Despite advances in pharmacology and endoscopy, placement of a balloon tamponade device is occasionally required to stabilize a patient with acute variceal bleeding.
Currently, there are 3 devices available: the Linton-Nachlas (gastric balloon only), the Blakemore (gastric and esophageal balloons), and the Minnesota (gastric and esophageal balloons) tubes.
The tube should initially be passed at least to the 50-cm mark and preferably to the maximum depth allowed by the length of the tube.
Once the gastric balloon is inflated and correct position confirmed, traction must be applied to keep the gastric balloon engaged in the cardia and fundus of the stomach.
An overhead pulley system is the preferred method to deliver traction. If you don't have weights for the pulley system, a 1-liter bag of crystalloid provides the desired 1.0 kg of traction.
