Intra-aortic balloon counterpulsation for cardiogenic shock from cardiac contusion.

Two patients who sustained cardiac contusions secondary to blunt chest trauma developed refractory cardiogenic shock. Use of intra-aortic balloon counterpulsation improved circulatory dynamics in each case and one patient survived. Requirements for inotropic agents were diminished or eliminated, cardiac output was increased, acidosis was reversed, and the electrocardiogram reverted to normal. Although balloon counterpulsation is most effectively employed in patients with ischemic cardiac deficits, its early application coupled with appropriate pharmacologic treatment is also effective in raising low cardiac output that results from myocardial trauma.