Airway Stents:Development of a physiotherapy guideline

<fig><object-id>erj;64/suppl_68/PA626/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Introduction:</bold> Airway stents are used as a palliative intervention or as a bridge to curative therapy for airway obstruction. Stent-related complications occur in up to 60% of patients, with retained secretions causing 20% of such complications¹. Retained secretions are a crucial aspect of respiratory physiotherapy. No respiratory physiotherapy guidelines exist for patients post airway stent insertion. <bold>Methods:</bold> A multi-step method of data collection was used. A scoping review was conducted in four databases and the search strategy included keywords ‘respiratory physiotherapy’ AND ‘airway stent’. A local audit of physiotherapy management was performed as well as benchmarking. An expert panel reviewed all aspects of patient care. <bold>Results:</bold> The literature review found no studies linked to physiotherapy management. The audit included 22 patients, 65% of patients assessed on day 1 had retained secretions. On discharge, only 50% of patients had an effective airway clearance technique. The benchmarking did not provide any consensus for the management of airway stents. The expert panel each gave recommendations for best practice. A respiratory physiotherapy pathway was then developed (figure1), alongside a patient leaflet and MDT meetings. <bold>Conclusion:</bold> Airway stenting is a new area of respiratory medicine with limited evidence. This respiratory physiotherapy pathway is an initial guide to best practice for patients post-stent insertion with the aim of further research.