#2 Update

Averi had her second blood transfusion last night before she crashed. Her last blood gas was not where they wanted it to be, so they are thinking about putting an arterial line in her right arm. I clarified with her that Averi is no longer on the high frequency ventilator, but has been switched back to the conventional monitor.

What is an arterial line? Why the right arm?

Pulmonary hypertension that is present in CDH babies causes deoxygenated blood to be shunted away from the lungs and into the aorta and circulate into body. The shunting happens from right to left. Because of this, they use the radial artery (if you hold your right arm so that your palm is parallel to the ceiling, the artery will be on the outside--along the radius bone, where it gets its name--of your forearm. ) on the right arm to obtain blood gas samples from preductal blood. This in conjunction with a postductal pulse oximeter usually provides fairly accurate results. Warning: I'm about to get all nerdy on you! The pulse-ox monitor is a device that has a pair of small LEDs (one red, one infrared) lined up with a photodiode through a translucent part of the body. In a newborn, they usually use the hand or foot. Each light has its own wavelength. Absorption at these wavelengths differs between oxygenated hemoglobin and deoxygenated hemoglobin. The ratio of the absorption of these lights is directly related to the oxy/deoxyhemoglobin ratio. They then get an idea of the oxygen level. You might have had a doctor get a pulse ox from you before. In older children and adults, it is a plastic thing that they pinch and put on your finger.

Anyway, all that to say that they try to use multiple tools to give them information so that they can ensure that their numbers are accurate. An arterial line essentially is the same thing as an IV, but instead of a vein, they use an artery.

Teresa is exhausted and worried about Averi and feels like they've taken a huge step back. However, the doctors are satisfied with where she is right now. With CDH, it is literally one hour... and sometimes one minute... at a time. Please keep praying!