Blood gases continue to look poor, base deficit is high (indicating a worsening metabolic acidosis), lactate is increasing. Emerson is very sick. The decision was made to take her to the OR stat to remove her line & look for new, temporary access. There is significant concern they won't find anything & cardiology is on standby to come in for a venous cut down, balloon placement, &/or creative wiring, as indicated, to achieve access. The team believes if they don't take her soon we'll lose our window to safely get her through surgery. She'll return to the room intubated & remain that way until gases improve and things are better under control. The vent will take away her work of breathing & hopefully give her more energy to fight this infection. The million dollar question now is, where is it all coming from? If it's a line infection Emerson has a chance at clearing it. If it's seeding from a deteriorating bowel there's no hope. I've had lengthy conversations with everyone here - transplant, PICU, surgery, etc. We are in a potentially difficult spot & are taking this one decision at a time. I've formally enacted a DNR for chest compressions & cardio electric shock...
Please keep them all in your prayers.
