To the Editor:
We read with great interest Roewer's report "Can Pulmonary Aspiration of Gastric Contents Be Prevented by Balloon Occlusion of the Cardia? A Study with a New Nasogastric Tube" .
Probably the first use of a nasogastric tube with a balloon for preventing pulmonary aspiration of gastric contents was reported by Kausch early in 1903  and subsequently by Macintosh in 1951  (but its balloon was placed in the esophagus), by Fisher in 1953  using a Miller-Abbott tube, and by Gilman and Abrams in 1956 . Since 1962 we have successfully used the Miller-Abbott tube or the Sengstaken-Blakemore tube for patients with a full stomach, gastrointestinal obstruction, massive gastrointestinal bleeding, lower esophageal pathology such as achalasia, diverticulum, and incompetent lower esophageal sphincter .
Dr. Roewer, however, did not cite these previous reports in his introduction or discussion. We presume that these reports could not be retrieved from MEDLARS.
Yukio Kubota, MD
Yoshiro Toyoda, MD
Hiroshi Kubota, MD
Department of Anesthesia, Osaka Kohseinenkin Hospital, Osaka, 553, Japan
Akira Asada, MD, PhD
Department of Anesthesiology and Intensive Care Medicine, Medical School, Osaka City University, Osaka, 545, Japan
1. Roewer N. Can pulmonary aspiration of gastric contents be prevented by balloon occlusion of the cardia? A study with a new nasogastric tube. Anesth Analg 1995;80:378-83.
2. Kausch W. Zur Narkose beim Ileus. Klin Wochenschr 1903;40:753-55.
3. Macintosh RR. Cuffed stomach tube. BMJ 1951;2:545.
4. Fisher CW. Prevention of aspiration of gastric contents. Anesthesiology 1953;14:506.
5. Gilman S, Abrams AL. Prevention of aspiration of gastric contents during general anesthesia. N Engl J Med 1956;255:508-9.
6. Kubota Y, Toyoda Y, Kubota H, et al. Frequency of anesthetic cardiac arrest and death in the operating room at a single general hospital over a 30-year period. J Clin Anesth 1994;6:227-38.