TY - JOUR
T1 - Swallowing during provision of helmet ventilation
T2 - Review and provisional multidisciplinary guidance
AU - Vergara, José
AU - Brenner, Michael J.
AU - Skoretz, Stacey A.
AU - Pandian, Vinciya
AU - Freeman-Sanderson, Amy
AU - Dorça, Alessandra
AU - Suiter, Debra
AU - Brodsky, Martin B.
N1 - Publisher Copyright:
© The Intensive Care Society 2024.
PY - 2024/8
Y1 - 2024/8
N2 - Use of noninvasive ventilation provided by a helmet increased globally during and after the COVID-19 pandemic. This approach may reduce need for intubation and its associated clinical complications in critically ill patients. Use of helmet interface minimizes virus aerosolization while enabling verbal communication, oral feeding and coughing/expectoration of secretions during its administration. Although improved oral hydration is a recognized benefit of helmet NIV, relatively little is known about the safety and efficiency of swallowing during helmet NIV. Risk of aspiration is a key consideration given the fragile pulmonary status of critically ill patients requiring respiratory support, and therefore the decision to initiate oral intake is best made based on multidisciplinary input. We reviewed the current published evidence on NIV and its effects on upper airway physiology and swallowing function. We then presented a case example demonstrating preservation of swallowing performance with helmet NIV. Last, we offer provisional multidisciplinary guidance for clinical practice, and provide directions for future research.
AB - Use of noninvasive ventilation provided by a helmet increased globally during and after the COVID-19 pandemic. This approach may reduce need for intubation and its associated clinical complications in critically ill patients. Use of helmet interface minimizes virus aerosolization while enabling verbal communication, oral feeding and coughing/expectoration of secretions during its administration. Although improved oral hydration is a recognized benefit of helmet NIV, relatively little is known about the safety and efficiency of swallowing during helmet NIV. Risk of aspiration is a key consideration given the fragile pulmonary status of critically ill patients requiring respiratory support, and therefore the decision to initiate oral intake is best made based on multidisciplinary input. We reviewed the current published evidence on NIV and its effects on upper airway physiology and swallowing function. We then presented a case example demonstrating preservation of swallowing performance with helmet NIV. Last, we offer provisional multidisciplinary guidance for clinical practice, and provide directions for future research.
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U2 - 10.1177/17511437241231704
DO - 10.1177/17511437241231704
M3 - Article
C2 - 39224433
AN - SCOPUS:85186608957
SN - 1751-1437
VL - 25
SP - 326
EP - 332
JO - Journal of the Intensive Care Society
JF - Journal of the Intensive Care Society
IS - 3
ER -