Does cooling Sengstaken-Blakemore tubes aid insertion?
The current clinical practice of trainees for the insertion of SB tubes is to cool the tubes in the belief that this 'standard' practice aids tube insertion. We found no significant change in SB tube stiffness even after cooling to temperatures that would not be achieved during routine insertion. Furthermore, the rapid rise in tube temperature means that tubes approach room temperature by the time they reach the bedside. In the present era of evidence based medicine the current dogma that SB tubes should be cooled prior to insertion must be discarded.
Oral appliance therapy for obstructive sleep apnea is an effective treatment and ideal for use in military recruits. The appearance of periodic limb movements with arousal during oral appliance use should be considered as a cause of persistent daytime sleepiness despite effective treatment of obstructive sleep apnea in this subset of patients.