non-rebreather mask with brain air

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I have a question about NRB. I have seen few of pts were on NRB for 8-12 hours due to they had air trapped in the brain after crani. what is the mechanism/rationale behind this?

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Specializes in Transgender Medicine.

Hope somebody writes in, cuz I haven't a clue. Sounds interesting, though.

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Specializes in trauma/neuroscience ICU.

The theory is the same as why we us oxygen on a pneumothorax even when they are sats are ok. The high concentration of O2 is supposed to help reduce the pneumocephalus though osmotic diffusion through the surgical defect. i'm not sure it works in the case of a cranial pneumo, and our surgeons would scoff at this.

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Specializes in critical care, PACU.

I have heard this too and we do it at our place

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Similar to the pneumothorax, the theory behind this is to replace nitrogen with oxygen (Nitrogen Washout), which speeds absorption of intracranial air by increasing the diffusion gradient for nitrogen between the air collection and the surrounding cerebral tissue.

However, no one agrees if it works or what length of time for the NRB is to be left on. We try to avoid leaving a NRB on anyone more than 24 hours. Some neurosurgeons are happy with an FiO2 of 0.40 if the SpO2 is 100% and PaO2 is >100 mmHg.

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