Last night, we had a new helper.
The evening began with a missing medication. Manuela called me and asked me to try and find it in a pharmacy on the road. After an hour of searching, they finally found it in a drawer.
Then Gabriel was more awake than usual and the night was short.
From 2:30 onwards, he began to become agitated, with a tachycardia exceeding 190. This became an almost daily occurrence, and the problem was that his breathing also accelerated, sometimes exceeding 60 per minute.
At 4 a.m., I called the doctor who administered a rescue treatment, but it didn’t make much difference. Another doctor came by at 7 and prescribed a new treatment. In the meantime, his fever had risen to 38°C. Then, little by little, the situation improved.
The possible causes considered at the time were numerous: a virus, sedative withdrawal, teething… we don’t know.
Explanation from the pulmonologist
The pulmonologist came by today and explained that the phenomenon observed in Gabriel could correspond to what’s known as nocturnal hypoventilation with CO₂ retention, also known as nocturnal hypercapnia.
It’s still useful to have a pneumologist at the hospital, isn’t it? (it took 3 months to get one…)
How does it work?
- In a child with partially obstructed bronchi (as in bronchiolitis obliterans), ventilation is inadequate during sleep.
- Oxygen enters well, but CO₂ is not properly eliminated and accumulates in the blood(hypercapnia).
- On awakening, the body detects this surplus and triggers rapid breathing(polypnoea) to evacuate it.
Chronic, uncompensated hypercapnia can lead to fatigue, sleep disorders and, in some cases, cardiac overload.
The pulmonologist has advised us to try a nocturnal NIV (non-invasive ventilation) session to help better eliminate CO₂ and stabilize breathing during the night to avoid this crisis in the morning.
So we’re going to try it starting tonight!
The hospital seems to be full again: there are many cases of flu (be careful if you have children in Ceara).
Following this morning’s fever, this evening Gabriel did a PCR test to detect any respiratory viruses. There seems to have been an error in administration, and the result is currently blocked. We hope it will be released during the night…
Good night to all!
