June 29

 Brian is stable. His doctor called earlier in the day to discuss plans for the week. He does still need to get the CT scans that have been ordered but, as of the time I spoke to Brian's attending physician, he had not yet been taken to the imaging area. A pulmonary artery catheter was removed from Brian to give his artery a rest but will be inserted again on Thursday. (Its purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the effects of drugs.) The plan is to continue to allow Brian's body to rest so that on Friday, the same test will be repeated to see if his heart is strong enough to have the AV ECMO machine removed from Brian's heart. In the meantime, they continue to try and remove as much extra fluid as the two ECMO machines will tolerate. Part of the reason that it is advantageous to have Brian removed from the AV ECMO machine is that once he is on just one ECMO machine, there won't be as much fluid required to be pulled and returned to his body. The less fluid required, the more that can be filtered out by his dialysis machine, and the easier it will be for his heart to manage his circulatory system.  Brian's bilirubin is at 15.8.