Developing Guidelines for Difficult Airway Management in Cancer Patients
An initiative of the Onco Critical Care Society (OCCS)
THE CHALLENGE
Critically ill cancer patients face unique airway challenges: tumors, radiation fibrosis, bleeding risks, and anatomical distortion. Yet, no specific guidelines exist for this high-risk population. OCCS is filling this gap.
STEERING COMMITTEE
Intensivists: Saurabh Kumar Das, Shiela Nainan Myatra, Bram Rochwerg , Javier Perez Fernandez
Anaesthesiologists: Priyam Saikia, Habib Md Reazaul Karim, Rakesh Garg, Gundhar Padhi
Pulmonologists: Vijay Hadda, Parveen Kaur
Head & Neck Oncology Surgery: Bishwajyoti Hazarika
Delphi methodologist: Ravi Jain
KEY OBJECTIVES
1. Define “difficult airway” in oncology
2. Create a cancer-specific assessment & preparation bundle
3. Provide algorithmic, tiered management strategies (including extubation)
METHODOLOGY
Modified Delphi process: 3 rounds, ≥75% consensus. Steering committee + independent Delphi expert. 30–40 international experts (intensivists, anesthesiologists, emergency physician , pulmonologist, surgeons). Strong/weak consensus grading, stability testing, ACCORD reporting.
TIMELINE – 9 MONTHS
Literature review (months 1-2) → Delphi round 1 (month 3) → Delphi round 2 (month 4) → Delphi round 3 (month 5) → Analysis & grading (month 6) → Final guideline writing (months 7-8) → Publication (month 9)
DISSEMINATION
Peer-reviewed publication, OCCS website, infographics, social media.
OUTCOME
First-ever evidence-based, consensus-driven recommendations to improve airway safety in oncology critical care.