{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:15:21Z","timestamp":1793661321334,"version":"4.5.1"},"reference-count":122,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    The All India Difficult Airway Association (AIDAA) guidelines for 2025 regarding the extubation of \u201cat-risk airways\u201d following anaesthesia emphasise the importance of recognising, preparing for, and executing a planned extubation procedure for these potentially vulnerable airways. AIDAA has reviewed its previous extubation guidelines and developed a new algorithm based on the latest evidence, a Delphi survey, and expert opinions to incorporate necessary changes for patients with \u201cat-risk airways\u201d, ultimately aiming to achieve successful extubation. This is articulated through a four-pronged strategy known as\n                    <jats:bold>SAFE:<\/jats:bold>\n                    S-Stratify Risk, A-Assemble and Anticipate, F-Facilitate Extubation, and E-Evaluate and Escalate. This stepwise approach is designed to enhance patient safety during the extubation process. The guidelines emphasise the significance of peri-extubation oxygen (PerEOx) supplementation. Furthermore, it is crucial to quantitatively assess recovery from neuromuscular blockade prior to extubation. A three-limb approach to extubation has been devised to address specific situations: Limb 1 focuses on suppressing the haemodynamic response during extubation in scenarios that require such control but do not pose a risk to the airway, Limb 2 involves a\n                    <jats:italic toggle=\"yes\">staged sequential extubation<\/jats:italic>\n                    , and Limb 3 addresses the need for\n                    <jats:italic toggle=\"yes\">delayed extubation<\/jats:italic>\n                    . Patients at higher risk of airway compromise, collapse, or dependence on the tube may benefit from a staged sequential extubation or delayed extubation strategy rather than a one-step extubation approach. The current guidelines also propose management plans for certain unusual situations, such as a stuck tracheal tube and unexpected extubation failure.\n                  <\/jats:p>","DOI":"10.4103\/ija.ija_766_25","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T19:01:28Z","timestamp":1761937288000},"page":"1187-1207","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["All India Difficult Airway Association 2025 guidelines for extubation of the \u201cat-risk\u201d airway"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5670-7932","authenticated-orcid":false,"given":"Pankaj","family":"Kundra","sequence":"first","affiliation":[{"name":"Professor, Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 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Hegde Charitable Hospital, K S Hegde Medical Academy, NITTE (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7384-4886","authenticated-orcid":false,"given":"Jigeeshu V","family":"Divatia","sequence":"additional","affiliation":[{"name":"Head, Critical Care Medicine, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-9282","authenticated-orcid":false,"given":"Jeson R.","family":"Doctor","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3992-4975","authenticated-orcid":false,"given":"Sripada 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