Seeking Clarification on Mother's ICU Condition Following ERCP
I’m reaching out for advice regarding my mother, a 48-year-old woman currently in the Intensive Care Unit. She was admitted after a distressing ten-day period during which she was unable to consume food because of a blockage in her common bile duct caused by a stone. Fortunately, she underwent a successful Endoscopic Retrograde Cholangiopancreatography (ERCP) procedure with stent insertion yesterday at 2:00 PM, and she did not exhibit any jaundice. **Current Condition Update:** - **Respiratory:** My mother is utilizing a BiPAP apparatus and has maintained an oxygen saturation level of 98% for over four hours. However, her levels drop to 80% without the machine. Despite her situation, she remains calm and alert. - **Digestive:** An NG tube is in place, draining a greenish-yellow fluid. As of now, she has not been able to tolerate any water. - **Physical State:** Her arms are noticeably swollen, prompting the medical team to insert a Central Line for improved access. Additionally, her hands feel cold when touched. **Recent Laboratory Findings (16 hours post-procedure):** - **Total Leukocyte Count (WBC):** Currently at 22,500 (previously recorded at 26,000 upon admission, then decreased to 21,000 before the current reading). - **Hemoglobin (HB):** 8.9 g/dL (considered low). - **Liver Functions:** SGPT (ALT) is 48, SGOT (AST) is 42, and Bilirubin is 0.81 (all values mostly within normal limits and stable). - **Kidney Function:** Creatinine level at 0.96 (normal range). - **Neutrophil Percentage:** 82%. **Concerns and Questions:** 1. Is the minor increase in WBC from 21,000 to 22,500 expected shortly after an ERCP since it can cause some agitation in the body? 2. Given the hemoglobin level of 8.9, is prolonged use of BiPAP typically necessary to maintain stable oxygen levels in such cases? 3. Does the presence of green fluid in the NG tube indicate that the stent is functioning as intended, despite it being secreted in a reversed manner for the moment? 4. What positive indicators or signs of improvement should I keep an eye out for in the next 12 hours to assess her recovery progress?
Answers (1)
2/14/2026, 11:00:46 AM
OpenHealth AI
I'm glad you're reaching out for clarity regarding your mother's condition. It sounds like she has been through a tough time, and your concerns are completely valid. Here’s a breakdown of your questions and concerns:
Main Points:
- WBC Increase: A minor rise in white blood cells (WBC) after an ERCP is common as the body responds to the procedure.
- Use of BiPAP: The necessity for BiPAP can vary, especially with low hemoglobin levels, and closer evaluation is essential.
- NG Tube Fluid: The greenish-yellow fluid suggests bile is draining, but the situation requires monitoring.
- Signs of Improvement: Look for signs like increased tolerance to liquids, stable oxygen levels, and improved overall alertness.
Explanation:
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WBC Increase: After an invasive procedure like ERCP, it’s not unusual for the WBC count to slightly increase, indicating the body may be responding to some minimal inflammation or stress. The decrease from 26,000 to 21,000, and then a minor increase to 22,500 is a natural fluctuation as she heals.
-
BiPAP Necessity: While BiPAP is helpful for managing breathing difficulties, a low hemoglobin level (8.9 g/dL) can affect oxygen transport. The medical team may need to monitor her hemoglobin levels closely, as low levels can lead to increased reliance on oxygen support.
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NG Tube Fluid: The greenish-yellow fluid draining from the NG tube usually indicates bile, which could mean that the stent is functioning properly. However, the fact that she hasn’t tolerated any water may necessitate further digestive evaluations.
-
Signs of Improvement: In the next 12 hours, watch for:
- An increase in her ability to tolerate oral fluids.
- Better stability in her oxygen saturation levels without needing BiPAP.
- Signs of reduced swelling in her arms.
- Improved alertness or decreased drowsiness.
- Any positive changes in her digestive output or reduction of abdominal discomfort.
Next Steps:
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Monitor Symptoms:
- Keep an eye on her oxygen saturation levels and alert the medical team if her oxygen drops frequently.
- Note any changes in her ability to tolerate water or food.
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Stay Close to the Medical Team:
- Ask about periodic checks on her hemoglobin levels to determine if a blood transfusion is needed.
- Inquire if any adjustments to her BiPAP management can be made as she stabilizes.
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Emotional Support: Be there for your mother emotionally, as she is likely feeling vulnerable in the ICU. Your presence and calm demeanor can be very reassuring.
Please don’t hesitate to continue asking questions, either with the medical team or here. It’s essential to stay informed about her care and progress. Your vigilance will play a crucial role in her recovery.
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