Balloon Tamponade
Minnesota Tube (4 lumen) is current standard for use; Lumens include:
Gastric suction
Esophageal suction
Gastric balloon and pressure monitoring
Esophageal balloon and pressure monitoring
Sengstaken-Blakemore Tube (3 lumen): older style that did not include separate esophageal suction lumen
INDICATIONS:
Acute bleeding from esophageal or gastric varices unresponsive to medical therapy (lavage, correction of clotting abnormalities, intravenous octreotide) and endoscopic therapy (band ligation and/or sclerotherapy)
Greatest role is temporarily stabilizing active bleeding while awaiting emergent TIPS
Alternative: Angiography and/or TIPS for uncontrollable bleeding
Efficacy: 50-92%
Worse outcome if patient has ascites, jaundice, encephalopathy
Long term efficacy depends in part on patients underlying liver disease
METHODS (IN GENERAL):
Pre-procedure
Intubate patient to protect airway
Always read a particular manufactures instructions
EGD to confirm source of bleeding and attempt band ligation or sclerotherapy; Start Octreotide dripRelated posts:
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