Intra-aortic balloon counterpulsation: potential for therapy in hemorrhagic shock with associated myocardial failure

After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope of their ventricular function curve was reduced to either 75% (Group I), 50% (Group II), or 25% (Group III) of their baseline value. Resuscitation was attempted in all dogs by the intravenous infusion of shed blood plus additional balanced salt solution. This infusate was administered to maintain either the mean aortic pressure within 15 mm Hg of the baseline value or a left atrial pressure of 15 mm Hg, whichever occurred forst. One half of the dogs received, in addition, intra-aortic balloon counterpulsation. All dogs not receiving counterpulsation expired within two hours. There was no apparent effect of counterpulsation on Group I animals. Three of five animals (Group II) and four of five animals (Group III) receiving counterpulsation survived to the end of the experiment with significant (p smaller than .01) improvement in the parameters monitored. The utilization of counterpulsation as an adjunct to treatment in hemorrhagic shock is suggested.