Swallowing during provision of helmet ventilation: Review and provisional multidisciplinary guidance

José Vergara, Michael J. Brenner, Stacey A. Skoretz, Vinciya Pandian, Amy Freeman-Sanderson, Alessandra Dorça, Debra Suiter, Martin B. Brodsky

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
JournalJournal of the Intensive Care Society
StateAccepted/In press - 2024

Bibliographical note

Publisher Copyright:
© The Intensive Care Society 2024.


  • COVID-19
  • NIV
  • Noninvasive ventilation
  • SARS-CoV-2
  • coronavirus
  • deglutition
  • dysphagia
  • helmet
  • voice

ASJC Scopus subject areas

  • Critical Care
  • Critical Care and Intensive Care Medicine


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