Noninvasive ventilation and the upper airway: Should we pay more attention?

Eline Oppersma, Jonne Doorduin, Erik H.F.M. van der Heijden, Johannes G. van der Hoeven, Leo M.A. Heunks*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


In an effort to reduce the complications related to invasive ventilation, the use of noninvasive ventilation (NIV) has increased over the last years in patients with acute respiratory failure. However, failure rates for NIV remain high in specific patient categories. Several studies have identified factors that contribute to NIV failure, including low experience of the medical team and patient-ventilator asynchrony. An important difference between invasive ventilation and NIV is the role of the upper airway. During invasive ventilation the endotracheal tube bypasses the upper airway, but during NIV upper airway patency may play a role in the successful application of NIV. In response to positive pressure, upper airway patency may decrease and therefore impair minute ventilation. This paper aims to discuss the effect of positive pressure ventilation on upper airway patency and its possible clinical implications, and to stimulate research in this field.

Original languageEnglish
Article number245
JournalCritical Care
Issue number6
Publication statusPublished - 5 Dec 2013

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