AboutHillarie Speziale Expertise I can answer general questions about ICU care, the frequently used medications, procedures, and life supports. I can also explain many of the diagnoses and supportive measures used for patients with that particular illness. I am familiar with the infectious, cardiac, pulmonary, renal, and gastric problems that can land you in the ICU. I can not tell you exactly how long the patient stay will be, diagnosis your symptoms, or tell you with any certainty that the care you (or your loved one) received was wrong. I can also answer career questions regarding RRT and RN fields. Please note: neurology is not a field I have a great deal of familiarity with..
Experience I have 17 yrs experience as a Respiratory Therapist, and 9 yrs as a critical care nurse. I am familiar with infectious, cardiac, respiratory, renal and gastric diagnoses that can land you in the ICU.
Education/Credentials Assoc. Degree in Respiratory Therapy, Bachelor of Science in Nursing, Master of science in psychiatric nurse practitioning.
Question My son was admitted to ICU with pancreatitis and is on a ventilator since admission. He is 38 years old and otherwise no health issues. I am divorced and his father has POA so I am not able to get pertinent iformation. Could you please explain why the ventilator and what are the usual care procedures for this type of case. As you can imagine, I am frantic.
Answer Hi Tracey,
This must be really difficult for you. I hope there is some possibility of putting aside differences at a time like this, but I know it's not always up to us. If there is a chance of being with your son I do urge you to do so. I do understand, however, that there may be extenuating circumstances that make this impossible. I'll do my best to tell you what I know.
The pancreas contains the enzymes used to digest fats, proteins and carbohydrates within the small intestine. Normally these enzymes are not activated until they reach the intestine.
Pancreatitis occurs when the enzymes are activated and begin to digest the pancreatic tissue itself. This is often an acute and self-limiting process. The care is supportive. The patient must completely rest the gut. Often a nasogastric tube is placed to keep the stomach empty, and IV fluids are administered to prevent dehydration.
Unfortunately, pancreatitis can run the gamut from this brief and self limiting bout to a severe and life-threatening illness. Pancreatitis can become life-threatening if there is leakage of some of the inflammatory debri into the blood. These toxins result in damage to the rest of the bodily tissues. Capillaries through out the body may become leaky resulting in fluid seeping out of the capillary bed into body tissues and the lungs. In addition, the small muscle bed surrounding the veins lose their tone, allowing blood to pool in the periphery of the body.
The combination of less blood volume and loss of venous tone results in a profound drop in blood pressure. Meanwhile, the seepage of fluid into the lungs makes it difficult for the patient to get enough oxygen. These insults of low blood pressure and low oxygen may, in combination with the toxins building within the body, result in kidney damage. I am afraid to say, there is also the worry of what is occurring in the pancreas as it auto-digests. There is danger that there may be bleeding into the organ or the development of pseudocysts, which may need to be tapped if they become large enough.
Care remains a process of supporting what ever bodily functions are being compromised while waiting for the inflammatory process to run itself out. Intravenous fluids and medications to support the blood pressure are administered. The ventilator can assists the lungs in providing adequate oxygenation. Nutrition is provided intravenously so the gut can continue to rest. If need be, dialysis can be used to support kidney function. You'd think we would have more to offer with all these medical advances we always hear about.
I am sorry. Pancreatitis can be a very difficult disease. On the plus side however, your son is young and otherwise healthy. These things will be in his favor.
I will keep your family in my thoughts. Please write with any more questions you may have. I pray he will do well.
Sincerely, Hillarie
