DOI: https://doi.org/10.14710/jai.v0i0.82634

Early Percutaneous Dilatational Tracheostomy to Facilitate Ventilator Weaning in a Patient with Blunt Abdominal Trauma and Hemorrhagic Shock: A Case Report

Department Anesthesiology and Intensive Care, Medical Faculty Jenderal Soedirman University – General Hospital Prof. Dr. Margono Soekarjo, Purwokerto Middle Java, Indonesia, Indonesia

Received: 22 Feb 2026; Revised: 6 May 2026; Accepted: 6 May 2026; Available online: 7 May 2026.
Open Access Copyright 2026 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: Hemorrhagic shock and the requirement for continuous mechanical breathing are frequent outcomes of blunt abdominal injuries, a dangerous illness. Long-term endotracheal intubation increases the risk of ventilator-related problems. In critically ill patients, percutaneous dilatational tracheostomy (PDT) has been proposed as a means of facilitating their transition off the ventilator and reducing the risk of pulmonary complications.

Case: A 53-year-old woman showed up after falling from around 10 meters in the air. It was discovered that she had suffered blunt abdominal trauma, which caused hemorrhagic shock and extensive brain bruises. An exploratory laparotomy was done in an emergency. This treatment included fixing a left kidney tear, restoring the bladder, and establishing a transverse colostomy because of colon damage. She needed continuous mechanical ventilation in the intensive care unit after surgery. On the seventh day of intubation, an early percutaneous dilatational tracheostomy (PDT) was performed because the patient was having trouble detaching from the ventilator. Fifteen days after the PDT was implanted, the patient's respiratory state gradually improved, and she was successfully decannulated. She spent 23 days in the hospital overall.

Discussion: In trauma patients who need continuous mechanical ventilation, tracheostomy may result in improved comfort, less sedation, simpler pulmonary toileting, and perhaps a decrease in ventilator-associated pneumonia. In this instance, successful ventilator weaning without major complications was made possible by early PDT performance.

Conclusion: Early percutaneous dilatational tracheostomy is a safe and efficient way to help trauma patients who have been on mechanical breathing for a long time wean themselves off of it. For best results, time and patient selection are crucial. 

Keywords:ventilator weaning, hemorrhagic shock, percutaneous dilatational tracheostomy, and blunt abdominal trauma

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Chest X-Ray After Percutaneous Dilatational Tracheostomy (PDT)
Subject chest X-ray; post-tracheostomy; percutaneous dilatational tracheostomy; tube position; radiology; ventilator weaning
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Keywords: blunt abdominal trauma; hemorrhagic shock; percutaneous dilatational tracheostomy; ventilator weaning; case report
Funding: None declared

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Section: Case Reports
Language : EN
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  1. Bloom BA, Gibbons RC. Focused assessment with sonography for trauma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022
  2. Bowo A, Isngadi, Pramono WB. Preoperative management in emergency patients with internal bleeding. J Komplikasi Anestesi. 2020;7(2):45-52
  3. Dwi WN, Pramono WB, Budiwan H. Duration of mechanical ventilation and ICU mortality. Medula. 2022;12(3):456-462
  4. Czajka S, Ziębińska K, Marczenko K, et al. Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and 30-day mortality prediction in a mixed intensive care unit in Poland: a cohort study. BMC Anesthesiol. 2020;20(1):296
  5. Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ. 2005;330(7502):1243-1246
  6. Durbin CG. Tracheostomy: why, when, and how? Respir Care. 2010;55(8):1056-1068
  7. Andriolo BN, Andriolo RB, Saconato H, Atallah ÁN, Valente O. Early versus late tracheostomy for critically ill patients. Cochrane Database Syst Rev. 2015;1:CD007271
  8. Rodriguez JL, Steinberg SM, Luchetti FA, Gibbons KJ, Taheri PA, Flint LM. Early tracheostomy for primary airway management in the surgical critical care setting. J Trauma. 1990;30(3):289-292
  9. Heffner JE. The role of tracheotomy in ventilator management. Chest. 2001;120(6):375S-381S
  10. Freeman BD, Borecki IB, Coopersmith CM, Buchman TG. Relationship between tracheostomy timing and duration of mechanical ventilation in critically ill patients. Crit Care Med. 2005;33(11):2513-2520
  11. Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med. 2004;32(8):1689-1694
  12. Terragni PP, Antonelli M, Fumagalli R, et al. Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA. 2010;303(15):1483-1489
  13. Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure; preliminary report. Chest. 1985;87(6):715-719
  14. Higgins KM, Punthakee X. Meta-analysis comparison of open versus percutaneous tracheostomy. Laryngoscope. 2007;117(3):447-454
  15. Heffner JE. Tracheostomy decannulation: marathons and finish lines. Respir Care. 2010;55(3):338-340

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