Floated over to the cardiothoracic ICU today to get in my ECMO (extra-corporeal membranous oxygenation) hours in. It's so rare that we have a case in the pediatric ICU , and the CTICU has been staffing their own, so it's been a while for all the PICU nurses. Anyway, the patient was a couple of days old, and had had reconstructive cardiac surgery. The surgeons left the chest open, which is not uncommon, covering the vital organs with a patch and an occlusive dressing. The night shift said that the team was planning on taking the baby off ECMO, so G and I were prepared when the surgical team rounded.
The procedure began in earnest later that morning, in the patient's room. The scrub and circulating nurses wheeled in all the equipment, we all masked and bonneted up, and the surgeons proceeded to remove the patch and we crossclamped. We started some epi, but the srugeons soon decided that today was not going to be the day. They cleaned up some clot in the chest wall, sewed on another patch, put on a new occlusive dressing, and that was that. We soon got the patient back to the previous ECMO settings, and had a really boring rest of the day.
However, I will note that the sight of this baby's beating heart under the new patch struck me as particularly amazing and awesome. Tiny thing, this premie baby, and small for its gestational age. However, that will to live still manifests itself. Don't know how things will turn out, as the baby still has a long way to go, but I'm rooting for this one.
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