Day +7 BMT

Her liver and kidney are still impaired with serum bilirubin and creatine level keep rising to 170 umol/L and 190 umol/L, respectively. The blood urea is also increased. The urine output was improved to 2000 ml over past 24 hours. But, she still remains in positive fluid balance (input fluid more than output). The fluid inputs are mainly from blood transfusion, antibiotics and parenteral nutrition which is important for her. Her lung status remain the same and still can maintain the blood oxygenation that she required. 

She will be referred to Renal Unit for hemodialysis to help her kidneys excrete what ever excess of water and electrolytes in the body. Hopefully, this can overcome the electrolytes imbalance more faster because at this moment her kidneys are still sick and unable to cope with  all workloads. A good news is she remains afebrile despite very low white blood cells. These cells are expected to increase on Day +10 onward. 

Informed by Infection Disease Physician that the culture of bronchoalveolar lavage (BAL) from bronchoscopy  grew bacterial (Pseudomonas aeruginosa) which is sensitive to few antibiotics.

Arterial catheter was inserted in the right femoral artery, and tonight she will be started on hemodialysis.