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Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study
BACKGROUND: Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. AIMS: We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine vari...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408522/ https://www.ncbi.nlm.nih.gov/pubmed/28393777 http://dx.doi.org/10.4103/aca.ACA_237_16 |
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author | Mazzeffi, Michael Hammer, Benjamin Chen, Edward Caridi-Scheible, Mark Ramsay, James Paciullo, Christopher |
author_facet | Mazzeffi, Michael Hammer, Benjamin Chen, Edward Caridi-Scheible, Mark Ramsay, James Paciullo, Christopher |
author_sort | Mazzeffi, Michael |
collection | PubMed |
description | BACKGROUND: Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. AIMS: We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine variables that predicted response to MB. SETTING AND DESIGN: This was conducted in a tertiary care medical center; this study was a retrospective cohort study. MATERIALS AND METHODS: Adult cardiac surgery patients who received MB for post-CPB VS over a 2-year period were studied. Mean arterial blood pressure (MAP) and vasopressor doses were compared before and after MB, and logistic regression was used to model which variables predicted response. RESULTS: Eighty-eight patients received MB for post-CPB VS during the study period. MB administration was associated with an 8 mmHg increase in MAP (P = 0.004), and peak response occurred at 2 h. Variables that were associated with a positive drug response were deep hypothermic circulatory arrest during surgery and higher MAP at the time of drug administration (P = 0.006 and 0.02). A positive response had no correlation with in-hospital mortality (P = 0.09). CONCLUSIONS: MB modestly increases MAP in cardiac surgery patients with VS. Higher MAP at the time of drug administration and surgery with deep hypothermic circulatory arrest predict a greater drug response. |
format | Online Article Text |
id | pubmed-5408522 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-54085222017-05-08 Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study Mazzeffi, Michael Hammer, Benjamin Chen, Edward Caridi-Scheible, Mark Ramsay, James Paciullo, Christopher Ann Card Anaesth Original Article BACKGROUND: Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. AIMS: We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine variables that predicted response to MB. SETTING AND DESIGN: This was conducted in a tertiary care medical center; this study was a retrospective cohort study. MATERIALS AND METHODS: Adult cardiac surgery patients who received MB for post-CPB VS over a 2-year period were studied. Mean arterial blood pressure (MAP) and vasopressor doses were compared before and after MB, and logistic regression was used to model which variables predicted response. RESULTS: Eighty-eight patients received MB for post-CPB VS during the study period. MB administration was associated with an 8 mmHg increase in MAP (P = 0.004), and peak response occurred at 2 h. Variables that were associated with a positive drug response were deep hypothermic circulatory arrest during surgery and higher MAP at the time of drug administration (P = 0.006 and 0.02). A positive response had no correlation with in-hospital mortality (P = 0.09). CONCLUSIONS: MB modestly increases MAP in cardiac surgery patients with VS. Higher MAP at the time of drug administration and surgery with deep hypothermic circulatory arrest predict a greater drug response. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5408522/ /pubmed/28393777 http://dx.doi.org/10.4103/aca.ACA_237_16 Text en Copyright: © 2017 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Mazzeffi, Michael Hammer, Benjamin Chen, Edward Caridi-Scheible, Mark Ramsay, James Paciullo, Christopher Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study |
title | Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study |
title_full | Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study |
title_fullStr | Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study |
title_full_unstemmed | Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study |
title_short | Methylene Blue for Postcardiopulmonary Bypass Vasoplegic Syndrome: A Cohort Study |
title_sort | methylene blue for postcardiopulmonary bypass vasoplegic syndrome: a cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408522/ https://www.ncbi.nlm.nih.gov/pubmed/28393777 http://dx.doi.org/10.4103/aca.ACA_237_16 |
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