Salem Khalid, Drinhaus Hendrik, Hart Dominique, Böttiger Bernd W, Steinbicker Andrea U, Dorweiler Bernhard, Dusse Fabian
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Department of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
3D Print Med. 2025 May 30;11(1):22. doi: 10.1186/s41205-025-00270-1.
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.
经皮扩张气管切开术是危重症患者气道安全保障的成熟技术。最常见的并发症之一是切口周围出血或损伤解剖位置相近的大血管后出血。我们报告一例血小板减少患者在手术过程中，于第9和第10段支气管分叉处发生危及生命的出血，显然是由未识别的导丝导致的黏膜损伤引起。需要立即进行广泛的支气管镜检查和止血干预以确保氧合。为更好地说明这一并发症，随后使用3D打印机创建了患者支气管系统的患者特异性（1:1）三维模型。总之，3D打印有助于在重症监护干预期间可视化罕见并发症。建议在支气管镜控制下，仅将导丝推进至气管隆突处。字数：135。
