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Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock
OBJECTIVE: Highlight the utility of methylene blue (MTB) infusion for extended period for refractory vasoplegia. INTRODUCTION: Hypotension refractory to vasopressor therapy in sepsis is associated with high mortality and limited therapeutic options. Dysregulated nitric oxide (NO) pathway seems to be...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Jaypee Brothers Medical Publishers
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225767/ https://www.ncbi.nlm.nih.gov/pubmed/32435102 http://dx.doi.org/10.5005/jp-journals-10071-23376 |
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author | Jaiswal, Abhishek Kumar, Manish Silver, Elizabeth |
author_facet | Jaiswal, Abhishek Kumar, Manish Silver, Elizabeth |
author_sort | Jaiswal, Abhishek |
collection | PubMed |
description | OBJECTIVE: Highlight the utility of methylene blue (MTB) infusion for extended period for refractory vasoplegia. INTRODUCTION: Hypotension refractory to vasopressor therapy in sepsis is associated with high mortality and limited therapeutic options. Dysregulated nitric oxide (NO) pathway seems to be a major driver, and, therefore, MTB, which inhibits inducible NO synthase activity and decreases cyclic guanosine monophosphate (GMP) accumulation by directly competing with NO by binding to soluble guanylyl cyclase, has been explored. CASE DESCRIPTION: We describe a successful reversal of refractory septic shock with prolonged MTB infusion in a patient supported on multiple vasopressors at the highest clinical doses as well as venovenous extracorporeal membrane oxygenation (VV-ECMO). CONCLUSION AND CLINICAL SIGNIFICANCE: Current report suggests a potential role of MTB infusion in refractory vasoplegia even in advanced vasoplegic shock. HOW TO CITE THIS ARTICLE: Jaiswal A, Kumar M, Silver E. Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock. Indian J Crit Care Med 2020;24(3):206–207. |
format | Online Article Text |
id | pubmed-7225767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-72257672020-05-20 Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock Jaiswal, Abhishek Kumar, Manish Silver, Elizabeth Indian J Crit Care Med Case Report OBJECTIVE: Highlight the utility of methylene blue (MTB) infusion for extended period for refractory vasoplegia. INTRODUCTION: Hypotension refractory to vasopressor therapy in sepsis is associated with high mortality and limited therapeutic options. Dysregulated nitric oxide (NO) pathway seems to be a major driver, and, therefore, MTB, which inhibits inducible NO synthase activity and decreases cyclic guanosine monophosphate (GMP) accumulation by directly competing with NO by binding to soluble guanylyl cyclase, has been explored. CASE DESCRIPTION: We describe a successful reversal of refractory septic shock with prolonged MTB infusion in a patient supported on multiple vasopressors at the highest clinical doses as well as venovenous extracorporeal membrane oxygenation (VV-ECMO). CONCLUSION AND CLINICAL SIGNIFICANCE: Current report suggests a potential role of MTB infusion in refractory vasoplegia even in advanced vasoplegic shock. HOW TO CITE THIS ARTICLE: Jaiswal A, Kumar M, Silver E. Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock. Indian J Crit Care Med 2020;24(3):206–207. Jaypee Brothers Medical Publishers 2020-03 /pmc/articles/PMC7225767/ /pubmed/32435102 http://dx.doi.org/10.5005/jp-journals-10071-23376 Text en Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd. © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Jaiswal, Abhishek Kumar, Manish Silver, Elizabeth Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock |
title | Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock |
title_full | Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock |
title_fullStr | Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock |
title_full_unstemmed | Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock |
title_short | Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock |
title_sort | extended continuous infusion of methylene blue for refractory septic shock |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225767/ https://www.ncbi.nlm.nih.gov/pubmed/32435102 http://dx.doi.org/10.5005/jp-journals-10071-23376 |
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