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Does cooling Sengstaken-Blakemore tubes aid insertion? An evidence based approach
Janet C Dearden1, Giles O Hellawell, John Pilling
1Department of Medicine, Chase Farm Hospital, The Ridgeway, Enfield, Middlesex, UK. janet.dearden@doctors.org.uk
European Journal of Gastroenterology & Hepatology
|October 19, 2004
Summary
Cooling Sengstaken-Blakemore (SB) tubes does not alter their stiffness, despite common practice. Evidence-based medicine suggests discarding the dogma of cooling SB tubes before insertion.
Area of Science:
- Gastroenterology
- Medical Devices
- Clinical Practice
Background:
- Sengstaken-Blakemore (SB) tubes are used for acute variceal bleeds.
- Cooling SB tubes is a common clinical practice among trainees.
- The rationale for cooling is believed to aid tube insertion.
Purpose of the Study:
- To survey current clinical practices regarding SB tube usage.
- To determine if cooling SB tubes affects their stiffness.
Main Methods:
- Telephone questionnaires administered to gastroenterology registrars and ITU departments.
- Measurement of SB tube stiffness at -10°C and 20°C.
- Assessment of SB tube warming time from -30°C in air and on skin contact.
Main Results:
- 95% of registrars used cooled SB tubes, based on clinical teaching.
- No significant difference in SB tube stiffness was observed between -10°C and 20°C.
- SB tubes warmed rapidly, reaching room temperature within 30 seconds on skin contact.
Conclusions:
- The practice of cooling SB tubes is not supported by evidence of altered stiffness.
- Rapid warming negates the potential benefits of pre-insertion cooling.
- The dogma of cooling SB tubes should be discarded in favor of evidence-based medicine.