Air in the head?

[bellehill, RN]

I had a patient recently with a VP shunt placed. This patient developed a pocket of air in her head near the surgical site. The patient was placed on flat bedrest for two days and a 100% oxygen face mask. Does anyone have any information on this surgical complication? I am particularly curious why she needed to be on a 100% face mask (no respiratory problems, O2 sat was fine) and how does this resolve? The other nurses on the floor knew how to treat it but not the physiology...I need your help!

[Zee_RN, BSN, RN]

I don't have an answer for you but I thought I'd "bump" your post up to see if any Neuro nurses can help you. Maybe post your question under Neuro ICU section too.

I'll be interested in hearing the answer when someone has it....

[gwenith, BSN, RN]

I am not sure of the exact application in the circumstance you describe but some years ago the treatment for the "bends" which is just nitrogen emboli was changed from immediate decompression to treatment with 100% oxygen. I would hazard that they were treating a primary air embolus the same way as air is 78% nitrogen. The rationale is to reverse the pressure gradient for that particular gas.

As the nitrogen which is naturally disolved in our bloodstream at sea level is "washed out" by the oxygen then the nitrogen in the air bubble will equalise back into the blood stream.

[canoehead, BSN, RN]

My girl's wicked smart:)

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

My guess for the O2 would be that an increase in CO2 levels causes an increase in ICP. They would also be doing other things to protect her from having an increased ICP (dark room, low stimuli). But then, I am a cardiac nurse and hate heads...

[Zee_RN, BSN, RN]

I'm with you Moonshadeau!

[bellehill, RN]

Thanks for all the help, I am still trying to talk with the docs about it...I'll let you know when I find out!