The First Graduation

During our visit today they switched Calder from the always-pumping and very noisy jet ventilator to the conventional ventilator. He took to the change pretty well and at least based on his appearance seems to like it a lot better. I'm pretty sure that a conventional vent can do more damage to the lungs, though, because it isn't as gentle, so we don't want him here very long. Next step will be CPAP, followed by nasal canula.

The new ventilator!

We are also starting to be able to hear him breathe, and I sometimes even hear him squeak! The respiratory specialist says that this is because there's a leak, and the air is breezing through his vocal chords. This leakage is to be expected to some degree because while he's growing, his tube isn't, so the space between the tube and his throat is enlarging. Since the air is escaping when he breathes out the machine cannot monitor his CO2, but he is still getting the oxygen and pressure that he needs, at least for now. He is in between tube sizes; right now he has a 2.5 but he isn't quite ready for a 3, and they don't make a 2.75. Because intubation is a tricky process, and because it's tough to tell when he's totally big enough for the next size up, they want to wait until absolutely necessary or until he extubates himself to try that next size.