Balloon tamponade for massive GI bleeding - Revision history

Danbot: Add verified PubMed references (PMIDs 30912098, 35065859)

2026-03-22T10:50:03Z

Add verified PubMed references (PMIDs 30912098, 35065859)

← Older revision		Revision as of 10:50, 22 March 2026
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	<!--T:2-->		<!--T:2-->
	*Unstable patient with massive [[Special:MyLanguage/upper GI bleed\|upper GI bleed]] and any of the following:		*Unstable patient with massive [[Special:MyLanguage/upper GI bleed\|upper GI bleed]] and any of the following:<ref>Rodrigues SG, et al. Balloon Tamponade and Esophageal Stenting for Esophageal Variceal Bleeding in Cirrhosis: A Systematic Review and Meta-analysis. Semin Liver Dis. 2019 May;39(2):178-194. PMID 30912098</ref>
	**Inability to perform endoscopy		**Inability to perform endoscopy
	**Endoscopy failed (e.g., cannot visualize source due to heavy bleeding)		**Endoscopy failed (e.g., cannot visualize source due to heavy bleeding)
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	<!--T:6-->		<!--T:6-->
	*Balloon device		*Balloon device
	**Sengstaken-Blakemore Tube		**Sengstaken-Blakemore Tube<ref>Bridwell RE, et al. Balloon Tamponade for the Management of Gastrointestinal Bleeding. J Emerg Med. 2022 Apr;62(4):545-558. PMID 35065859</ref>
	**Minnesota Tube		**Minnesota Tube
	*60 cc syringe		*60 cc syringe

Ostermayer: Marked this version for translation

2026-01-06T21:19:11Z

Marked this version for translation

← Older revision		Revision as of 21:19, 6 January 2026
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	<translate>		<translate>

	==Indications==		==Indications== <!--T:1-->

			<!--T:2-->
	*Unstable patient with massive [[Special:MyLanguage/upper GI bleed\|upper GI bleed]] and any of the following:		*Unstable patient with massive [[Special:MyLanguage/upper GI bleed\|upper GI bleed]] and any of the following:
	**Inability to perform endoscopy		**Inability to perform endoscopy
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	==Contraindications==		==Contraindications== <!--T:3-->

			<!--T:4-->
	*Esophageal stricture		*Esophageal stricture
	*Recent esophageal or gastric surgery		*Recent esophageal or gastric surgery


	==Equipment Needed==		==Equipment Needed== <!--T:5-->

			<!--T:6-->
	*Balloon device		*Balloon device
	**Sengstaken-Blakemore Tube		**Sengstaken-Blakemore Tube
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	==Procedure==		==Procedure== <!--T:7-->


	===Blakemore===		===Blakemore=== <!--T:8-->

			<!--T:9-->
	[[File:Sengstaken-Blakemore Tube.png\|thumb\|Sengstaken-Blakemore Tube]]		[[File:Sengstaken-Blakemore Tube.png\|thumb\|Sengstaken-Blakemore Tube]]
	[[File:Sengstaken-Blakemore.png\|thumb\|Sengstaken-Blakemore Tube]]		[[File:Sengstaken-Blakemore.png\|thumb\|Sengstaken-Blakemore Tube]]
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	===Minnesota===		===Minnesota=== <!--T:10-->

			<!--T:11-->
	https://www.youtube.com/watch?v=4FHIiA_doWU		https://www.youtube.com/watch?v=4FHIiA_doWU
	#Get the kit, 4 Kelly clamps, 50 mL syringe, lube		#Get the kit, 4 Kelly clamps, 50 mL syringe, lube
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	#Unclamp the gastric inflation port, pump 50 mL, then re-clamp, then pump again, repeat until you hit 10 total times		#Unclamp the gastric inflation port, pump 50 mL, then re-clamp, then pump again, repeat until you hit 10 total times

			<!--T:12-->
	'''PEARLS'''		'''PEARLS'''
	*No need to use 3 way stopcocks/ Christmas tree adaptors, just Kelly clamp all ports other than gastric inflation site		*No need to use 3 way stopcocks/ Christmas tree adaptors, just Kelly clamp all ports other than gastric inflation site
Line 88:		Line 94:


	==Complications==		==Complications== <!--T:13-->

			<!--T:14-->
	*Due to misplaced balloon, migration, over-inflation, prolonged use		*Due to misplaced balloon, migration, over-inflation, prolonged use
	**Mucosal ulceration		**Mucosal ulceration
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	==See Also==		==See Also== <!--T:15-->

	</translate>		</translate>
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	==External Links==		==External Links== <!--T:16-->

			<!--T:17-->
	*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]		*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]
	*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]		*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]


	==References==		==References== <!--T:18-->

			<!--T:19-->
	<references/>		<references/>

			<!--T:20-->
	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:GI]]		[[Category:GI]]
	[[category:Critical Care]]		[[category:Critical Care]]
	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T21:43:34Z

Prepared the page for translation

← Older revision		Revision as of 21:43, 4 January 2026
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			<languages/>
			<translate>

	==Indications==		==Indications==
	*Unstable patient with massive [[upper GI bleed]] and any of the following:
			*Unstable patient with massive [[Special:MyLanguage/upper GI bleed\|upper GI bleed]] and any of the following:
	**Inability to perform endoscopy		**Inability to perform endoscopy
	**Endoscopy failed (e.g., cannot visualize source due to heavy bleeding)		**Endoscopy failed (e.g., cannot visualize source due to heavy bleeding)
	**Delay in endoscopy or GI consultation		**Delay in endoscopy or GI consultation
	**Need to stabilize prior to transfer		**Need to stabilize prior to transfer


	==Contraindications==		==Contraindications==

	*Esophageal stricture		*Esophageal stricture
	*Recent esophageal or gastric surgery		*Recent esophageal or gastric surgery


	==Equipment Needed==		==Equipment Needed==

	*Balloon device		*Balloon device
	**Sengstaken-Blakemore Tube		**Sengstaken-Blakemore Tube
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	*1 L bag IVF		*1 L bag IVF
	*May need Magill forceps for manoeuvring tube into the esophagus		*May need Magill forceps for manoeuvring tube into the esophagus


	==Procedure==		==Procedure==


	===Blakemore===		===Blakemore===

	[[File:Sengstaken-Blakemore Tube.png\|thumb\|Sengstaken-Blakemore Tube]]		[[File:Sengstaken-Blakemore Tube.png\|thumb\|Sengstaken-Blakemore Tube]]
	[[File:Sengstaken-Blakemore.png\|thumb\|Sengstaken-Blakemore Tube]]		[[File:Sengstaken-Blakemore.png\|thumb\|Sengstaken-Blakemore Tube]]
	https://www.youtube.com/watch?v=NHelCd5Jtp4		https://www.youtube.com/watch?v=NHelCd5Jtp4
	#[[Intubate]] patient		#[[Special:MyLanguage/Intubate\|Intubate]] patient
	#Fully inflate and deflate each balloon using its respective port to check for leaks		#Fully inflate and deflate each balloon using its respective port to check for leaks
	#If using Sengstaken-Blakemore tube, secure NG tube to tamponade device with distal end of NG tube 3 cm proximal to esophageal balloon		#If using Sengstaken-Blakemore tube, secure NG tube to tamponade device with distal end of NG tube 3 cm proximal to esophageal balloon
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	#*Inflate to 20-40 mm Hg (use manometer to test pressure)		#*Inflate to 20-40 mm Hg (use manometer to test pressure)
	#*Do not inflate more than 45 mm Hg		#*Do not inflate more than 45 mm Hg


	===Minnesota===		===Minnesota===

	https://www.youtube.com/watch?v=4FHIiA_doWU		https://www.youtube.com/watch?v=4FHIiA_doWU
	#Get the kit, 4 Kelly clamps, 50 mL syringe, lube		#Get the kit, 4 Kelly clamps, 50 mL syringe, lube
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	#*Put gastric suction to suction		#*Put gastric suction to suction
	#Test the gastric tube with air to see that they inflate in water bath		#Test the gastric tube with air to see that they inflate in water bath
	#Insert lubed tube to 50-60 cm mark (estimate bridge of nose to xiphoid process) and test pump 50 mL air then get a [[KUB]] to verify position		#Insert lubed tube to 50-60 cm mark (estimate bridge of nose to xiphoid process) and test pump 50 mL air then get a [[Special:MyLanguage/KUB\|KUB]] to verify position
	#Then count carefully to 9 more pumps of 50 mL (Minnesota gastric tube holds 500cc, you need 9 more pumps after the initial 50 mL.		#Then count carefully to 9 more pumps of 50 mL (Minnesota gastric tube holds 500cc, you need 9 more pumps after the initial 50 mL.
	#*have someone count with you)		#*have someone count with you)
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	*No need to use esophageal tube or manometer as MOST of the time the gastric tamponade will be sufficient and you don’t want to risk over inflating the esophagus		*No need to use esophageal tube or manometer as MOST of the time the gastric tamponade will be sufficient and you don’t want to risk over inflating the esophagus
	**Have someone count with you to not lose count of how much air you’ve inserted!		**Have someone count with you to not lose count of how much air you’ve inserted!


	==Complications==		==Complications==

	*Due to misplaced balloon, migration, over-inflation, prolonged use		*Due to misplaced balloon, migration, over-inflation, prolonged use
	**Mucosal ulceration		**Mucosal ulceration
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	**Airway or large vessel obstruction		**Airway or large vessel obstruction
	**Esophageal rupture		**Esophageal rupture


	==See Also==		==See Also==

			</translate>
	{{GI bleeding pages}}		{{GI bleeding pages}}
			<translate>


	==External Links==		==External Links==

	*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]		*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]
	*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]		*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]


	==References==		==References==

	<references/>		<references/>

Line 93:		Line 117:
	[[Category:GI]]		[[Category:GI]]
	[[category:Critical Care]]		[[category:Critical Care]]
			</translate>

Rossdonaldson1 at 19:15, 19 June 2024

2024-06-19T19:15:31Z

@@ Line 11: / Line 11: @@
 ==Equipment Needed==
 *Balloon device
 **Sengstaken-Blakemore Tube
@@ Line 28: / Line 26: @@
 ==Procedure==
 ===Blakemore===
 https://www.youtube.com/watch?v=NHelCd5Jtp4
 #[[Intubate]] patient
@@ Line 72: / Line 50: @@
 #*Inflate to 20-40 mm Hg (use manometer to test pressure)
 #*Do not inflate more than 45 mm Hg
 ==Complications==
-*Due to misplaced balloon, migration, overinflation, prolonged use
+*Due to misplaced balloon, migration, over-inflation, prolonged use
 **Mucosal ulceration
 **Aspiration

Rossdonaldson1: /* Minnesota */

2024-06-19T19:13:30Z

Minnesota

← Older revision		Revision as of 19:13, 19 June 2024
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	#Unclamp the gastric inflation port, pump 50 mL, then re-clamp, then pump again, repeat until you hit 10 total times		#Unclamp the gastric inflation port, pump 50 mL, then re-clamp, then pump again, repeat until you hit 10 total times

	PEARLS:		'''PEARLS'''
	*No need to use 3 way stopcocks/ Christmas tree adaptors, just Kelly clamp all ports other than gastric inflation site		*No need to use 3 way stopcocks/ Christmas tree adaptors, just Kelly clamp all ports other than gastric inflation site
	**We initially tried to find all the adaptors etc., but ended up having air leaks because they were not connected correctly or the right kind and the gastric balloon did not stay inflated. Don't use anything other than Kelly clamps		**We initially tried to find all the adaptors etc., but ended up having air leaks because they were not connected correctly or the right kind and the gastric balloon did not stay inflated. Don't use anything other than Kelly clamps

Rossdonaldson1: /* Procedure */

2024-06-19T19:07:49Z

Procedure

← Older revision		Revision as of 19:07, 19 June 2024
Line 28:		Line 28:

	==Procedure==		==Procedure==
	*Minnesota ~~(at HUMC):~~ https://www.youtube.com/watch?v=4FHIiA_doWU		===Minnesota===
			https://www.youtube.com/watch?v=4FHIiA_doWU
	#Get the kit, 4 Kelly clamps, 50 mL syringe, lube		#Get the kit, 4 Kelly clamps, 50 mL syringe, lube
	#Take out ~~NGT- NGT~~ depth can be used to estimate how far to place Minnesota		#Take out nasogastric tube, if present
			#*Nasogastric tube depth can be used to estimate how far to place Minnesota
	#Clamp all ports on Minnesota EXCEPT gastric inflation and suction with Kelly clamps		#Clamp all ports on Minnesota EXCEPT gastric inflation and suction with Kelly clamps
	#*Take out the little white stoppers in all the ports		#*Take out the little white stoppers in all the ports
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	#*Put gastric suction to suction		#*Put gastric suction to suction
	#Test the gastric tube with air to see that they inflate in water bath		#Test the gastric tube with air to see that they inflate in water bath
	#Insert lubed tube to 50-60 cm mark (estimate bridge of nose to xiphoid process) and test pump 50 cc air then get a KUB to verify position		#Insert lubed tube to 50-60 cm mark (estimate bridge of nose to xiphoid process) and test pump 50 mL air then get a [[KUB]] to verify position
	#Then count carefully to 9 more pumps of 50 ~~ccs~~ (Minnesota gastric tube holds 500cc, you need 9 more pumps after the initial 50 cc.		#Then count carefully to 9 more pumps of 50 mL (Minnesota gastric tube holds 500cc, you need 9 more pumps after the initial 50 mL.
	#*have someone count with you)		#*have someone count with you)
	#Unclamp the gastric inflation port, pump 50 cc, then ~~reclamp~~, then pump again, repeat until you hit 10 total times		#Unclamp the gastric inflation port, pump 50 mL, then re-clamp, then pump again, repeat until you hit 10 total times

	PEARLS:		PEARLS:
	*No need to use 3 way stopcocks/ ~~christmas~~ tree adaptors, just ~~kelly~~ clamp all ports other than gastric inflation site		*No need to use 3 way stopcocks/ Christmas tree adaptors, just Kelly clamp all ports other than gastric inflation site
	**We initially tried to find all the adaptors etc, but ended up having air leaks because they were not connected correctly or the right kind and the gastric balloon did not stay inflated. Don't use anything other than ~~kelly~~ clamps		**We initially tried to find all the adaptors etc., but ended up having air leaks because they were not connected correctly or the right kind and the gastric balloon did not stay inflated. Don't use anything other than Kelly clamps
	**Can connect suction to gastric suction but in general, ignore all ports other than gastric inflation.		**Can connect suction to gastric suction but in general, ignore all ports other than gastric inflation.
	*No need to use esophageal tube or manometer as MOST of the time the gastric tamponade will be sufficient and you don’t want to risk over inflating the esophagus		*No need to use esophageal tube or manometer as MOST of the time the gastric tamponade will be sufficient and you don’t want to risk over inflating the esophagus
	**Have someone count with you to not lose count of how much air you’ve inserted!		**Have someone count with you to not lose count of how much air you’ve inserted!

			===Blakemore===
			https://www.youtube.com/watch?v=NHelCd5Jtp4
	*Blakemore: https://www.youtube.com/watch?v=NHelCd5Jtp4		#[[Intubate]] patient

	#Intubate patient
	#Fully inflate and deflate each balloon using its respective port to check for leaks		#Fully inflate and deflate each balloon using its respective port to check for leaks
	#If using Sengstaken-Blakemore tube, secure NG tube to tamponade device with distal end of NG tube 3 cm proximal to esophageal balloon		#If using Sengstaken-Blakemore tube, secure NG tube to tamponade device with distal end of NG tube 3 cm proximal to esophageal balloon

Rossdonaldson1: /* Procedure */

2024-06-19T19:02:46Z

Procedure

@@ Line 29: / Line 29: @@
 ==Procedure==
 *Minnesota (at HUMC):  https://www.youtube.com/watch?v=4FHIiA_doWU
 *Blakemore:  https://www.youtube.com/watch?v=NHelCd5Jtp4

Rossdonaldson1: /* See Also */

2022-03-12T14:07:30Z

Bchap23: /* Procedure */

2020-01-15T00:54:23Z

Procedure

← Older revision		Revision as of 00:54, 15 January 2020
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	==Procedure==		==Procedure==
			*Minnesota (at HUMC): https://www.youtube.com/watch?v=4FHIiA_doWU
			*Blakemore: https://www.youtube.com/watch?v=NHelCd5Jtp4

	#Intubate patient		#Intubate patient
	#Fully inflate and deflate each balloon using its respective port to check for leaks		#Fully inflate and deflate each balloon using its respective port to check for leaks

ClaireLewis at 19:34, 29 September 2019

2019-09-29T19:34:06Z

← Older revision		Revision as of 19:34, 29 September 2019
Line 1:		Line 1:
	==Indications==		==Indications==
	*Unstable patient with massive upper GI bleed and any of the following:		*Unstable patient with massive [[upper GI bleed]] and any of the following:
	**Inability to perform endoscopy		**Inability to perform endoscopy
	**Endoscopy failed (e.g., cannot visualize source due to heavy bleeding)		**Endoscopy failed (e.g., cannot visualize source due to heavy bleeding)
Line 68:		Line 68:
	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:GI]]		[[Category:GI]]
			[[category:Critical Care]]

← Older revision		Revision as of 14:07, 12 March 2022
Line 60:		Line 60:

	==See Also==		==See Also==
	*[[Upper gastrointestinal bleeding]]		{{GI bleeding pages}}

	==External Links==		==External Links==