Was over visiting Dad today, who's been unusually zonked for the last few days, when we ran into an unusually lucid respiratory therapist - one who made it his business to make sure we *understood* the why's of what's going on with the respirator weaning process as well as the what's.
Essentially Dad has been sedated the last week because of what we were told was "unusual and possibly dangerous heart rates" and sedation (Atavan) was being used to counter. Fine'n'dandy.
But as Paul Harvey used to say, the rest of the story...as it turns out, and not surprisingly, being weaned off a respirator can be a bit traumatic as it can feel like your air is cut off. Anxiety-producing, even.
Anxiety, in turn, ramps up the metabolism with increased heart rate and respiratory effort...followed shortly by aspiration and return to the respirator. As I understand it, this leads to the current regiment of a delicate balance between zombie and over-anxious during the weaning itself, followed post-weaning by bringing the patient back up mentally, if all has gone well.
Yesterday Dad was on heated & and humidified air w/o mechanical respiration for 16 hours. Today when we were in, he still required suction, but was on heated/humidified air with a 29% oxygen content, 98% oxygen saturation, a good sinus rhythm, and a heartrate of around 70...
Sounds like improvement, though not immediately apparent at a visual level, particularly as he was zonked on atavan when we arrived and his leads had disconnected when he'd moved...resulting in *instant* consultation time (I was good. I did not use the classic "He who shall be obeyed" in combination with attention getting verbiage. )
We'll see what the next few days hold.