Intraaortic Balloon Counter Pulsation in Septic Shock

Clinical Center

Investigators

Abstract

The purpose of this study is to examine the role of intra-aortic balloon pump counterpulsation (IABC) in the treatment of septic shock. In many patients, the hemodynamic compromise characteristic of septic shock is multifactorial. Early in the development of sepsis syndrome, the combined cardiopulmonary and peripheral vasodilatory effects of sepsis result in a reduced ability to maintain blood pressure in the periphery. However, as sepsis progresses, myocardial dysfunction emerges as an additional contributor in circulatory failure. Thirty percent of patients who die from sepsis are noted to have low cardiac output. This myocardial depression is characterized by a reduction in contractility and dilatation of the left ventricle, thereby impairing the heart's ability to respond to fluid resuscitation, which is a mainstay in the treatment of septic shock. Consequently, this myocardial dysfunction, in combination with the peripheral vasodilation seen in early sepsis, leads to circulatory collapse, multisystem organ failure, and death. We hypothesize that the intra-aortic balloon pump (IABP) may reduce the myocardial depression of sepsis by improving coronary blood flow and reducing left ventricular work; therefore resulting in a decrease in mortality during sepsis. All preliminary studies were performed and the technical aspects of the study have been completed. The main study is ongoing with three cycles (of 10) having been completed.