Yet another NEC vent :(

Specialties NICU

Published

So this kid I mentioned in the other post... she was a 29 week twin... full feeds and 10 days old on NP. Had a little poochy belly all night, small residuals... nothing super worrisome. Bam. 6 hours later... no viable bowel. Took her off. That was last saturday.

Last night I had her twin. Was told she looked odd and had 7 severe brady/desats that shift. First assessment had a huge loopy belly, not so soft, 7ml residual, and a huge normal stool. Of course MD didn't care and thought I was being paranoid. Next cares, looked a ton better, but was still sickly looking... pale and mottled, and just not right. She was still having spells. Small residual...fed again. By 2 I let the MD know she had 5 spells already. He didn't really seem to care and attributed it to prematurity and apnea. He wouldn't look at her... So no significant change by morning except a total of 7 spells. I asked if I could increase her NP from 0.5L to 1L to see if it helped... then I went home.

She slowly got worse on days. They even did an x-ray which was not conclusive and kept feeding. Finally made her NPO around 12 because of persistent apnea. X-ray showed tons of pneumatosis. When I got back they were intubating. Her sugar was over 400 and she had portal air. They sent her to Children's. Who wants to bet she dies?

Ugh. This sucks. I should have been more persistent, even though I am 99.9% sure I wouldn't have gotten my way.

I'm depressed....:crying2:

Specializes in NICU.

It sounds like you did everything that you could. You let the doctor know several times that there was something not right going on with this baby. They are the ones that never came to the bedside to actually assess the baby. Try not to dwell on this too much (I know - easier said that done...)

Ya it just sucks all around. Looks like I could be wrong... surgery went better then expected... I pray for her and her family. They already lost her twin to NEC.

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