Ehrich D A, Biddle T L, Kronenberg M W, Yu P N
Am Heart J. 1977 Mar;93(3):274-9. doi: 10.1016/s0002-8703(77)80244-5.
Sixteen patients with cardiogenic shock complicating acute myocardial infarction underwent serial hemodynamic studies during intra-aortic balloon counterpulsation (IABC) at an assist frequency of 1:1. Significant increase was noted during the first 12 hours of IABC in the systemic artery peak diastolic pressure (assisted), cardiac index, stroke index, and stroke work index. During the second 12 hours further significant improvement was noted in the latter three parameters and, in addition, the systemic artery systolic pressure increased significantly. The pulmonary wedge pressure fell as did the total systemic resistance (TSR) during the first 24 hours of IABC. Patients found to be balloon independent after reduction in balloon assist frequency demonstrated significantly greater increase in systemic artery peak diastolic pressure during the first 12 hours of IABC than did those patients found to be balloon dependent. Likewise, the improvement noted in CI, SI, and SWI during the second 12 hours of IABC was of greater magnitude in balloon-independent than in balloon-dependent patients. The data suggest late hemodynamic deterioration after 48 hours of IABC. It is concluded that IABC is effective in improving the deranged hemodynamics of cardiogenic shock. Maximum response is noted between 24 and 48 hours. It is suggested that patients who are balloon independent may be distinguished from those who are balloon dependent by the hemodynamic response within the first 24 hours of IABC.
16例急性心肌梗死并发心源性休克的患者在主动脉内球囊反搏（IABC）期间，以1:1的辅助频率进行了系列血流动力学研究。在IABC的最初12小时内，观察到体动脉舒张期峰值压力（辅助后）、心脏指数、每搏指数和每搏作功指数显著增加。在随后的12小时内，后三项参数进一步显著改善，此外，体动脉收缩压也显著升高。在IABC的最初24小时内，肺楔压和总体循环阻力（TSR）均下降。在降低球囊辅助频率后被发现可脱离球囊的患者，在IABC的最初12小时内体动脉舒张期峰值压力的增加幅度明显大于那些被发现依赖球囊的患者。同样，在IABC的第二个12小时内，CI、SI和SWI的改善在不依赖球囊的患者中比依赖球囊的患者更大。数据表明IABC 48小时后血流动力学出现晚期恶化。结论是IABC能有效改善心源性休克紊乱的血流动力学。在24至48小时之间观察到最大反应。建议通过IABC最初24小时内的血流动力学反应，可区分不依赖球囊的患者和依赖球囊的患者。
