78 yr old Female c hx of hypotension , ulcerative colitis , TIA, DVT , kidney cancer resulting in removal of 1 kidney, subsequent CKD stage for with 20% function remaining. 6 days ago arrived in ICU due to abscess size of twinkie in rectum. Primrose in place to facilitate drainage. Sepsis with postivite resistant staph hominis. Tx with doxycycline and clindamycin. Intubated x3 days to prevent ALI, now on SIMV. No hypoxic events. Sedated with ativan and morphine. Off sedation for 25 hours with still no movement. Kidney function still adequate, WBC now 9,000. Lungs clear, liver function good. TPN to rest gut. Why has she not awakened?
You yourself admitted that she is under sedation and again asking why she has not awakened which are contradictory. You need to understand that she is in a very critical condition. The fact that all the organ functions are normal is a good sign. If her sepsis IC controlled, and she is weaned off the ventilator gradually, there is all likelihood that she would recover completely, but all this will take time perhaps few days to weeks. We need to have patience