Weaning and blood gases played second fiddle today to some severe hypotensive events, coupled with severe hypertensive events in response to the meds to bring his pressure back up. It took hours for Tyler to stabilize. His fever rose quite a bit today. Just to confound the doctors a little bit more, the second test they ran for HHV-6 came back negative today. So that likely means that Tyler’s own immune system fought off that viral infection before he started the anti-viral for it (yay for Ty’s new donor cells!).
So…that means all they know is he is definitely fighting an infection again, but aren’t sure what it is. Since he tolerated so many weans yesterday, it’s likely not a new lung infection. They are drawing many blood cultures each day, but nothing is growing. In the meantime, they’re going with the likelihood that the source of infection is his skin since he has so many different lines going into him, plus wounds from skin breakdown. They started him on Vancomycin tonight to cover that possibility.
Vanc is one of the meds suspected in his earlier drug rash. Since he already has a really bad rash that started a couple days ago, we won’t be able to tell if he reacts to Vanc again. Seriously, if Tyler represents the typical PICU patient, I have no idea how the doctors deal with these kinds of daily frustrations! In addition to his blood pressure and fever struggles, Tyler had his PICC line, bone marrow and skin biopsy procedures. It was a big day for Tyler, but not the type of big day we were hopeful for! Despite everything, Tyler maintained his Delta P setting and only had to go back one notch on his Hz. So from that standpoint, he really kept most of his progress from yesterday; he just developed some new little wrinkles.