TissueDB/Simulators/Massive Hemoptysis Simulator (New)
General Information
Manikin-based bronchoscopy training platform for the practice of massive hemoptysis management. A 3D-printed thermoplastic polyurethane (TPU) airway tree replaces the upper airways of an intubatable manikin. The model reproduces anatomically accurate trachea, bronchi, and segmental bronchi from a deidentified CT scan. Peripheral IV catheters glued to selected segmental bronchi connect to external bags of simulated blood via roller-clamped extension tubing, enabling controllable bleeding into specific airway segments. The simulator accommodates endotracheal intubation, mainstem intubation, endobronchial blocker placement, lateral decubitus positioning, and bronchoscopic airway clearance using real clinical equipment. A companion curriculum paper documents trainee performance improvement using this simulator.[1][2]
| Field | Details |
|---|---|
| General Information | A manikin-based platform for practising the management of massive (life-threatening) hemoptysis. A 3D-printed thermoplastic-polyurethane airway tree — trachea, bilateral main bronchi, and segmental bronchi, printed from a deidentified CT scan — is seated inside an intubatable manikin, and a roller-clamped tubing system delivers simulated blood into selected airway segments at a controllable rate. The platform supports endotracheal and mainstem intubation, endobronchial blocker placement, lateral decubitus positioning, and bronchoscopic airway clearance using real clinical equipment. Source: New et al., Chest 2024;165(3):636–644.[1] |
| Features and Basic Operation | The simulator supports endotracheal intubation, mainstem intubation, endobronchial blocker placement, lateral decubitus positioning, bronchoscopic airway clearance, and direct bleeding interventions (wedge positioning, tamponade, application of topical agents). A survey of ten pulmonary and critical care attendings selected these as the important or essential procedural elements for managing massive hemoptysis. A facilitator connects the simulated-blood bag to one of several labelled airway sites and controls the bleeding rate with a roller clamp. The connection can switch between sites without opening the simulator.[1] |
| Current Development Status | Built and tested; shown construct validity in expert-versus-novice comparison and universally preferred over a computer-based bronchoscopy simulator in attending-physician evaluation.[1] |
| Estimated Build Time and Cost | Not stated in source., ~$600[1] |
| Specialized Tools and Equipment | Fabrication requires an industrial selective-laser-sintering printer (EOS P770 or equivalent); consumer FDM printers are not suitable for the required tolerances. Trainee-side use requires real clinical equipment: a bronchoscope, endotracheal tube, endobronchial blocker, and glide scope. Participants emphasised the use of actual clinical instruments as a strength of the simulator over the computer-based alternative.[1] |
| Version | Not stated in source |
| 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.[1] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Trachea | 1 | TPU | ~$600 | Monolithic 3D-printed airway tree including trachea, bronchi, and segmental bronchi; participants described it as looking "like a cadaver airway" with more accurate tactile feel than a computer-based simulator. Printed on an SLS printer (EOS P770) with EOS TPU 1301 industrial-grade powder.[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Intubatable manikin | 1 | SimMan3G or Nursing Anne | Equipment (salvaged) | Base platform for the 3D-printed airway tree; sourced from manikins that would otherwise have been discarded.[1] |
| Peripheral IV catheters | 1 set | Standard medical supply | ~$5 | Liquid channels between the bleeding bag and specific segmental bronchi on the airway tree.[1] |
| Extension tubing with roller clamps | 1 set | Standard medical supply | ~$5 | Conduit between the airway-tree catheters and the external simulated-blood bag; one roller clamp per line for bleeding-rate control.[1] |
| Dyed saline mixture | 1 L | Saline with food colouring and corn starch | ~$5 | Simulated blood; cornstarch in the saline for opacity, with periodic agitation for suspension.[1] |
| Bronchoscope (for reset) | 1 | Clinical equipment | Equipment (clinical) | Clinical instrument for between-case fluid clearance; not a build component.[1] |
Build Instructions
Phase 1: Airway Tree Fabrication
- Obtain a deidentified CT scan and generate a digital 3D rendering of the main airways including trachea, bronchi, and segmental bronchi.[1] The digital workflow for creating the STL file is described in Jacobson et al. 2023.[3]
- Print the airway tree using an SLS printer (EOS P770, EOS) with EOS TPU 1301 thermoplastic polyurethane powder (EOS). Note: this requires industrial SLS infrastructure, not consumer FDM equipment.[1]
Verification checkpoint: Confirm that the printed airway tree includes trachea, bilateral main bronchi, and segmental bronchi with lumens large enough to accept a standard bronchoscope.
Phase 2: Manikin Integration
- Remove the internal manikin components in the chest cavity space, including the original manikin airways.[1]
- Seat the 3D-printed airway tree in the anatomically appropriate position just distal to the manikin vocal cords.[1]
- Fix the airway tree in place with adhesive glue.[1]
Verification checkpoint: Confirm that a standard endotracheal tube can be advanced through the manikin vocal cords into the 3D-printed trachea, and that a bronchoscope can navigate through the trachea into bilateral main bronchi and segmental bronchi.
Phase 3: Bleeding System Assembly
- Cut the catheters off peripheral IVs and glue them to the ends of selected segmental bronchi bilaterally to create liquid channels for simulated bleeding.[1]
- Connect extension tubing to the IVs on the airway tree and extend to the outside of the manikin.[1]
- Attach a roller clamp to each extension tube to control the rate of bleeding into selected airways.[1]
- 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.[1]
- Connect the simulated blood bag to the external end of the extension tubing.[1]
Verification checkpoint: Open a roller clamp and 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.
Not Suitable For
- Double-lumen endotracheal tube placement training — only 40% of content survey respondents selected this as important for massive hemoptysis; not a primary design target[1]
- Electrocautery — selected by only 30% of respondents; not incorporated into the paper's validation[1]
- Nursing, respiratory therapy, or EMS training — validation cohorts included only pulmonary and critical care medicine attendings and internal medicine residents[1]
- Chronic or low-volume hemoptysis — simulator replicates the massive (life-threatening) hemoptysis scenario with active bleeding requiring immediate intervention[1]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 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.
- ↑ 2.0 2.1 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.
- ↑ 3.0 3.1 Jacobson N, McClain H, New ML. Digital workflow for high-risk, low-volume procedure simulation. J Biomed Res. 2023;4(1):1–7.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Massive Hemoptysis Simulator (New)". Appropedia. Retrieved June 4, 2026. |