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Malignant central airway obstruction — SCE Respiratory MCQ

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HardInterventional PulmonologyMalignant central airway obstructionSCE Respiratory

A 65-year-old man has a central endobronchial squamous carcinoma causing severe right main bronchus obstruction, lobar collapse and recurrent post-obstructive pneumonia. He is not fit for curative therapy and becomes acutely breathless when lying flat. What is the most appropriate ventilation strategy?

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Correct answer: C — Urgent therapeutic bronchoscopy with airway debulking or stenting under experienced airway support

Central malignant airway obstruction is a mechanical problem, so airway intervention such as therapeutic bronchoscopy, debulking or stenting is often the most effective ventilatory strategy. NIV or oxygen alone may temporarily support gas exchange but will not relieve the obstruction. Palliative status should prompt symptom-relieving intervention when feasible rather than therapeutic nihilism.

Reference: NICE NG122; BTS Bronchoscopy guidance