Septic shock is the most common cause of death in medical and surgical intensive care units in the United States. Thirty percent of patients who die from sepsis are noted to have low cardiac output. The purpose of this study is to examine the role of intra-aortic balloon pump counterpulsation (IABC) in the treatment of septic shock. The goal of placing an intra-aortic balloon pump (IABP) is twofold. It reduces the afterload on the heart, thereby allowing it to do less work, "assisted systole", while enhancing its coronary blood flow, thereby providing it with more energy, "diastolic augmentation." We have an ACUC approved protocol to perform a controlled, randomized survival study of IABC in a well characterized low cardiac output animal model of sepsis. [unreadable] [unreadable] The overall effect of the IABC is to increase myocardial oxygen supply by increasing coronary perfusion during diastole, and decrease myocardial oxygen demand by decreasing afterload during systole. We found that intra-aortic balloon pumping resulted in a increase in survival time and a decrease in vasopressor dependence. This data is continuing to be analyzed and a manuscript is expected to be completed in the next 3-4 months.