Update - Monday, April 4, 2011

As was mentioned previously, the doctors are working on a plan to ween Maddox off ECMO. The ECMO machine is what's keeping him alive and are doing the function of his heart and lungs. So it's pretty scary to hear that they are wanting to get him off of ECMO as soon as they can. But they need to challenge his lungs and to test if he's ready to get off ECMO. The typical run on ECMO is 10-14 days.  Maddox is on day 12 so it's time to make an attempt.  It's crucial on getting him off of ECMO because he will continue to bleed in the area where he had his surgeries. Also, staying on ECMO presents another host of problems that can potentially harm Maddox.  In order for the machine to function, Heparin (blood thinner) is fed through the circuit to prevent the machine from clotting.  For someone that just had surgery, blood thinner is the last thing that you want.  It's a delicate balance to say the least.  They have to put just enough heparin in the machine so will not clot but not put too much or Maddox will continually bleed out. 

Today Maddox isn't doing too well. He's been bleeding alot in different areas. The doctors said the only way to stop the bleeding  is for him to get off of ECMO. The doctors were concerned with his bleeding so they ordered Maddox to have a head ultrasound to see if he has any bleeding in his head. And the test came back negative. Whew!!!! Since early this morning, they gradually lowered the flow of the ECMO from 130 down to 80. It has been 80 since 4 pm this afternoon. The lowest they can go with the flow is 50. Which means the lower the flow, the less support that is given to Maddox.  In turn, Maddox lungs are working and is tollerating the less support on ECMO. This is good news. The ENT came and put a new breathing tube with a cuff down his throat. The new tube is helping with eliminating the leakage of air that was a problem with the last tube. This tube goes toward his lungs and to help inflate it so it can work. Evidently Maddox didn't like the hassle of the new tube and so his saturation numbers went really low to the 70s. Maddox doesn't really like to be bothered and is very sensitive. So the doctors decided to wait till tomorrow to ween him off of ECMO while Maddox's numbers are at it's best. The trial off ECMO will be done tomorrow. This is done where they clamp down on the circuit so the flow is not giving any support to Maddox for 20 mins first and they will do a blood gas every 5 mins to see how he tolerates it. And if he does well they will do it for several hours and his ventilator support has to be at a setting of 50 or lower. Because when Maddox gets off of ECMO, the only thing that will support him is the ventilator. They will need room to work with in case he needs more ventilator support. The highest setting for the ventilator is 100.  All of these factors is what contribute to the final decision that he is ready to come off ECMO.  If he can't get off of ECMO, then they will have to change the circuit because currently the circuit has some blood clots in it.  Please continue to pray that Maddox lungs are strong enough to get off of the ECMO machine tomorrow. It's definitely a roller coaster. Maddox is fighting and is hanging in there. We love him sooo much!!! He was sleeping so peacefully tonight. He's such a beauty! Awwww..... :)

Below are some pictures to get an idea how the ECMO machine looks and how Maddox's room is set up...

 Maddox is connected to the ECMO machine below. : - (

 A very sweet nurse name Carleen made a name tag for Maddox. Purple is for team Maddox belong to.

 The machine to the left is the ventilator.