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Difficult Airway Management in Oncology: An International Delphi Consensus Study (DAMO)
Sponsor: Onco Critical Care Society
Summary
Airway management in patients with cancer carries risks that general difficult-airway guidelines do not address. Tumour in the head, neck, or mediastinum can distort or narrow the airway; previous radiotherapy causes fibrosis and restricts neck movement; low platelet counts increase bleeding during instrumentation; and obstruction may sit below the point at which a breathing tube ends, so that intubation alone does not restore ventilation. Existing international airway guidelines are written for general populations and contain little cancer-specific guidance. This study uses a modified Delphi method to develop an international expert consensus statement on the prediction, preparation for, and management of the difficult airway in adults with cancer. An international panel of clinicians with expertise in anaesthesiology, intensive care, interventional pulmonology, head and neck surgery, and emergency medicine votes anonymously on a set of candidate statements across ten clinical domains, using a seven-point agreement scale with free-text comment. Voting takes place over a minimum of three rounds. Between rounds, panellists receive anonymised group results and a summary of comments, and statements are revised accordingly. Consensus is defined a priori as agreement by at least 80 percent of respondents together with a median score of 5 or above; strong consensus requires at least 90 percent agreement with a median of 6 or 7. Statements that do not reach consensus are reported as such and form a prioritised research agenda. Reporting follows the ACCORD reporting guideline for consensus methods.
Official title: International Consensus Statement on Difficult Airway Management in Oncology (DAMO): Protocol for a Modified Delphi Consensus Study
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
OBSERVATIONAL
Enrollment
40
Start Date
2026-08-19
Completion Date
2027-01-31
Last Updated
2026-09-16
Healthy Volunteers
No
Conditions
Interventions
Questionnaire Administration
Panellists complete a minimum of three rounds of anonymous electronic questionnaires covering ten clinical domains of difficult airway management in patients with cancer. Each statement is rated on a seven-point Likert scale from 1 (strongly disagree) to 7 (strongly agree), with an optional free-text field that becomes mandatory for any rating of 1 to 3. Each round remains open for a minimum of three weeks, with up to two reminders. No clinical intervention is administered to any patient and no patient-identifiable data are collected.
Locations (1)
Max Super specialty Hospital Shalimar bagh
Delhi, National Capital Territory of Delhi, India