What is SOND Sengstaken-Blakemore?

Posted by Specialist Doctor I Nguyen Cong Hoa - ICU Doctor - Intensive Care Department - Vinmec Times City International General Hospital

SOND Sengstaken-Blakemore is an emergency device for bleeding esophageal varices that has been described as early as the 1930s. So how is SOND Sengstaken-Blakemore structured and who is indicated for use?

SOND Sengstaken-Blakemore is a first-aid device for bleeding esophageal varices that has been described as early as the 1930s. In addition, they are also a two-balloon gastroesophageal tube inserted by Sengstaken developed by Sengstaken. and Blakemore in 1950 have passed many years, but relatively little has changed to the present day.

2.1. What is the role of SOND Sengstaken-Blakemore? Currently, the advent of endoscopy has reduced the use of Sonde Blakemore, but the use of these devices still plays an important role, especially in district hospitals where endoscopy is not available, or in cases where endoscopy is not available. massive bleeding that cannot be endoscopically immediately.
2.2. When was SOND Sengstaken-Blakemore assigned? SOND Sengstaken-Blakemore is indicated when the patient is bleeding profusely, due to esophageal varices without endoscopy, or cannot be taken to endoscopy, cannot invite endoscopy.
Besides, SOND Sengstaken-Blakemore is indicated when the patient does not respond to endoscopic hemostasis and vasoconstriction. or due to other causes of UGI Bleedingpeptic ulcer, Mallory-Weis melanoma. Temporarily awaiting TIPS (transjugular in liver portacaval shunting).
2.3. Is SOND Sengstaken-Blakemore contraindicated? SOND Sengstaken-Blakemore is contraindicated in the following cases:
Esophageal venous bleeding has stopped, or the flow is slow. Had recent esophageal surgery in the esophagus. There is a history of esophageal stricture.

Steps to intubate SOND Sengstaken-Blakemore are as follows:
If bleeding heavily requires endotracheal intubation Local anesthetic to nostrils, throat Lie supine with 45 degrees. Estimated length Determine length: nasolabial fold, earlobe (T), sternal cavity + 10 cm Balloon leak test. Lubricate the balloon and tube If placed through the mouth, need a laryngoscope to enter the esophagus Determine the best position of the tube X-ray (gastric balloon is located in the stomach) Inflate the stomach with gas 50ml to 250-300ml for SBT or 450-500ml for Minnesota tube. Use a fluid bottle to pull the balloon to prevent it from drifting into the fundus with traction and a pulley system with a 500ml bag of fluid Balloon pressure is usually 30-45 mmHg

After placing SOND Sengstaken-Blakemore, the patient should be monitored as follows:
Every 30 minutes, gastric lavage is still available. In the other case, pump the DD balloon enough 250ml. After that, continue to pump more TQ balloons 70 ml
On the first day, every 6 hours deflate the 30ml esophageal balloon but keep the catheter in place. If bleeding occurs, re-inflate the esophagus as before. If there is no bleeding: for another 24 hours without bleeding, discharge the gastric balloon and remove the catheter. If past day 2: every 4 hours flush the esophagus 30ml

Some complications that may occur when SOND Sengstaken-Blakemore is inserted are as follows:
Hemorrhage. Pain or discomfort (check position, provide sedation and analgesia) Pneumothorax: (Patients can be intubated and head position 30-45 degrees) Necrosis, perforation of esophagus (make sure both balloons are fully deflated prior to insertion, avoid high pressure on the esophageal balloon, and ensure the gastric balloon is in the correct position during inflation) Acute airway obstruction due to gastric insertion. The SOND Sengstaken-Blakemore arrhythmia is an esophageal varices bleeding emergency device that has been described and used. Today, with the development of modern medicine, this device is less used. However, in some cases they may still be indicated for use.