Balloon Tamponade Tubes

What are Balloon Tamponade Tubes?

Balloon tamponadeusually refers to the use of balloons inserted into the esophagus(passage between mouth and stomach, also the food pipe), stomach or uterus, and inflated to alleviate or stop refractory bleeding. A balloon tamponade tube is a tube similar to a Nasogastric Tubes (NG Tube), inserted into the food pipe via the nose, except it is larger, has three channels to aspirate fluid and blood through and has two balloons on the outside.

When inserted into the esophagus or stomach, balloon catheters are intended to stop bleeding such as from vascular structures—including Oesophageal Varices and gastric varices — in the upper gastrointestinal tract, by compressing the bleeding source. As you can see in the image below, the tube is also being held in place by putting gentle traction on it from the outside, with a small weight 250-500 mg. This is to keep the tube in the right position.

During this period where your loved one has the balloon tamponade tube in place, he or she will be intubated(Intubation) with a Breathing Tube or Endotracheal Tube and he or she will be mechanically ventilated with Ventilators (Breathing Machines). The reason for being mechanically ventilated is that the bleeding and the tube to stop the bleeding usually interfere with normal, regular breathing and in order to ensure safety and Patient comfort, Intubation and mechanical ventilation are the treatment of choice.

There are many different types of balloons manufactured for the purpose of tamponading upper gastrointestinal bleeds, each with different volume capacities and aspiration ports tailored for the specific requirement. In Intensive Care, staff will regularly aspirate gastric(stomach) content and check for signs of bleeding. Once the bleeding is under control, the ICU team, the surgeon and/or the gastroenterologist will decide for the balloon tamponade tube to be removed.

Examples include:

  • Sengstaken-Blakemore tube, with three lumens (two balloons and a gastric aspiration port). Pressure can be applied to gastric and esophageal varices by balloon inflation and traction.
  • Linton tube, with a large gastric balloon, and gastric and esophageal aspirates
  • Minnesota four-lumen tube, with esophageal and gastric balloons, and esophageal and gastric aspirates.

Balloon tamponade is considered a bridge or temporary measure to more definitive treatment modalities, and is usually administered in the Emergency Department or in the intensive-care unit setting, due to the illness of Patients and the complications of the procedure.

File:Sengstaken-Blakemore scheme EN.svg

Any questions?

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 What are the risks?

Common risks while having a Balloon Tamponade Tube inserted and also while it is in situ are

  • inadvertent insertion into the trachea(wind pipe)
  • rupture of the oesophagus
  • rupture of the stomach
  • aspiration of blood or gastric content into the lungs
  • Oesophagus and/or Stomach necrosis(tissue and cell death) secondary to too much pressure from the inflated balloon

 

Any Questions?

Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.

All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. Please discuss these issues with the medical and nursing staff who are caring for your loved one.

The information contained on this page is general in nature and therefore cannot reflect individual Patient variation. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. INTENSIVE CARE HOTLINE attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual Patient. Please refer to the full disclaimer.

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