Recently identified was a mass in my mother's lower lung. Dr.'s believe it to be a hemotoma- bleed. They tested for infection and found MRSA in ears nose and throat, and E-coli in lower respirator tract. Fluid was removed around lung with chest tube, but there was no infection within the fluid. Dr's have her on Vancomyacin,cleomyacin,aztreonam (spelling of drugs may be poor)
Dr's say that the bleed should resolve itself similiar to a bruise. My mom has been on a vent since 7/24. Right now she tolerates CPAP for 6 to 8 hours with 12 pressure. I also got the indicator that this bleed bruise developed over the past few weeks while at the SNF. She has been prone to clots so they now have her on cumadin.
Originally at the first hospital stay she was on heparin and then removed from the drug after a screen was placed to avoid blood clots from traveling to lung. The hospital also indicated to me that bleeding was occuring in her lungs, so they removed her from the heparin. After transfering to a SNF they put her back on heparin to avoid clots, this is the time frame that she developed the bleed in the lung the size of a fist. Once the SNF determined this, they sent her back to the hospital, for treatment as described above.
My mother has smoked for many years, not very many cigarettes, bur for a long time, she is now 66 years old.
Does anyone have any experience with how long it takes someone with such a condition to get better--off vent. Does this hematoma as the Dr describes inhibit her from breathing well?
The hematoma that you have described may make your mother a little sensitive when it comes to breathing. However, when weaning from a ventilator, each patient is different. CPAP of 12 for 6-8 hours is a start. Are they actively trying to wean her or are they leaving her on the pressure of 12? It sounds as if your mom is on the way to getting off the ventilator. With that said, it may take her a little while to do so. Pulmonary contusions can make weaning a little difficult. Her age may be a factor when I say this. I have weaned patients off of ventilators with broken ribs, pulmonary contusions, and pneumothoraces with chest tubes and they do fine...very tender but they breathe OK. These patients are also much younger. But as I said, each patient is different. I know this has been a long road for you and your mother and I have responded to your other questions so I know that sometimes this can be frustrating. I hope your mother continues to come along, even though it may take some time. Try and be positive and reassuring to yourself and your mother. Poistive re-enforcement is important. Hopefully they can extend her weaning trials from 6-8 hours to 10-12 hours. Baby steps. Take care and good luck...
JCI RRT, RCP.
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