In a patient of bleeding oesophageal varices, what should the pressure in oesophageal balloon of Sengstaken tube: (AIIMS Nov 2009)
a. In cases in which pharmacologic or endoscopic therapies fail to control the hemorrhage, balloon tamponade can be successful in temporizing the hemorrhage.
b. The Sengstaken-Blakemore tube consists of a gastric tube with esophageal and gastric balloons. The gastric balloon is inflated, and tension is applied to the gastroesophageal junction.
c. The Minnesota tube includes a proximal esophageal lumen for aspirating swallowed secretions. These tubes are associated with a high rate of complications related to both aspiration and inappropriate placement with esophageal perforation.
d. Hemorrhage recurs on deflation in up to 50% of patients.
f. In cases of severe variceal bleeding that cannot be controlled endoscopically, emergent portal decompression is indicated. This is most commonly achieved by means of percutaneous transjugular intrahepatic portosystemic shunt (TIPS).
g. The TIPS procedure can be lifesaving in patients who are hemodynamically unstable from refractory variceal bleeding and is associated with significantly less morbidity and mortality than surgical decompression.
h. Long-term patency rates are even lower although many cases can be salvaged with careful surveillance and percutaneous techniques