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Oct 18, 2021
Contributor: Dylan Luyten, MD
Educational Pearls:
- To place a Blakemore/Minnesota Tube:
- Insert into esophagus under visualization
- Inflate gastric port with 60 cc of air and obtain a chest xray to ensure the balloon below the diaphragm
- Once confirmed, place a total of 500cc of air into the gastric balloon via the gastric port
- Tie a liter saline bad to the tube using Kerlix and hang it off an IV pole or other object to provide about 2 lbs of traction
- Now the the tube is in place under traction, attach a manometer to the esophageal balloon port
- Provide low pressure to tamponade a variceal bleed, which is about 33 mmHg
- This is a temporizing measure and often patients need to get a Transjugular Intrahepatic Portosystemic Shunt (TIPS) from interventional radiology for more definitive treatment
References
Powell M, Journey JD. Sengstaken-Blakemore Tube. [Updated 2021 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558924/
Amazing video of placement by EM:RAP ProductionsPlacement of a Minnesota Tube for Bleeding Varices
Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD