TissueDB/Simulators/Massive Hemoptysis Simulator (New)
The Massive Hemoptysis Simulator (New) is an adult manikin-based airway trainer for practising how to manage massive (life-threatening) hemoptysis. An industrially 3D-printed (selective-laser-sintered) airway tree sits inside a repurposed intubation manikin. This trainer does not use locally available materials. The 3D-printed TPU airway tree replaces the manikin's internal airways. The tree includes the trachea, main bronchi, and segmental bronchi, and it derives from a deidentified CT scan. Peripheral IV catheters glued to selected segmental bronchi feed simulated blood from an external bag through roller-clamped tubing. A facilitator can therefore drive controllable bleeding into chosen airway segments. The trainer supports endotracheal and mainstem intubation, endobronchial blocker placement, and lateral decubitus positioning. It also supports bronchoscopic airway clearance with real clinical equipment. A companion paper reports a curriculum built on it.[1][2]
| Field | Details |
|---|---|
| Features and Basic Operation | On this trainer a learner can practise endotracheal intubation, mainstem intubation, endobronchial blocker placement, and lateral decubitus positioning. A learner can also practise bronchoscopic airway clearance and direct bleeding interventions (wedge positioning, tamponade, applying topical agents). A facilitator connects the simulated-blood bag to one of three labelled airway sites. The facilitator sets the bleeding rate with a roller clamp. The facilitator can switch the connection between sites without opening the simulator. Between cases, suction residual fluid from the airway tree with a bronchoscope and remove inserted tools. The trainer then resets without opening it. |
| Current Development Status | Built and pilot-tested; construct validity demonstrated at a single centre. Clinical skills transfer is not yet established.[1] |
| Estimated Build Time and Cost | - |
| Specialized Tools and Equipment | Fabrication requires an industrial selective-laser-sintering (SLS) printer (EOS P770 or equivalent). Consumer FDM printers are not suitable. Fabrication also requires a deidentified CT/DICOM scan and the airway-tree model file. The model file appears in the paper's e-Appendix 1, and Jacobson et al. 2023 describe the digital workflow. Trainee-side use requires real clinical equipment: a bronchoscope, endotracheal tube, and endobronchial blocker (participants also used a glide scope). |
| Version | Version 1 |
| Development Team Contact Information | Melissa L. New (corresponding author), Timothy Amass, Anna Neumeier, Nicholas M. Jacobson, Tristan J. Huie — Division of Pulmonary Sciences and Critical Care Medicine and the College of Engineering, Design and Computing, University of Colorado, Denver/Aurora, Colorado, USA. The 3D-printed airway model was developed and produced by Hayden McClain and the Inworks Innovation Initiative. |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Airway tree | 1 | TPU | $600 | The source used EOS TPU 1301. 3D-printed lower airway tree (trachea, main and segmental bronchi) from a deidentified CT scan. Participants said it looked "like a cadaver airway" and felt more accurate than a computer-based simulator. |
| Simulated blood | 1 L | Normal saline (or water) with food colouring and corn starch | — | Saline (or water) tinted with food colouring and thickened with corn starch for opacity. Agitated periodically to keep the starch suspended, and prepared fresh for each session (quantities in the build steps). |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Intubatable manikin | 1 | Commercial manikin | — | The source used SimMan3G or Nursing Anne (Laerdal Medical) as the base platform. Its internal chest components and original airways are removed for the printed airway tree. The authors used otherwise-discarded manikins, so the build cost excludes it. |
| Peripheral IV catheters | 1 set | — | Catheters cut from peripheral IVs and glued to selected segmental bronchi to channel simulated blood into the airway. | |
| Extension tubing with roller clamp | 1 set | — | Connects the airway-tree catheters to the external simulated-blood bag. A roller clamp on each line controls the bleeding rate. | |
| Adhesive glue | 1 | — | Fixes the 3D-printed airway tree in the manikin and seals the IV-catheter-to-bronchus junctions, which must not leak. |
Build Instructions
Phase 1: Airway Tree Fabrication
Step 1: Obtain a deidentified CT scan. Generate a digital 3D rendering of the main airways including trachea, bronchi, and segmental bronchi. The airway-tree model file appears in the paper's e-Appendix 1. Jacobson et al. 2023 describe the digital workflow.[3]
Step 2: Print the airway tree using an SLS printer (EOS P770, EOS) with EOS TPU 1301 powder (EOS). Note: this requires industrial SLS infrastructure, not consumer FDM equipment.
Verification checkpoint: Confirm that the printed airway tree includes trachea, bilateral main bronchi, and segmental bronchi. Confirm that the lumens are large enough to accept a standard bronchoscope.
Phase 2: Manikin Integration
Step 1: Remove the internal manikin components in the chest cavity space, including the original manikin airways.
Step 2: Seat the 3D-printed airway tree in the anatomically appropriate position just distal to the manikin vocal cords.
Step 3: Fix the airway tree in place with adhesive glue.
Verification checkpoint: Confirm that a standard endotracheal tube advances through the manikin vocal cords into the 3D-printed trachea. Confirm that a bronchoscope navigates through the trachea into bilateral main bronchi and segmental bronchi.
Phase 3: Bleeding System Assembly
Step 1: Cut the catheters off peripheral IVs. Glue them to the ends of selected segmental bronchi bilaterally to create liquid channels for simulated bleeding.
Step 2: Connect extension tubing to the IVs on the airway tree and extend to the outside of the manikin.
Step 3: Attach a roller clamp to each extension tube to control the rate of bleeding into selected airways.
Step 4: Prepare simulated blood. Mix 20 mL red food coloring, a few drops of blue food coloring, and 1 tablespoon of corn starch into a 1 L bag of normal saline or water. Agitate the bag to suspend the corn starch.
Step 5: Connect the simulated blood bag to the external end of the extension tubing.
Verification checkpoint: Open a roller clamp. Confirm that simulated blood flows through the extension tubing, through the IV catheter, and into the targeted segmental bronchus. Confirm that the flow rate is controllable by adjusting the roller clamp. Verify there are no leaks at the catheter-bronchus junction.
References
- ↑ 1.0 1.1 New ML, Amass T, Neumeier A, Jacobson NM, Huie TJ. Creation and validation of a massive hemoptysis simulator. Chest 2024;165(3):636–644. DOI: 10.1016/j.chest.2023.10.014. PMID 37852436.
- ↑ New ML, Amass T, Neumeier A, Huie TJ. Massive hemoptysis simulation curriculum improves performance. Chest 2024. DOI: 10.1016/j.chest.2023.10.013. PMID 37852435.
- ↑ Jacobson N, McClain H, New ML. Digital workflow for high-risk, low-volume procedure simulation. J Biomed Res. 2023;4(1):1–7.
| Authors | Ian-laurel, Arturo Pelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturo Pelayo (2026). "TissueDB/Simulators/Massive Hemoptysis Simulator (New)". Appropedia. Retrieved November 12, 2026. |