Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation

Abstract Percutaneous dilatational tracheostomy is an established technique for securing the airway in critically ill patients. One of the most common complications is bleeding around the incision or after injury to major vessels in anatomic proximity. We report a case in which a thrombocytopenic pa...

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Main Authors: Khalid Salem, Hendrik Drinhaus, Dominique Hart, Bernd W. Böttiger, Andrea U. Steinbicker, Bernhard Dorweiler, Fabian Dusse
Format: Article
Language:English
Published: BMC 2025-05-01
Series:3D Printing in Medicine
Subjects:
Online Access:https://doi.org/10.1186/s41205-025-00270-1
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author Khalid Salem
Hendrik Drinhaus
Dominique Hart
Bernd W. Böttiger
Andrea U. Steinbicker
Bernhard Dorweiler
Fabian Dusse
author_facet Khalid Salem
Hendrik Drinhaus
Dominique Hart
Bernd W. Böttiger
Andrea U. Steinbicker
Bernhard Dorweiler
Fabian Dusse
author_sort Khalid Salem
collection DOAJ
description Abstract Percutaneous dilatational tracheostomy is an established technique for securing the airway in critically ill patients. One of the most common complications is bleeding around the incision or after injury to major vessels in anatomic proximity. We report a case in which a thrombocytopenic patient experienced life-threatening bleeding during the procedure at the bifurcation between segmental bronchus 9 and 10, apparently caused by an unrecognized guide wire-induced mucosal lesion. Immediate extensive bronchoscopy and hemostatic interventions were required to ensure oxygenation. To better illustrate this complication, a patient-specific (1:1) three-dimensional model of the patient’s bronchial system was subsequently created using a 3D printer. In conclusion, 3d printing can help to visualize uncommon complications during intensive care interventions. It is recommended to advance the guide wire the guide wire only until the tracheal carina under bronchoscopic control. Word count: 135.
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language English
publishDate 2025-05-01
publisher BMC
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series 3D Printing in Medicine
spelling doaj-art-142e95cd26fa43379ac412ee64a7ff2a2025-08-20T03:16:52ZengBMC3D Printing in Medicine2365-62712025-05-011111810.1186/s41205-025-00270-1Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulationKhalid Salem0Hendrik Drinhaus1Dominique Hart2Bernd W. Böttiger3Andrea U. Steinbicker4Bernhard Dorweiler5Fabian Dusse6Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of CologneDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of CologneAbstract Percutaneous dilatational tracheostomy is an established technique for securing the airway in critically ill patients. One of the most common complications is bleeding around the incision or after injury to major vessels in anatomic proximity. We report a case in which a thrombocytopenic patient experienced life-threatening bleeding during the procedure at the bifurcation between segmental bronchus 9 and 10, apparently caused by an unrecognized guide wire-induced mucosal lesion. Immediate extensive bronchoscopy and hemostatic interventions were required to ensure oxygenation. To better illustrate this complication, a patient-specific (1:1) three-dimensional model of the patient’s bronchial system was subsequently created using a 3D printer. In conclusion, 3d printing can help to visualize uncommon complications during intensive care interventions. It is recommended to advance the guide wire the guide wire only until the tracheal carina under bronchoscopic control. Word count: 135.https://doi.org/10.1186/s41205-025-00270-1Guide wireBronchoscopyMucosal lesionThrombocytopenia
spellingShingle Khalid Salem
Hendrik Drinhaus
Dominique Hart
Bernd W. Böttiger
Andrea U. Steinbicker
Bernhard Dorweiler
Fabian Dusse
Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation
3D Printing in Medicine
Guide wire
Bronchoscopy
Mucosal lesion
Thrombocytopenia
title Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation
title_full Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation
title_fullStr Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation
title_full_unstemmed Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation
title_short Unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy: a case report and 3D simulation
title_sort unperceived bronchial bleeding complications during percutaneous dilatational tracheotomy a case report and 3d simulation
topic Guide wire
Bronchoscopy
Mucosal lesion
Thrombocytopenia
url https://doi.org/10.1186/s41205-025-00270-1
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