Twins 'weaned' off drugs
2003-10-15 22:17
Dallas - Doctors have started to decrease the drugs that have kept formerly conjoined 2-year-old twin Egyptian boys in comas since they were surgically separated over the weekend.
"So far we've seen no adverse signs of the tapering of these medications, but expect that it may take several hours to a couple of days for the effects of these medications to actually begin to wear off," Dr James Thomas, chief of critical care at Children's Medical Centre Dallas, said on Wednesday.
He said the drugs that induced the coma will gradually be reduced.
Once out of their comas, the boys will be watched for spontaneous motor functions seen in even a sedated child: reaching to grab out tubes, looking around the room, grimacing, doctors said.
The boys, joined at the top of their heads when they were born in Egypt on June 2, 2001, have been doing well since they were separated on Sunday during a 34-hour surgery.
"All in all, the medical team members are delighted with the boys' progress, but all of us involved in their care remain vigilant to possible complications," Thomas said.
The boys, who remain on mechanical ventilators, have no signs of infections or spinal fluid leaks, Thomas said.
He said doctors have been decreasing blood pressure medication and reducing doses of steroids used to prevent postoperative brain swelling. Doctors on Wednesday night will stop preventive antibiotics, Thomas said.
Also on Wednesday, the boys will return to the operating room to have endotracheal tubes changed. The original breathing tubes were wired to their jaw so they wouldn't dislodged.
"This routine procedure will facilitate the process of decreasing their mechanical respiratory support in the upcoming days," Thomas said.
Thomas said they will know more about whether the boys have any neurological damage as they come off the various support systems.
It probably will be many weeks before doctors can begin to determine their levels of function, he said.
After surgery, the boys' wounds were covered with skin and tissue created by skin expanders put in their thighs and heads about five months ago. The boys will need additional reconstructive surgery in the coming years.
- AP