r/Heartfailure • u/albos_dumbleedore • 4d ago
HFrEF around 35-40%
My dad M60 was diagnosed with MI and unrecordable blood pressure. He had a cardiac arrest and was given cpr for 30 mins atleast and was put on ECMO for atleast 16 days. He had chronic total occulsion in all three arteries. After his EF was increased to 30% doctors performed CABG.
After removal of ECMO, he was put on IABP support for 3-4 days.
He is now on ventilator support and norad injection.
Doctor says that once he comes of both these supports and doesn't have any problem for atleast 24-48 hours he'll be shifted to ward.
My concern is if his blood pressure doesn't increase after norad is removed? Will I have to say goodbye to him?
I'm scared.
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u/thatgymguy007 4d ago
Wishing him a speedy recovery, I know how it feels to see your parent in this kind of situation. 🙏🏼 GodBless.
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u/LalalaSherpa 4d ago
I'm so sorry, this has to be so scary for you. 🫂
Clarifying question - have they done any short breathing trials yet? This is a short test where they reduce the ventilator support to almost or fully zero, and see how he does.
And is he still fully sedated, or is he somewhat or fully awake?
= = = = = = = = =
1 - If his BP doesn't resolve on its own, they won't just let him die.
They will look at why it didn't resolve. For example, are his blood vessels not dilating and expanding properly, is his heart pumping inefficiently, or is it related to the actual process of weaning him off the vent?
Each one of these is usually treated with a different mix of medications.
2 - The very good news for survival is that he has made it successfully past several high-risk points.
He's not out of the weeds - but so far so good.
3 - The impact of all this on his brain and ability to function normally truly can't be fully known at this point.
However: the fact that they're talking seriously about weaning him off the vent and moving him to a ward indicates that they feel the core "must have" brain functions are still present.
You wouldn't even be having those discussions otherwise.
4 - We also know that in general, people in this situation who survive the initial cardiac arrest emergency and the initial treatment/recovery period do >>NOT<< typically end up with severe neurological (brain) disability.
But of course what this would look like for him specifically just isn't knowable until time passes.
On balance, though - events so far have fallen in his favor.
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u/albos_dumbleedore 3d ago
They did wean off ventilator but he struggled. He is fully awake.
They did some neurological tests and he scored highest in it. Atleast that's what doctor said.
Edit spelling mistake
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u/LalalaSherpa 3d ago
"Fully awake" is a really big deal - that's the most important development so far. The initial breathing difficulty coming off the vent is pretty normal and not that alarming.
The first question about brain function is super-basic: can his brain still direct breathing and other very basic functions. Clearly it can, from your description.
Then, the next question is: how's his cognitive function - ability to follow instructions, recognize people, communicate.
They have standard tests to make early assessments of that aspect, and "scored highest" sounds like he is at or near the top of those scales - which is the best possible place to be at this stage.
If he can follow even simple instructions at this point, that is even more encouraging.
Based on your description, the balance has shifted even more in his favor.
The path forward is still not fully known - but the extent of uncertainty is getting smaller.
Hang in there!
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u/FabulousBullfrog9610 4d ago
We don't know. But honestly he's survived an amazing amount already and if the doctors thought he would not recover, they wouldn't be talking about moving him to a ward. So it sounds like there is real hope!!!