(a) Four lumen Sengstaken-Blakemore (Minnesota) tube. The gastric balloon is inflated with 150–200 mL of air and then pulled on the cardioesophageal junction and secured by different options such as a specially designed helmet (b). The esophageal balloon is inflated with air to a pressure of 40–50 mmHg. As shown, the tube has four lumen: the gastric and esophageal balloon inflation ports and the gastric and esophageal aspiration ports.