Intra-aortic balloon pumping. Hemodynamic and metabolic effects during cardiogenic shock in patients with triple coronary artery obstructive disease

Mechanical devices which maintain viability during periods of reduced or absent mechanical cardiac function have permitted the utilization of a variety of surgical techniques for the treatment of acquired and congenital cardiac disease. In addition, many advances in cardiac pharmacology have improved the treatment of abnormal mechanical and electrical cardiac function. Despite a variety of therapeutic approaches, survival rate of hospital patients in cardiogenic shock remains between 10% to 20%.1Malach and Rosenberg2reviewed 264 consecutive cases of acute myocardial infarction at this institution and found the frequency of cardiogenic shock to be 9.4%. Those patients in shock were treated with several pharmacologic and volume replacement regimens with no survivors. More recently, Eichna3reported on the treatment of 26 cardiogenic shock cases at this institution using intravenously administered isoproterenol hydrochloride as the major pharmacologic agent. The death rate was 72%. Drugs remain the most frequent means of