Intraaortic balloon assistance in intractable cardiogenic shock.

The efficacy of intraaortic counterpulsation (IABP) in severe cardiogenic shock after acute myocardial infarction is questioned because of the lack of a large controlled series. Out of 52 patients treated for severe, prolonged cardiogenic shock 3 improved with 'conventional' treatment. Forty-nine patients did not improve and were in 'intractable' shock for an average of 10.74 +/- 7.14 h (means +/- SD). Of these, 34 were treated with IABP. Ten survived longer than a month. Of the remaining 15 patients of similar age, severity and duration of shock, in whom the balloon could not be made to operate, none survived. It is suggested that intraaortic counterpulsation can save a number of patients with severe protracted cardiogenic shock after all other available treatment modalities have failed.