see fhp for detailed pmh and allergies s-trached and sedated o-on arrival, pt opening eyes spontaneously, following simple commands by maes on bed. perl. ativan gtt at 2mg/hr. grimacing with movement and turning. mso4 gtt bolused and started in attempts to wean from ativan and assist with pain but unsuccesful due to tachypenia and diaphores when ativan off times 1/2hr. following ciwa scale. hemodynamically stable. hr 80-100s, ns/st with no viewed ectopy.sbp 90-120s. pulses palpable. cvp 3-5. routine ekg. breath sound clear and slightly dim at bases. routine cxr done, awaiting results. intial vent setting at 450/14/.35/5 and abg with respiratory acidosis. tvs and rr increased and repeat abg improved. suctioning for thick yellow thick secretion in moderate amounts. sputum culture sent and pending. foley draining clear yellow urine in adequate amounts. ordered for standing dose of lasix. urine culture pending. ivf, sodium bicarb gtt at 60cc/hr x 1l. abd firm and slightly distended, mass palpated around ruq. arriving with rectal tube in place but changed over to fib and intact. bag drain green liquid stools and moderate amounts. tpn restarted at 80cc/hr. abd ct with iv and po contrast showing 14 x 7cm cyst over pancreas with other cyst around abdominal cavity. no plans in place. peg clamped. low grade temp on arrival. cooling blanket at bedside. zosyn discontinued and started on meropenem. continue vanco and flagyl. socially lives alone and recently sepearated from wife. brother brother is spokesperson for brother. a/p:50 year old male with long complicated course in stable condition cardiac echo today no plans for intervention on cyst continue to monitor Procedure: Venous catheterization, not elsewhere classified Continuous invasive mechanical ventilation for 96 consecutive hours or more Parenteral infusion of concentrated nutritional substances Enteral infusion of concentrated nutritional substances Percutaneous abdominal drainage Closed [endoscopic] biopsy of bronchus Diagnoses: Tobacco use disorder Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled Infection with microorganisms resistant to penicillins Methicillin susceptible pneumonia due to Staphylococcus aureus Acute pancreatitis Other and unspecified alcohol dependence, continuous Attention to tracheostomy Attention to gastrostomy