CLINICAL practice guidelines providing critical recommendations for managing central airway obstruction (CAO), a condition linked to poor prognosis in both malignant and nonmalignant airway diseases, have recently been published. The evidence-based guidelines, developed by a multidisciplinary expert panel, emphasize a standardized approach to treatment, with therapeutic bronchoscopy as a key intervention to improve symptoms, quality of life, and survival outcomes.
CAO treatment varies widely based on provider expertise and available resources, often leading to inconsistent patient care. To address this, the expert panel conducted a comprehensive review of 9,688 abstracts, ultimately including 31 studies in their analysis. The result is a series of 10 graded recommendations and one good practice statement, guiding healthcare professionals in optimizing CAO management.
Key recommendations include the use of multi-modality therapeutic approaches such as rigid bronchoscopy with general anesthesia, tumor or tissue debridement, ablation, dilation, and stent placement when clinically appropriate. The guidelines also underscore the importance of tailoring treatment to the underlying cause of CAO and highlight the need for a multidisciplinary team approach with shared decision-making between providers and patients.
Despite these advancements, the overall certainty of evidence remains low, reinforcing the necessity for further research and clinical trials to refine best practices. These guidelines serve as a crucial step in improving consistency and effectiveness in CAO management, offering clinicians a structured framework to enhance patient care.
For pulmonologists, thoracic surgeons, and other healthcare professionals involved in airway management, these recommendations provide a much-needed roadmap to navigate the complexities of CAO treatment and improve clinical outcomes.
Reference: Mahmood K et al. Management of Central Airway Obstruction. Chest. 2025;167(1):283-95.
Anaya Malik | AMJ
