Oxygen Therapy with High-Flow Nasal Cannula as an Effective Treatment for Perioperative Pneumocephalus: Case Illustrations and Pathophysiological Review
Document Type
Article
Abstract
Pneumocephalus (PNC) is a condition in which when air is trapped inside the intracranial vault. The causes are varied, but include trauma and intracranial surgery. Treatment of PNC typically consists of augmenting patient oxygenation with the attempt of washing out pulmonary nitrogen, creating a gradient in which nitrogen in the intracranial air bubble diffuses out of the lungs via the blood. Though several high flow methods have been tested, the ideal mode of oxygenation has not fully been investigated. Here we present 3 cases of post-operative PNC who we felt were symptomatic from PNC. With administration of high-flow nasal cannula (HFNC), all patients improved both clinically and radiographically within a few hours, faster than in both anecdotal experience and published trials. Due to its steady FiO2 administration, positive pressure, comfort, and low side-effect profile, HFNC may be the ideal mode of oxygen delivery in PNC. We present a review of the physiology of PNC and the characteristics of several oxygen delivery systems to build a case for HFNC in this disease process.
Medical Subject Headings
Aged; Cannula; Craniotomy (adverse effects); Female; Humans; Male; Middle Aged; Oxygen Inhalation Therapy (instrumentation, methods); Pneumocephalus (etiology, physiopathology, therapy); Postoperative Complications (etiology, therapy)
Publication Date
12-1-2018
Publication Title
Neurocritical care
E-ISSN
1556-0961
Volume
29
Issue
3
First Page
366
Last Page
373
PubMed ID
28932993
Digital Object Identifier (DOI)
10.1007/s12028-017-0464-x
Recommended Citation
Siegel, Jason L.; Hampton, Karen; Rabinstein, Alejandro A.; McLaughlin, Diane; and Diaz-Gomez, Jose L., "Oxygen Therapy with High-Flow Nasal Cannula as an Effective Treatment for Perioperative Pneumocephalus: Case Illustrations and Pathophysiological Review" (2018). Neurology. 1977.
https://scholar.barrowneuro.org/neurology/1977