nicurn08

Thanks... his blood gases were perfect and xray looked great, I didn't want to give sedation because it wasn't affecting his gases and he would calm down immediately after his spells. He probably just needed the tube out, but the RT disagreed and just wanted to sedate. The other thing was during his desats his heart rate would increase and CO2 (from the TCom) would drop from the 50s to 30s during his spells. Thanks for your input :)

I had a 32 weeker that was intubated and was becoming agitated and fighting the vent. After recieving report of this and morning rounds, we all agreed to aggressively try to extubate to CPAP. About 8 hours later he was still intubated and having multiple desats (to the 50s) that would take about 5 minutes to recover. The neo attending told me he was agitated because of the tube, and hypoxia and was ultimately still trying "to breath through a straw" (the ett.) What I dont understand is that I thought a 32 weeker is an obligate nose breather... does this change if they are intubated?? I know the ETT is his only airway but would he not exhibit any other signs of respiratory distress?? Thanks!!