主支脉内囊反搏治疗双瓣替换术后低心排综合征探讨

目的 探讨主动脉内囊反搏（ＩＡＢＰ）在治疗双瓣替换术后低心排综合征的作用。方法 用ＩＡＢＰ治疗９例双瓣替换术后低心排综合征的病人。结果 ７例存活，２例死亡，抢救成功率为７８％。结论 ＩＡＢＰ对于抢救心脏外科术后危重病人，具有重要临床价值。     

双侧卵巢切除山羊不同时间段血生化指标的变化

动态观察山头假手术组（Ｓｈａｍ）和双侧卵巢切除组（ＯＶＸ）在术前、术后３月、６月、１２月和１８月不同时间段血甭骨特异性生磷酸酶（Ｂ－ＡＬＰ）、抗酒石酸酸性磷酸酶（ＲＴＡＰ）、血清骨钙素（ＢＧＰ）、血清磷（Ｐ）、血清钙（Ｃａ）的变化规律,以及术后１２月血清雌二醇（Ｅ２）水平的改变和术后６月、１８月子宫与阴道重量的变化。结果显示,Ｓｈａｎ组术后１８月Ｂ－ＡＬＰ水平明显高于术前（Ｐ〈０．０１）,其余各时     

围术期红细胞丙酮酸激酶活性的变化

目的：观察围术期红细胞内丙酮酸激酶（ＰＫ）活性的变化。方法：将３０例上腹部手术病人分成硬膜外阻滞（ＥＢ）和静脉普鲁卡因复合麻醉（ＩＰＢＡ）两组。结果：两组病人血糖于手术６０分时均开始明显升高，术后第一天值与基础值比较，ＥＢ组：８．２９±５０，４．８０±０．１８ｍｍｏｌ／Ｌ（Ｐ＜０．０１）；ＩＰＢＡ组：６．３６±０．３３，４．５５±０．１８ｍｍｏｌ／Ｌ（Ｐ＜０．０１）。红细胞内２，３－ＤＰＧ浓度无明显改变。但两组ＰＫ活性于术毕６０分时明显下降。其术后第一天值与基础值分别相比较，ＥＢ组：７．５９±１．０１，１１．６２±１．０６ＩＵ／ｇＨｂ（Ｐ＜０．０５）；ＩＰＢＡ组：７．７５±０．９４，１１．８４±１．１２ＩＵ／ｇＨｂ（Ｐ＜０．０５）。结论：在手术创伤后的高血糖反应下，红细胞内ＰＫ活性明显下降，２，３－ＤＰＧ浓度无变化。这可能与红细胞内糖酵解通路受抑制有关。     

风湿性瓣膜病合并冠心病的外科治疗

报告１９９１年１月至１９９５年１１月期间１５例风湿性瓣膜病合并冠心病病人瓣膜替换及冠脉桥术（ＣＡＢＧ）的体会。手术均在低温体外循环下进行。其中二尖瓣替换＋ＣＡＢＧ６例，主动脉瓣替换＋ＣＡＢＧ６例、双瓣替换＋ＣＡＢＧ３例，术后死亡３例，其余治愈出院，作者强调了术前明确诊断的重要性，并就冠脉搭桥、心肌保护、主动脉气囊反搏（ＩＡＢＰ）及药物的应用加以讨论。     

修补术加PGV与修补术加奥美拉唑方案治疗十二指肠溃疡穿孔的疗效对比

目的研究十二指肠溃疡穿孔的两种不同疗法——穿孔修补术加近侧胃迷走神经切断术（ＰＧＶ）与穿孔修补术加奥美拉唑方案的临床疗效。方法将１９９４年１月－１９９６年１２月相继入院的４８例十二指肠溃疡穿孔患者随机分为Ａ、Ｂ两组。Ａ组（２１例）在穿孔修补术的基础上，加行ＰＧＶ。Ｂ组（２７例）仅作穿孔修补术，术后辅予奥美拉唑方案（即口服奥美拉唑加羟氨苄青霉素加灭滴灵）。术后定期随访。随访结果按Ｖｉｓｉｃｋ标准分级。结果Ａ组术后半年和２年疗效优良者（ＶｉｓｉｃｋⅠ加Ⅱ级）分别为１８例（８５．７％）和１７例（８１．０％），溃疡复发者（ＶｉｓｉｃｋⅣ级）分别为１例（４．８％半年）和２例（９．５％２年）。Ｂ组术后半年和２年疗效优良者分别为１９例（６６．７％）和１０例（３７．０％），溃疡复发者分别为５例（１８．５％）和１２例（４４．５％）。Ａ组疗效优于Ｂ组（Ｐ＜０．０１）。Ｈｐ检测，Ａ组术后半年和两年的Ｈｐ阳性率分别为８１．０％和８５．７％（Ｐ＞０．０５）；Ｂ组分别为１８．５％和５１．９％（Ｐ＜０．０１）。结论十二指肠溃疡穿孔在施行修补术后，应同时加行ＰＧＶ，以提高对溃疡病的根治效果     

去势兔骨质疏松动物血清TRAP及BALP水平的观察

破骨细胞生成的抗滴石酸盐酸性磷酸酶（ｔａｒｔｒａｔｅ－ｒｅｓｉｓｔａｎｔａｃｉｄｐｈｏｓｐｈａｔａｓｅ，ＴＲＡＰ）及成骨细胞生成的骨碱性磷酸酶（ｂｏｎｅａｌｋａｌｉｎｅｐｈｏｓｐｈａｔａｓｅ，ＢＡＬＰ）均可分泌入血。因此，血中ＴＲＡＰ及ＢＡＬＰ水平可分别反映破骨细胞及成骨细胞的功能。本文在以往工作的基础上，观察了经双侧卵巢切除法诱导五月龄新西兰纯种大白兔形成骨质疏松动物的血清ＴＲＡＰ（采用对硝基酚磷酸盐法）及ＢＡＬＰ（热失活法）水平，结果显示：术后兔血清ＴＲＡＰ及ＢＡＬＰ活性均较术前升高，ＴＲＡＰ的变化先于ＢＡＬＰ。术后１月ＴＲＡＰ活性升至最高，然后逐渐降低，至术后２．２月左右基本降至术前水平；ＢＡＬＰ活性在术后２．２月左右升至最高，并在此水平上保持约半个月，其后很快下降，于术后３．７月左右基本降至手术前水平。对照兔血清ＴＲＡＰ及ＢＡＬＰ活性的变化趋势基本一致。结果说明：手术去势后首先刺激破骨细胞的骨吸收作用，然后刺激成骨细胞的骨形成作用。这可能是女性绝经后头几年内骨质快速丢失的一个原因。有关骨质疏松动物模型血中ＴＲＡＰ及ＢＡＩ．Ｐ变化规律的研究，目前国内外尚未见报道。本文研究结果为原发性骨质疏松的病因学、     

主动脉内气囊反搏泵的建立

主动脉内气囊反搏泵的建立曾侃１９８５年至１９９３年，我们曾用两种术式经股动脉建立主动脉内气囊反搏（ＩＡＢＰ）４８例，现总结如下，以求提高外科机械辅助循环抢救心衰的共识。临床资料本组中男２７例，女２１例。年龄７～６７岁，其中１３岁以下病儿４例，体重１８...     

急性心肌梗死心源性休克反复室颤紧急冠状动脉搭桥2例

我们对２例急性心肌梗死（ＡＭＩ）、心源性休克、反复室颤病人施行心肺复苏和紧急冠状动脉搭桥（ＣＡＢＧ）手术,效果满意。例１　男,４０岁。急性广泛前壁心梗伴心源性休克、脑梗塞。置入主动脉内球囊反搏（ＩＡＢＰ）,冠脉造影示左冠状动脉主干（ＬＭ）狭窄大于９５％,直接送手术室,２次发生室颤,经胸外挤压配合药物及胸外电除颤转复。紧急建立体外循环（ＣＰＢ）,用大隐静脉行冠状动脉搭桥２支。开放升主动脉后心脏自动复跳,病人顺利脱机。术后第５天再次脑梗塞,经治疗２５天基本恢复,术后１个月康复出院。例２　男,５７岁。…     

FDP对体外循环病人红细胞免疫功能影响的临床研究临床研究

目的　研究１,６二磷酸果糖（ＦＤＰ）对体外循环（ＣＰＢ）手术病人围术期红细胞免疫粘附功能（ＲＣＩＡ）的影响。方法　２４ 例心内直视手术患者随机分为２ 组,生理盐水（ＮＳ）组和ＦＤＰ组各１２例,两组分别于麻醉前、ＣＰＢ前、停机后５ 分钟、术后２４ 小时、术后７２ 小时抽取静脉血检测红细胞Ｃ３ ｂ 受体花环形成率（ＲＢＣ·Ｃ３ｂＲ）及红细胞免疫复合物花环形成率（ＲＢＣ·ＩＣＲ）。结果　停机后及术后２４ 小时,ＮＳ组患者ＲＢＣ·Ｃ３ｂＲ 及ＲＢＣ·ＩＣＲ 均显著下降,ＲＢＣ·Ｃ３ｂＲ 下降率分别为２７６６％ ,３２１０％ （Ｐ＜ ００１）;ＲＢＣ·ＩＣＲ下降率分别为２３２８％ ,３２１６％ （Ｐ＜ ００１）;而ＦＤＰ组停机后及术后２４ 小时,ＲＢＣ·Ｃ３ｂＲ分别降低１６１５％ ,２０３９％ ,与术前相比降低明显（Ｐ＜ ００１）;但与ＮＳ组相比,其降低程度则有所减少（Ｐ＜ ００５）;ＲＢＣ·ＩＣＲ降低分别为１８２８％ ,２２８１％ ,与ＮＳ组相比无统计学差异;术后ＲＣＩＡ 功能恢复ＦＤＰ组较ＮＳ组亦有所提高。结论　ＦＤＰ（２００ｍ ｇ／ｋｇ）于ＣＰＢ术前应用对ＲＣＩＡ有显著性保护作用     

氨甲环酸减少体外循环心脏手术后失血的作用及与抑肽酶的比较研究

目的 观察氨甲环酸减少体外循环（ＣＰＢ）心脏手术后失血的作用,探讨其其作用机制,并与抑肽酶比较。方法 随机选取ＰＣＢ心脏手术病人３０例,分为氨甲环酸用药组（ＴＡ组,１０例）,抑肽酶用药组（ＡＰ组,１０例）和对照组（Ｃ组,１０例）。于ＣＰＢ前、中、后２ｈ分别测定ｔ－ＰＡ和ＰＡＩ－Ｉ活性、ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量、ＡＤＰ诱导的血小板最大聚集率和血小板超微结构变化,记录各组术后纵隔心包引流     

Assisted Circulation in Cardiac and Respiratory Insufficiency

Summary: Intra-aortic counterpulsation with a balloon pump (IABP) was used in 63 patients with cardiogenic shock, heart failure after surgery with artificial circulation, internal lacerations of the myocardium, or unstable angina. It was found that the IABP was most efficient in conditions related to myocardial ischemia. Use of arteriovenous perfusion (in 11 patients) or artificial ventricles is indicated in severe perturbations of the pumping function of the heart. As experience has shown, cardiologic and heart surgery patients usually have multiorgan insufficiency. For this reason, it is necessary to use other artificial organs in complex treatment: artificial lungs, kidneys, livers, etc.     

Intra‐Aortic Balloon Pump Support in the Isolated Beating Porcine Heart in Nonischemic and Ischemic Pump Failure

The blood pressure changes induced by the intra‐aortic balloon pump (IABP) are expected to create clinical improvement in terms of coronary perfusion and myocardial oxygen consumption. However, the measured effects reported in literature are inconsistent. The aim of this study was to investigate the influence of ischemia on IABP efficacy in healthy hearts and in shock. Twelve slaughterhouse porcine hearts (hearts 1–12) were connected to an external circulatory system, while physiologic cardiac performance was restored. Different clinical scenarios, ranging from healthy to cardiogenic shock, were simulated by step‐wise administration of negative inotropic drugs. In hearts 7–12, severe global myocardial ischemia superimposed upon the decreased contractile states was created. IABP support was applied in all hearts under all conditions. Without ischemia, the IABP induced a mild increase in coronary blood flow and cardiac output. These effects were strongly augmented in the presence of persisting ischemia, where coronary blood flow increased by 49 ± 24% (P < 0.01) and cardiac output by 17 ± 6% (P < 0.01) in case of severe pump failure. As expected, myocardial oxygen consumption increased in case of ischemia (21 ± 17%; P < 0.01), while it slightly decreased without (?3 ± 6%; P < 0.01). In case of progressive pump failure due to persistent myocardial ischemia, the IABP increased hyperemic coronary blood flow and cardiac output significantly, and reversed the progressive hemodynamic deterioration within minutes. This suggests that IABP therapy in acute myocardial infarction is most effective in patients with viable myocardium, suffering from persistent myocardial ischemia, despite adequate epicardial reperfusion.     

Angiotensin Converting Enzyme Inhibitor Therapy in Severe Postcardiotomy Dysfunction: A Prospective Randomized Study

Abstract Background: Occurrence of severe postcardiotomy dysfunction requiring prolonged postoperative support with intra-aortic balloon counterpulsation (IABP) and inotropes, complicating surgery for coronary artery disease and valvular heart disease carries important hospital morbidity and mortality. This study evaluated the impact of angiotensin converting enzyme inhibitor (captopril) therapy in these patients in the early postoperative period. Methods: During a 5-year period, 298 patients with prolonged diminished cardiac output required support (> 48 to 72 hours) with IABP plus two or three inotropes. This cohort was randomized to two groups, group A (195 patients) who were continued on IABP and inotropes alone and group B (103 patients) who were given an angiotensin converting enzyme (ACE) inhibitor, captopril 48 to 72 hours postoperatively and continued on IABP and inotropes. Results: Tissue perfusion and he-modynamic parameters improved (p < 0.0001) in group B with early termination of IABP (duration of support mean 86 hours in group B vs 169 hours in group A) and inotropes. Peak improvement in tissue perfusion and hemodynamic parameters correlated with decreased serum angiotensin converting enzyme levels. Hospital mortality occurred in 31% of patients in group A and 14.5% in group B. Morbidity complications developed in 37% of patients in group A and 20% in group B. The average length of hospital stay in group A was 27 days and 17 days in group B. Cardiac, pulmonary, infective, gastrointestinal, renal, and neurological complications were common in both groups. Conclusion: Administration of ACE inhibitors in the early postoperative period to patients with severe postcardiotomy dysfunction caused improvement in tissue perfusion with decreases in mortality, morbidity, and length of hospital stay. These drugs, by effectively limiting physiological effects induced by renin angiotensin-aldosterone axis and other mechanisms, caused recovery of stunned myocardium. More randomized trials are needed before recommending these drugs for routine use in similar patients. (J Card Surg 1998;13;11–17)     

Experimental and Clinical Studies on the Effect of Intra-Aortic Balloon Pumping for Cardiogenic Shock Following Acute Myocardial Infarction

The effect of intra-aortic balloon pumping (IABP) on cardiogenic shock following acute myocardial infarction was studied experimentally and clinically. Effects of IABP on hemodynamic and electro-cardiographic changes were studied with cardiogenic shock which was produced by multiple ligation of the coronary artery in dogs. Consequently, the hemodynamics as well as the ECG could be improved by diastolic augmentation and systolic unloading during IABP. But, these favorable effects of IABP were not seen in dogs whose infarcted area involved more than 50% of the free wall of the left ventricle. These facts were seen clinically in three autopsied cases. IABP was also attempted in dogs with complications such as ventricular septal defect (VSD) and mitral regurgitation (MR) following acute myocardial infarction, and significant improvement was obtained by IABP. No effects of IABP were seen in these series, however, when the value of the pulmonary-to-systemic flow ratio was over 4.5 in the VSD group and the mean left atrial pressure was more than 30 mmHg in the MR group. Clinically, IABP was employed in 16 patients with cardiogenic shock secondary to acute myocardial infarction. Six (37.5%) were weaned from IABP. It can be concluded that IABP is effective in improving hernodynamics as well as the ECG.     

Left ventricular failure following valve replacement surgery in patients with mitral stenosis--its genesis, prognosis, and the method for the preoperative prediction

To detect the genesis and the prognosis of left ventricular failure (LVF) following the valve replacement surgery to mitral stenosis (MS), preoperative values and postoperative courses were assessed in 90 patients with MS. The criteria for LVF were as follows: postoperative severe left ventricular (LV) dysfunction which required intra-aortic balloon pumping (IABP) support with large doses of catecholamine. Among these 90 patients, LVF had occurred in 13 patients, of which 6 had a definite cause of LVF (group A), but the other 7 patients failed to LVF despite uneventful operation (group B). Comparing the pre- and postoperative values in these two groups, the duration of IABP support was much longer in group A, and the weaning rate from IABP was also poor in this group. Long-term survival was achieved only by one patient in group A, whereas 5 out of 6 patients of group B survived long-term postoperatively. Evaluating the preoperative LV function in group B patients, depressed LV function [%fractional shortening (%FS) less than or equal to 27%] was observed in 5 patients. Among these 5 patients, three had low cardiac output; in other two, preoperative %FS was severely depressed. In such patients, the responses to preoperative dobutamine administration tests were poor, and the values of %fibrosis of the LV myocardium, which was demonstrated by intraoperative biopsy, was greater in them. In conclusion, the causes of postoperative LVF following the mitral valve replacement to MS was divided into two categories: one due to perioperative complication and another due to preoperatively impaired LV function.(ABSTRACT TRUNCATED AT 250 WORDS)     

Primary extracorporeal membrane oxygenation versus primary ventricular assist device implantation in low cardiac output syndrome following cardiac operation

Mechanical support is often the only therapeutic option in low cardiac output (LCO) following cardiac operation using extracorporeal circulation (ECC). However, the question whether primary ventricular assist device (VAD) or primary extracorporeal membrane oxygenation (ECMO) followed by secondary VAD implantation is superior remains unclear. We analyzed the outcome of 183 patients with LCO following ECC. Primary VAD implantation (VAD) was performed on 20 patients and 163 patients underwent ECMO implantation (ECMO). Out of this group, 13 patients received a secondary VAD (ECMO-VAD). Age was significantly lower in the VAD group, while gender and type of operation were similarly distributed. Thirty-day mortalities were 50, 75, and 46% (VAD, ECMO, and ECMO-VAD, respectively; P < 0.05 ECMO vs. VAD and ECMO-VAD). Survival was best with VAD implantation 1.2 +/- 1.2 days following LCO. In conclusion, the outcome of LCO following ECC remains poor. Early VAD support provides best survival. Primary or secondary VAD implantation has no impact on survival.     

Vascular complications of the intra-aortic balloon pump.

The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart surgery (35%), unstable angina (5%), and cardiac arrest (14%). The incidence of IABP morbidity was 29%. Complications included ischemia (25%), bleeding (2%), lymph fistula (1%), and femoral neuropathy (1%). Twenty patients required 1 or more surgical interventions for lower extremity vascular complications. The majority of patients who underwent operation (70%) had significant pre-existing arterial occlusive disease. Local femoral artery reconstruction or repair was performed in 18 patients. Two patients had adjunctive bypasses. Continued IABP support was required in four patients after treatment of complications. One patient (1%) had an above-knee amputation. Limb ischemia was treated nonoperatively by removal of the IABP in five patients. Color-flow duplex scans were useful in distinguishing hematomas from pseudoaneurysms as well as for assessing femoral artery flow. We conclude that: (1) limb ischemia remains the primary complication of the IABP; (2) pre-insertion documentation of the severity of existing peripheral arterial disease by noninvasive studies may aid in the management of subsequent acute limb ischemia; (3) femoral artery thrombectomy or endarterectomy is usually sufficient for revascularization; and (4) noninvasive color flow studies are an important diagnostic tool in the nonoperative management of limb complications.     

不同心肌保护方法在双瓣膜置换术中对心肌的保护作用

目的 探讨双瓣膜置换术中更有效的心肌保护措施. 方法 纳入第三军医大学新桥医院2005年6～12月32例以主动脉瓣狭窄为主行二尖瓣和主动脉瓣双瓣膜置换术(DVR)患者进行心肌保护研究,根据入院顺序将患者分为4组,每组8例.顺行性灌注组(顺灌组):主动脉根部顺行性灌注冷血心脏停搏液,完成二尖瓣置换术(MVR),再经左、右冠状动脉开口,灌注冷血心脏停搏液,进行主动脉瓣置换术(AVR);逆行灌注组(逆灌组):经冠状静脉窦间断逆行灌注冷血心脏停搏液,完成DVR;顺灌+逆灌组:按顺行性灌注方法先完成MVR,再采用逆行灌注方法完成AVR;心脏不停跳组:经冠状静脉窦持续逆行灌注体外循环机氧合血,心脏不停跳下完成DVR.观察4组术后早期临床疗效;采用酶联免疫吸附测定(ELISA)法检测血清心肌肌钙蛋白Ⅰ(cTnI),Hitachi7150型全自动生化分析仪检测磷酸肌酸激酶同工酶(CK-MB)、心肌乳酸释放率,硫代巴比妥酸法检测心肌线粒体丙二醛(MDA)的含量变化.结果 32例患者无手术死亡,均痊愈出院.心脏不停跳组主动脉阻断80 min时心肌乳酸释放率,术后第1d血清cTnI,CK-MB含量,缝闭右心房时心肌线粒体MDA的含量分别为13.59％±6.27％、(1.17±0.25) ng/ml、( 56.43±16.50) U/L、(2.18±1.23) nmol/(ng.prot),均明显低于逆灌组[33.49％±8.29％、(1.82±0.58) ng/ml、(78.31±21.27) U/L、(5.07±2.35) nmol/(ng.prot),P＜0.05]和逆灌+顺灌组[20.87％±7.22％、(1.49±0.23) ng/ml、(66.67±19.13)U/L、(4.34±1.73) nmol/(ng.prot),P＜0 05];与顺灌组[18.83％±5.97％、(1.41±0.32) ng/ml、(63.21±37.52) U/L、(3.46±1.62) nmol/(ng.prot)]比较差异无统计学意义(P＞0.05). 结论 在DVR中,以上4种心肌保护方法均有效,但心脏不停跳组和顺灌组效果最好,应优先选择;顺行性灌注+逆行灌注操作方便,不影响手术,逆行灌注时间短,也是一种有效的选择.     

Heparin-free management of intra-aortic balloon pump after cardiac surgery

Abstract Background : Anticoagulation with heparin is recommended in patients with an intra‐aortic balloon pump (IABP) to prevent thrombosis and embolization. However, anticoagulation increases the risk of bleeding, particularly in the early postoperative period after cardiac surgery. We investigated the safety of heparin‐free management after IABP insertion in patients who underwent cardiac surgery. Methods : We studied 203 consecutive patients who received perioperative IABP support between August 2004 and December 2011. All patients were managed without heparin and were followed for thrombotic and/or hemorrhagic complications. Results : Patients were divided into two groups, according to time of IABP treatment following surgery. Group I, 81 patients (39.9%) were treated less than 24 hours following surgery and Group II, 122 patients (60.1%) were treated more than 24 hours following surgery. Vascular complications developed in seven patients (3.4%), two in Group I and five in Group II. Three patients had major and four had minor limb ischemia. There were no major bleeding complications, but minor bleeding complications were observed in eight patients (4.2%). Conclusion : In patients undergoing cardiac surgery with IABP support, the rate of thromboembolic complications was relatively low compared to historical controls. Heparin‐free management may reduce the risk of hemorrhagic complications, with a low risk of thrombotic complications. Heparin should not be routinely used in patients requiring IABP after cardiac surgery. (J Card Surg 2012;27:434‐437)     

Splanchnic blood flow response to intraaortic balloon pump assist of hemorrhagic shock

Hemorrhagic shock results in marked changes in splanchnic arterial blood flow. We studied the effects of intraaortic balloon pump assist (IABP) upon splanchnic blood flow during sustained hemorrhagic shock and following volume resuscitation. Hemorrhagic shock was induced (mean blood pressure = 30 mm Hg) for 120 min in 20 dogs. Controls (n = 11) underwent resuscitation with shed blood and lactated Ringers solution only. In the study group (n = 9), IABP was begun after 60 min of hemorrhagic shock and continued throughout a 90-min period after resuscitation. Hemodynamic parameters were assessed and splanchnic blood flow was estimated (radioactive microsphere technique) at baseline, through 120 min of sustained hypotension, and during the resuscitation period. Splanchnic blood flow was significantly reduced in both the control and the IABP groups during the period of hemorrhagic shock. Interestingly, the IABP group was found to have a return to preshock splanchnic viscera perfusion without the hyperemic reperfusion phenomenon seen in control animals resuscitated with shed blood and Ringers lactate alone. IABP assist of hemorrhagic shock appears to improve vasomotor control of splanchnic blood flow in this experimental preparation of shock. This may result in less reperfusion injury to the splanchnic viscera during the resuscitation of severe hemorrhagic shock.