Mina was transferred to Children’s Hospital to surgically close her PDA. The transfer did not come without complications. She became very unstable during the event and when she arrived the medical team needed to do a complete evaluation before they could proceed with any procedure. They had no cases to compare Mina’s case too, therefore, all interventions were essentially uncharted territory. After they compiled their own data from tests and scans they assembled a panel of doctors from all departments in order to collaborate on a treatment plan. It was determined that her bottom left lung was fused to the bottom of her right lung, creating a horseshoe like shape. This in itself has been seen before and is manageable; however they realized that there are only a few pockets of air in her lungs and the rest is fluid. They had no idea where the fluid was coming from but it did mean that Mina’s lungs have been collapsed for quite some time. This explains why her oxygen needs had been increasing and her body was retaining a significant amount of carbon dioxide. Mina was moved back onto the oscillator in hopes to open her lung back up and push out the fluid so it can once again be filled with air. Her Co2 levels immediately responded to being back on the oscillator as they began to drop back down. Although her oxygen needs have decreased they are still much higher than any doctor would have liked to seen. Our medical team suggested that we should speak with palliative care as she was deemed one of the sickest babies within the unit.