What is a Sengstaken-Blakemore tube?
The Sengstaken-Blakemore (SB)tube is a red tube offered to prevent or sluggish bleeding from the esophagus and also stomach. The bleeding is frequently caused by gastric or esophageal varices, which space veins that have actually swollen native obstructed blood flow. A sport of the SB tube, called the Minnesota tube, can likewise be supplied to decompress or drainpipe the stomach to prevent insertion the a 2nd tube referred to as a nasogastric tube.
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The SB tube has three ports in ~ one end, each v a different function:esophageal balloon port, which inflates a little balloon in the esophagusgastric aspiration port, which clears fluid and also air out of the stomachgastric balloon port, which inflates a balloon in the stomach
At the other end of the SB tube are two balloons. Once inflated, these balloons put pressure on the areas that room bleeding to prevent blood flow. The tube is generally inserted through the mouth, however it can likewise be put through the nose to reach the stomach. Physicians will eliminate it as soon as the bleeding has actually stopped.
The SB pipe is provided as an emergency method to regulate bleeding from swollen esophageal veins. Esophageal and gastric veins often swell from portal hypertension or vascular congestion. The much more the veins swell, the much more likely the veins will rupture, causing extreme bleeding or shock from shedding too much blood. If left untreated or treated too late, excessive blood ns can cause death.
Before selecting to usage the SB tube, physicians will exhaust every other actions to slow-moving or prevent bleeding. This techniques could include endoscopic variceal banding and also glue injections. If a doctor chooses to use the SB tube, that will work-related only temporarily.
In the adhering to cases, physicians advise versus using the SB tube:Variceal bleeding stop or slows down.The patience recently had surgery including the stomach or stomach muscles.
A doctor have the right to insert the SB tube with the nose, however it’s an ext likely come be put through the mouth. Prior to inserting the tube, you would commonly be intubated and also mechanically ventilated to manage your breathing. You’re additionally given IV fluids to maintain blood circulation and also volume.
The physician then checks for air leaks in the esophageal and gastric balloons discovered at the end of the tube. To execute this, castle inflate the balloons and place lock in water. If there are no waiting leaks, the balloons will be deflated.
The doctor likewise needs come insert a Salem sump tube for this procedure to drainpipe the stomach.
The doctor actions these 2 tubes to ensure exact placement in the stomach. First, the SB tube must be effectively positioned in the stomach. They following measure the Salem sump tube versus the SB tube and mark it at the desired point.
After measuring, the SB tube must be lubricated to lull the insertion process. The pipe is put until the mark made by the medical professional is at your gums or opened of her mouth.
To ensure the tube reaches her stomach, the medical professional inflates the gastric balloon through a tiny amount that air. Castle then use an X-ray come confirm ideal placement. If the inflated balloon is positioned properly in the stomach, they inflate it with additional air to reach the preferred pressure.
Once castle insert the SB tube, the physician connects it to a weight for traction. The included resistance may cause the tube to stretch. In this case, they need to note the new point whereby the tube leaves your mouth. The doctor additionally needs to pull the tube gently until they feeling resistance. This indicates the balloon is appropriately inflated and also applying press to the bleeding.
After emotion resistance and also measuring the SB tube, the medical professional inserts the Salem sump tube. Both the SB tube and the Salem sump tube are secured after placement to avoid movement.
The doctor applies suction to the SB aspiration port and the Salem sump to remove any type of blood clots. If bleeding continues, castle may rise the inflation pressure. It’s essential not to overinflate the esophageal balloon for this reason it no pop.
Once the bleeding has stopped, the doctor performs these steps to remove the SB tube:Deflate the esophageal balloon.Remove traction from the SB tube.Deflate the gastric balloon.Remove the SB tube.
There room a couple of risks linked with using the SB tube. You can expect some discomfort indigenous the procedure, specifically a sore neck if the pipe was inserted through the mouth. If inserted incorrectly, the SB tube can affect your capacity to breathe.
Other symptom from wrongly positioning this tube or ruptured balloons include:painrecurrent bleedingmucosal ulceration, or ulcers that type on mucous membranesacute laryngeal obstruction, or a blockage in your airways that restricts oxygen intake
An SB pipe is a an equipment used to prevent bleeding in your esophagus and stomach. It’s frequently used in emergency situations and only for quick periods of time. This and similar endoscopic procedures have actually a high success rate.
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If you have questions about this procedure or have actually experienced complications, talk about your involves with a doctor.
Medically the review by Deborah Weatherspoon, Ph.D., R.N., CRNA — created by Kiara Anthony — to update on September 18, 2018