The use of diastolic augmentation with the intra-aortic balloon in human septic shock with associated coronary artery disease.
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Biomedical subjects
Publications and source records attributed to V K Saini.
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The thoracic duct was cannulated in six patients who were actively bleeding from varices and had not responded to conservative treatment but draining lymph from the thoracic duct did not control bleeding in five patients. There was no drop in intrasplenic pulp pressure following this procedure when recorded in three of these patients. Bleeding stopped in one patient after lymph had been drained for nine and a half hours, and there was only a modest change in intrasplenic pressure. The therapeutic use of this technique to control oesophageal varices could not be substantiated.
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Intra-aortic balloon counterpulsation (IABC) is the form of mechanical circulatory assistance in widest clinical use today. The clinical results with IABC employed in 63 patients over a four-year period are presented. The clinical conditions necessitating mechanical circulatory assistance were: cardiogenic shock following acute myocardial infarction; myocardial infarction complicated by mitral valyular regurgitation or ventricular septal defect; preinfarction angina syndrome; postcardiotomy cardiogenic shock with pump oxygenator dependence; postcardiotomy cardiogenic shock during the postoperative recovery period; and septic shock. Survival and discharge from hospital occurred with 32 of 63 patients (51%). Evaluations of left ventricular function were studied in 20 patients on IABC by construction of Frank Starling curves, with cardiac output determined by thermodilution techniques. In general, IABC shifted the curves to the left and increased their slope.
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