Out of Surgery!

The surgeries were a success! The surgeon said Doctors said that Averi is more stable now than she was before surgery. As I said before, they put her on ECMO first, and then did the repair. They were able to do a primary repair, which means that they just stitched the hole closed! This is awesome because it means that she won't have to have a later surgery to replace a patch that won't grow with her body. Her lungs were a little beat up and there was little blood loss. Following the surgery, they moved Averi, ECMO machine and all, to the PICU, where the princess gets to have her very own room!

Here is a diagram of the ECMO contraption... the machine is actually huge, but this gives you an idea of what the circuit does:
Basically there are two cannulas in the neck. Blood is taken out of one of them, cleaned, oxygenated, warmed, and then it is put back into the baby via the other cannula. Interestingly enough, you can see the color change in the blood after it is oxygenated!

The next 48 hours is absolutely crucial. Keep in mind as you read the updates that most babies get a little sicker before they get better. The ECMO is a scary thing to think about. It is the biggest fear that every CDH parent has. Truly, though, is a lifesaver. It will give Averi's lungs a chance to rest, expand, and gradually start working on their own. Kevin and Teresa felt overwhelmed at their first glimpse of Averi. The tubes of blood are about 3/8" in diameter and run several feet. Pictures really cannot prepare you for what it is like in person.

Over the next few days, they'll be running lots of tests to determine how much lung she has on the left side, watching it to see if it expands, and do ultrasounds of the head daily or every other day to make sure there are no bleeds. (There is heparin, a blood thinner, in the ECMO circuit, which means that they have to be super careful to make sure no bleeding occurs. They don't even like to poke the skin with a needle!)

They will also continue to run periodic blood gases, which will determine when they start weaning her off of the ECMO pump. You will probably start seeing reports of "numbers" associated with the ECMO pump. The target number is usually 120-100 before they start talking about taking a baby off of ECMO. My daughter's beginning number was 400, and she was on for 7 days. I'm not sure what number Averi is starting at!

∞•∞Specific prayer requests∞•∞

> As Megan said on Facebook, ECMO is hard on the kidneys. The kidneys depend on the beat of the heart to function. Since ECMO is doing the job of the heart and lungs, the heart doesn't beat at the normal rate... It almost stops. So pray that the kidneys remain functional.

> Bleeding. Pray that there will be no cranial bleeding!

>Pray that as Averi's lungs have a chance to rest, that they will start doing some of the work on their own. As she does this, the ventilator will be turned up and the ECMO pump will be turned down. (While on a high degree of ECMO, they don't use much ventilator... just enough to keep the lungs from collapsing.)

> Eventually we want them to be able to hear some crackling in the lungs which means they are waking up! We also want the pulmonary hypertension level to reduce!

I will update with more specific information as I get it, but this should get you going for right now! :)