Quantitative indices of intra-aortic balloon pump (IABP) dependence during post-infarction cardiogenic shock.

In an attempt to quantitate intra-aortic balloon pump (IABP) dependence and differentiate retrievable post-infarction cardiogenic shock situations, thirty-five patients were analyzed in regard to age, duration of IABP support, and hemodynamic performance. Survivors were younger than non-survivors (P 250 hours), there was a 100% mortality. IABP dependence was best recognized by time-course trajectory plots of cardiac index versus systemic vascular resistance. Three trends were observed. All patients who improved to Class A (CIgt; 2.1 L/min/m2, SVR 2100 dynes sec cm-5) expired early despite IABP support and were considered irretrievable. This study suggests that post-infarction cardiogenic shock IABP-dependence can be quantitated to a certain degree. Post-infarction IABP-dependent patients are relatively young (40–55), do not expire during the first 50 hours of IABP support, neither improve nor deteriorate during the second 50 hours of support, and remain in Class B for 7–10 days without the occurrence of life-threatening ventricular dysrhythmias. In such situations, sufficient time may be available for cardiac catheterization to determine the appropriateness of subsequent operative interventions.