but if the pCO2 continues to rise, then switching off will have to be considered.

[monty0703]

thanks for your answers folks. i'm going to sign off now as i just can't stop crying but need to try so i can compose myself for seeing my mum.

[boxtops]

Monty, we're thinking of you - here if you need us, please come back if you feel like it. Love to you and your mum ♥

[sara3]

agreed, boxy.. all the best to you and your mum, monty x

[joko]

in this instance i would personally insist they do all they could.

she is clearly not brain dead or even damaged, so she may well in time recover enough

you hear stories about how people, against all odds, fight an survive and it sounds like she may have a chance

me personally, i would always be wondering what if...

(this is all assuming she is not in agony, does not have some degenerative illness etc)

[marie26]

I am very sorry that your Mum is so unwell, and you and your family have my good wishes during this worrying time/
The problem seems to be that your Mum cannot get rid of her high levels co2, and that means that her o2 levels must be too low when she is off the ventilator. Giving more oxygen will not be the answer, because as her o2 level rises her co2 level will rise higher. I wonder if your Mum has any pre-existing respiratory condition that would account for this development post surgery? Also, I wonder if the ITU or the chest team at your hospital provide any form of non invasive ventilation? This type of ventilatory support is used successfully in many chest units for many patients who have this type of respiratory failure. It involves a mask and a small ventilator, and the patient uses it for short periods during the day, and for several hours at night for as long as necessary until the co2 and o2 levels are steady.
Patients with pre-existing chest conditions have many problems coming off ventilation with a tube - endotracheal or trachy.