No change overnight

Hello to all you early risers and East Coasters. Riley had a stable night with no change. His BP has been pretty constant but there has been no reduction in his Tenkoff drainage. He is still averaging ~100cc of output an hour from that drain in his lower torso, or over 1500ml a day. The plan earlier in the evening had been to start to bring him out of the coma a bit to raise his blood pressure, allowing the doctors to reduce his albumin intake, thereby (hopefully) reducing his Tenkoff. That plan was scrapped at about 11pm when his BPs went down again so the intensivists decided to keep him on the current albumin plan (he gets albumin at 75% of the previous hour's Tenkoff volume). The Tenkoff volumes are an indication that his lower circulation system is having a hard time adjusting to the new Fontan pressures. Fenestration is one way to deal with that until his body is able to handle it. We're not sure if that means fenestration is back on the table until we talk to the cardiologists today. We know that fenestration isn't a solution if his ventricle can't handle the Fontan, but it may be a possible course of action if it looks like his heart is recovering but his lower body circulation system needs relief.

Doctors weren't too concerned about the lower pressures during that period since they come up quickly when he is stimulated and when his liver is pressed on. Right now he is in a good range. His bed linens were changed and he got another bath. Dad has had night duty, Mom is at a friend's apartment nearby sleeping.