Intra-aortic balloon counterpulsation in septic shock

Mortality in patients in septic shock remains high (50% to 80%) despite available treatment. In a 76-year-old women with hypodynamic septic shock intra-aortic balloon counterpulsation (IABC) successfully improved the hemodynamic status to the point at which the patient could maintain adequate cardiac output without assistance. The pertinent literature on experimental and clinical shock in which mechanical assistance devices were used, is reviewed. From the few clinical reports available it appears that IABC may be life-saving in those patients with hypodynamic septic shock who deteriorate despite the administration of antibiotics, steroids and vasopressors. Its value in hyperdynamic shock remains doubtful. Since the mortality associated with septic shock has not decreased despite modern management, there is justification in searching for new modalities of treatment, and the use of IABC seems most appropriate and promising.