Hoemorrhage of the brachiocephalic trunk due to erosion after implantation of a "trochoosafe" device for tracheostoma maintenance - a case report

We report on a nineteen-year-old woman with multiple trauma who underwent translaryngeal tracheostomy according to the Fantoni technique in consequence of her injuries. After succesful weaning, a "Tracheosafe" device was applied to keep the tracheostoma open. Sixteen days after its insertion, the device led to acute bleeding due to erosion-Of the right brachiocephalic trunk and haemorrhagic shock requiring resuscitation. The patient survived in an apallic state. This complication has so far only been described in conventional surgical tracheostomy and dilatational tracheostomy according to Ciagla. The putative causes discussed are the placement of the "Tracheosafe" device for an unduly long time and a prior damage to the trachea as a result of a similarly unduly long time of tracheal cannula placement. It is recommended to apply the "Tracheosafe" device for as short as possible if an appropriate indication is given.