Abstract
This study of 29 patients was accomplished in order to understand better the different hemodynamic effects of external counterpulsation (ECP) and the intra-aortic balloon pump (IABP). In cardiogenic shock, seven patients treated with ECP (without the negative pressure phase] had less diastolic augmentation and less myocardial rest in comparison to nine patients treated with balloon pumping (IABP). However, the two devices produced similar increases in cardiac output and mean blood pressure. The increase in cardiac output observed with ECP is due not only to the arterial counterpulsation effect but also to the effect of increased ventricular preload from mobilized venous blood. Support for this includes the increase in central blood volume (CBV) [two percent) and left atrial (LA) pressure (1 mm. Hg) observed with ECP in contrast to the decrease of 11 percent and three mm. Hg, respectively, with the IABP (both parameters significantly different). The use of ECP in nine postcardiac surgery “normal” patients and in four patients with septic shock produced no significant change in systemic perfusion.
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