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    ICU One Pager Minnesota Tube

    Uploaded by

    Nicholas Helmstetter
    The Minnesota tube (MT) is a four-lumen gastric tube used to tamponade gastric and esophageal bleeding from life-threatening upper GI hemorrhage. It allows for continuous aspiration of gastric and esophageal contents. Placement involves measuring from the mouth to the ear to xiphoid process and inserting the tube to that depth, then an additional 10 cm. Placement is confirmed with imaging and balloons are inflated until the desired pressures are reached. The gastric balloon is used first to control bleeding, and if needed the esophageal balloon is inflated to tamponade varices. Removal involves slowly deflating the balloons over time if bleeding does not recur.

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    ICU One Pager Minnesota Tube

    Uploaded by

    Nicholas Helmstetter
    138 views1 page
    The Minnesota tube (MT) is a four-lumen gastric tube used to tamponade gastric and esophageal bleeding from life-threatening upper GI hemorrhage. It allows for continuous aspiration of gastric and esophageal contents. Placement involves measuring from the mouth to the ear to xiphoid process and inserting the tube to that depth, then an additional 10 cm. Placement is confirmed with imaging and balloons are inflated until the desired pressures are reached. The gastric balloon is used first to control bleeding, and if needed the esophageal balloon is inflated to tamponade varices. Removal involves slowly deflating the balloons over time if bleeding does not recur.

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    ICU_One_Pager_Minnesota_tube

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    The Minnesota tube (MT) is a four-lumen gastric tube used to tamponade gastric and esophageal bleeding from life-threatening upper GI hemorrhage. It allows for continuous aspiration of gastric and esophageal contents. Placement involves measuring from the mouth to the ear to xiphoid process and inserting the tube to that depth, then an additional 10 cm. Placement is confirmed with imaging and balloons are inflated until the desired pressures are reached. The gastric balloon is used first to control bleeding, and if needed the esophageal balloon is inflated to tamponade varices. Removal involves slowly deflating the balloons over time if bleeding does not recur.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    138 views1 page

    ICU One Pager Minnesota Tube

    Uploaded by

    Nicholas Helmstetter
    The Minnesota tube (MT) is a four-lumen gastric tube used to tamponade gastric and esophageal bleeding from life-threatening upper GI hemorrhage. It allows for continuous aspiration of gastric and esophageal contents. Placement involves measuring from the mouth to the ear to xiphoid process and inserting the tube to that depth, then an additional 10 cm. Placement is confirmed with imaging and balloons are inflated until the desired pressures are reached. The gastric balloon is used first to control bleeding, and if needed the esophageal balloon is inflated to tamponade varices. Removal involves slowly deflating the balloons over time if bleeding does not recur.

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    © All Rights Reserved
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    of 1

    MINNESOTA TUBES FOR UPPER GI BLEEDS by Nick Mark MD ONE onepagericu.

    com Link to the


    most current
    @nickmmark version →
    PURPOSE: GENERAL RULES:
    • Minnesota tubes (MT) are typically placed in intubated patients with life-threatening • Always INFLATE the GASTRIC balloon first
    GI hemorrhage (particular esophageal varices) when interventional approaches to Use 2 suction setups
    • Always DEFLATE the ESOPHAGEAL balloon first (1 for each port)
    control hemorrhage have been unsuccessful or are unavailable. • If there’s a doubt about placement, repeat CXR
    • The MT is a four-lumen gastric tube that permits tamponade of gastric and • Never exceed 15 mmHg with the GASTRIC balloon Suction Wall
    esophageal bleeding as well as continuous aspiration of gastric & esophageal or 45 mmHg with the ESOPHAGEAL balloon canister suction
    contents. It is an improvement over the older Sengstaken–Blakemore tube (SBT), • Never irrigate the ESOPHAGEAL suction port regulator
    which only permitted gastric contents to be aspirated.
    • Endotracheal intubation with HOB >45° is recommended prior to MT placement. 1 kg weight traction
    PLACEMENT: (excellent step by step videos are also available) (prevents the MT from 1400

    sliding in too deep)


    1. Test the balloons by inflating and submerging underwater to ensure no leaks. Attach the 1200

    sphygmomanometer/syringe GASTRIC balloon port and inflate to 100, 200, and 500 cc (note the 1000

    pressure at each volume). Completely deflate the balloons after testing. Lubricate the distal 15 800

    cm of the MT prior to insertion. 600

    2. Measure from the mouth to ear to xiphoid process and insert the tube through the mouth to that 400
    OFF
    INT
    CON

    depth. Use a video laryngoscope to help guide MT insertion into the esophagus. GASTRIC 200
    3. Insert MT to the measured distance + 10 cm (typically about 50-60 cm) & verify placement: aspiration
    • Instill 50-100 cc of air into the GASTRIC port &

    CC BY-SA 3.0
    port Controls determine
    obtain CXR Manometer GASTRIC
    ESOPHAGEAL intermittent or
    • POCUS can also be used to confirm the 60 cc allow
    balloon port
    balloon
    continuous suction &
    presence of MT in the stomach. syringe pressure port
    the pressure applied
    • If imaging confirms gastric placement of MT, monitoring
    continue to inflate to 300-500 mL ESOPHAGEAL ESOPHAGEAL GASTRIC balloon
    • If pressure rises above 15 mmHg STOP aspiration balloon compresses the GE
    4. Once placement is confirmed, connect gastric aspiration to port directly junction reducing
    intermittent suction (negative 60-120 mmHg). Clamp the ESOPHAGEAL compresses blood flow to
    gastric balloon port. Assess for ongoing bleeding. aspiration varices esophageal varices
    5. In the majority of cases the gastric balloon is able to control Y-connector opening
    hemorrhage. However, if bleeding continues, inflate the
    ESOPHAGEAL balloon to tamponade varices further. Pilot balloon
    • Instill 50cc of air at time and measure pressure. Rubber lined
    indicates that
    • Goal is 25-40 mmHg of ESOPHAGEAL pressure hemostats are
    ESOPHAGEAL
    (higher can cause esophageal erosion). used to clamp
    balloon is
    • Clamp the ESOPHAGEAL balloon. Obtain CXR. the tube
    deflated
    • Connect the ESOPHAGEAL port to continuous wall
    suction at negative 120-200 mmHg.
    6. Mark the tube at the lips & record depth. Secure the tube w/
    a 1 kg weight for traction. A catcher’s mask can also be used.

    REMOVAL:
    1. If bleeding resolves, DEFLATE the ESOPHAGEAL balloon by 5
    The distance from mouth to
    mmHg every 3 hours until completely deflated.
    ear to xiphoid approximates
    2. If no bleeding recurs for 24 hours, release traction & deflate the
    the distance from the mouth to
    GASTRIC balloon. GASTRIC aspiration
    the stomach
    3. If no bleeding for another 24 hours, remove the MT. openings

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