Result 1 - 10 of total 30
Chest
| Keywords | covid19 |
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| Publisher | Elsevier; PMC |
| Document type | Article ; Online |
| DOI | 10.1016/j.chest.2020.09.155 |
| Database | COVID19 |
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2019 Volume 24, Issue 3, Page(s) 206–207
Abstract: ... Continuous Infusion of Methylene Blue for Refractory Septic Shock. Indian J Crit Care Med 2020;24(3):206-207. ... septic shock with prolonged MTB infusion in a patient supported on multiple vasopressors at the highest ... Objective: Highlight the utility of methylene blue (MTB) infusion for extended period ...
| Abstract | 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. |
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| Language | English |
| Publishing date | 2019-07-19 |
| Publishing country | India |
| Document type | Case Reports |
| ZDB-ID | 2121263-6 |
| ISSN | 1998-359X ; 0972-5229 |
| ISSN (online) | 1998-359X |
| ISSN | 0972-5229 |
| DOI | 10.5005/jp-journals-10071-23376 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2010 Volume 30, Issue 3, Page(s) 323
Abstract: ... in patients with septic shock refractory to catecholamine vasopressors and as an agent to maintain hemodynamic ... As an inhibitor of nitric oxide, methylene blue has been investigated as an alternative vasopressor ... of methylene blue as a vasopressor in patents receiving continuous renal replacement therapy has not been evaluated ...
| Abstract | As an inhibitor of nitric oxide, methylene blue has been investigated as an alternative vasopressor in patients with septic shock refractory to catecholamine vasopressors and as an agent to maintain hemodynamic stability in patients receiving intermittent hemodialysis. However, to our knowledge, the use of methylene blue as a vasopressor in patents receiving continuous renal replacement therapy has not been evaluated. We describe a 56-year-old man who was receiving continuous venovenous hemodiafiltration (CVVHDF) for acute renal failure secondary to sepsis. After a difficult hospital stay for injuries sustained from a motor vehicle accident, the patient developed sepsis and subsequent renal failure. On hospital day 47, after an adequate course of antibiotics, the patient developed refractory shock while receiving norepinephrine, phenylephrine, vasopressin, and hydrocortisone. He was then given a continuous infusion of methylene blue, which increased his mean arterial pressure and allowed for weaning of the catecholamine vasopressors. Eight hours after the start of methylene blue, the CVVHDF filter failed, and the hemodiafiltration was stopped. Because the filter was blue, a sample of the patient's effluent was analyzed by using ultraviolet-visible spectroscopy. No methylene blue was detected in the sample, suggesting that the drug was not being removed by CVVHDF. Clinicians should use caution when they are considering the use of methylene blue in patients with refractory shock who are also receiving CVVHDF. |
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| MeSH term(s) | Accidents, Traffic ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Blood Pressure/drug effects ; Catecholamines ; Contraindications ; Drug Resistance ; Fatal Outcome ; Hemodiafiltration ; Humans ; Male ; Methylene Blue/therapeutic use ; Middle Aged ; Nitric Oxide/antagonists & inhibitors ; Renal Replacement Therapy ; Sepsis/complications ; Shock, Septic/complications ; Shock, Septic/drug therapy ; Vasoconstrictor Agents/therapeutic use |
| Chemical Substances | Catecholamines ; Vasoconstrictor Agents ; Nitric Oxide (31C4KY9ESH) ; Methylene Blue (T42P99266K) |
| Language | English |
| Publishing date | 2010-03 |
| Publishing country | United States |
| Document type | Case Reports ; Journal Article |
| ZDB-ID | 603158-4 |
| ISSN | 1875-9114 ; 0277-0008 |
| ISSN (online) | 1875-9114 |
| ISSN | 0277-0008 |
| DOI | 10.1592/phco.30.3.323 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 1738: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
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| Zs.MO 585: Show issues |
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BMJ case reports
2022 Volume 15, Issue 2
Abstract: Current therapies frequently used for refractory septic shock include hydrocortisone, vasopressin ... very limited. We present a case of a 5-year-old patient with refractory septic shock, secondary to ... extracorporeal membrane oxygenation (ECMO) support, inodilators, levosimendan and methylene blue. The evidence for these treatments is ...
| Abstract | Current therapies frequently used for refractory septic shock include hydrocortisone, vasopressin, extracorporeal membrane oxygenation (ECMO) support, inodilators, levosimendan and methylene blue. The evidence for these treatments is very limited. We present a case of a 5-year-old patient with refractory septic shock, secondary to |
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| MeSH term(s) | Child ; Child, Preschool ; Extracorporeal Membrane Oxygenation/methods ; Female ; Humans ; Listeriosis/complications ; Listeriosis/drug therapy ; Methylene Blue/therapeutic use ; Shock, Septic/complications ; Shock, Septic/drug therapy ; Vasoconstrictor Agents/therapeutic use |
| Chemical Substances | Vasoconstrictor Agents ; Methylene Blue (T42P99266K) |
| Language | English |
| Publishing date | 2022-02-28 |
| Publishing country | England |
| Document type | Case Reports ; Journal Article |
| ISSN | 1757-790X |
| ISSN (online) | 1757-790X |
| DOI | 10.1136/bcr-2021-243772 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2023 Volume 27, Issue 9, Page(s) 669–674
Abstract: ... methylene blue infusion on hemodynamic improvement and mortality in patients with refractory shock ... patients with refractory shock were included in the study. With the use of IV methylene blue, 41 (53.9 ... Conclusion: The use of IV methylene blue in refractory shock as an adjuvant therapy significantly improved ...
| Abstract | Introduction: Refractory shock, which fails to respond to conventional vasopressor therapy, is a common complication of sepsis. Methylene blue has emerged as a potential adjunctive treatment option for reversing refractory shock in sepsis. The aim of this study was to evaluate the impact of intravenous methylene blue infusion on hemodynamic improvement and mortality in patients with refractory shock. Methodology: This was an observational prospective study for the duration of six months conducted at intensive care a medical college and teaching hospital including 76 patients with a diagnosis of septic shock requiring vasopressor therapy. Intravenous (IV) methylene blue was infused as a bolus dose with 2 mg/kg dose in 20 minutes and its response to mean arterial blood pressure, decrease in vasopressor therapy, lactate level, and urine output was recorded in next 2 hours. Patients with improvement in mean arterial pressure (MAP) by 10% or decrease in vasopressor therapy in the next 2 hours were leveled as responder. The length of intensive care unit (ICU) stay, duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared between responder and non-responder. Results: A total of 76 patients with refractory shock were included in the study. With the use of IV methylene blue, 41 (53.9%) patients showed significant improvement in MAP within 2 hours (70.17 ± 8.30 vs 64.28 ± 11.84, Conclusion: The use of IV methylene blue in refractory shock as an adjuvant therapy significantly improved the mean arterial blood pressure and decreased the requirement of vasopressor therapy as well as improvement in the survival time. However, there was no change in the mortality, length of ICU stay, ventilator-free days, or incidence of AKI in the patients. How to cite this article: Rajbanshi LK, Bajracharya A, Arjyal B, Devkota D. Can Use of Intravenous Methylene Blue Improve the Hemodynamics and Outcome of the Patients with Refractory Septic Shock? An Observational Study. Indian J Crit Care Med 2023;27(9):669-674. |
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| Language | English |
| Publishing date | 2023-09-14 |
| Publishing country | India |
| Document type | Journal Article |
| ZDB-ID | 2121263-6 |
| ISSN | 1998-359X ; 0972-5229 |
| ISSN (online) | 1998-359X |
| ISSN | 0972-5229 |
| DOI | 10.5005/jp-journals-10071-24535 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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Journal of neonatal-perinatal medicine
2021 Volume 15, Issue 2, Page(s) 265–273
Abstract: Background: Refractory septic shock in neonates is still associated with high mortality ... for refractory septic shock in the preterm neonate.: Methods: A double-blinded randomized controlled trial was ... with refractory septic shock were randomized to receive either MB or TP as an adjuvant to conventional therapy ...
| Abstract | Background: Refractory septic shock in neonates is still associated with high mortality, necessitating an alternative therapy, despite all currently available treatments. This study aims to assess the vasopressor effect of methylene blue (MB) in comparison to terlipressin (TP) as adjuvant therapy for refractory septic shock in the preterm neonate. Methods: A double-blinded randomized controlled trial was conducted in the Neonatal Intensive Care Units at Ain Shams University, Egypt. Thirty preterm neonates with refractory septic shock were randomized to receive either MB or TP as an adjuvant to conventional therapy. Both MB and TP were administered as an intravenous loading dose followed by continuous intravenous infusion. The hemodynamic variables, functional echocardiographic variables, and oxidant stress marker were assessed over a 24 h period together with the side effects of MB. Results: MB causes significant improvement in mean arterial blood pressure with a significant decrease of the norepinephrine requirements (1.15±0.21μm/kg/min at baseline vs. 0.55±0.15μm/kg/min at 24 h). MB infusion causes an increase of the pulmonary pressure (44.73±8.53 mmHg at baseline vs. 47.27±7.91 mmHg after 24 h) without affecting the cardiac output. Serum malonaldehyde decreased from 5.45±1.30 nmol/mL at baseline to 4.40±0.90 nmol/mL at 24 h in the MB group. Conclusion: Administration of MB to preterm infants with refractory septic shock showed rapid increases in systemic vascular resistance and arterial blood pressure with minimal side effects. |
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| MeSH term(s) | Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Methylene Blue/pharmacology ; Methylene Blue/therapeutic use ; Shock, Septic/drug therapy ; Terlipressin/therapeutic use ; Vasoconstrictor Agents/therapeutic use ; Vasopressins/therapeutic use |
| Chemical Substances | Vasoconstrictor Agents ; Vasopressins (11000-17-2) ; Terlipressin (7Z5X49W53P) ; Methylene Blue (T42P99266K) |
| Language | English |
| Publishing date | 2021-11-12 |
| Publishing country | Netherlands |
| Document type | Journal Article ; Randomized Controlled Trial |
| ZDB-ID | 2435387-5 |
| ISSN | 1878-4429 ; 1934-5798 |
| ISSN (online) | 1878-4429 |
| ISSN | 1934-5798 |
| DOI | 10.3233/NPM-210824 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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Journal of Pediatric Intensive Care
2023
Abstract: ... for myocarditis, septic shock, postcardiac arrest, high output chylothorax, scoliosis repair, and one multisystem ... risk of mortality. We seek to provide further data on the safety and effectiveness of methylene blue ... intensive care unit at Mount Sinai Kravis Children's Hospital from 2011 to 2021 who received MB for refractory shock ...
| Abstract | Catecholamine-resistant shock, also known as vasoplegia, is a challenging entity with a significant risk of mortality. We seek to provide further data on the safety and effectiveness of methylene blue (MB) for vasoplegic shock in the pediatric population. We conducted a retrospective observational study of pediatric patients admitted to the pediatric intensive care unit or pediatric cardiac intensive care unit at Mount Sinai Kravis Children's Hospital from 2011 to 2021 who received MB for refractory shock. A list of patients was obtained by performing a pharmaceutical query from 2011 to 2021 for “MB.” Chart review was performed to determine indication for use and to collect demographic and clinical data. There were 33 MB administrations: 18 administrations (16 unique patients) for vasoplegic shock, 11 for surgical dye, and 4 for methemoglobinemia. The median age was 5 years (interquartile range [IQR]: 0.08, 13). Ten patients required MB following congenital cardiac repair (62.5%); one administration for myocarditis, septic shock, postcardiac arrest, high output chylothorax, scoliosis repair, and one multisystem inflammatory syndrome in children. No patients experienced hemolytic anemia or serotonin syndrome following administration. The median dose of MB was 1 mg/kg. Vasoactive-inotrope score (VIS) improved in 4 out of 18 administrations at 1 hour. Mean arterial pressure (MAP) improved in 10 out of 18 administrations at 1 hour. Systolic blood pressure (SBP) improved in 8 out of 18 administrations at 1 hour. VIS, MAP, and SBP improved in 8 out of 18 administrations at 6 hours. MB may be safely considered as rescue therapy in catecholamine-resistant shock in pediatrics. |
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| Keywords | vasoplegic shock ; methylene blue ; vasoplegia ; pediatrics |
| Language | English |
| Publishing date | 2023-01-05 |
| Publisher | Georg Thieme Verlag KG |
| Publishing place | Stuttgart ; New York |
| Document type | Article |
| ISSN | 2146-4626 ; 2146-4618 |
| ISSN (online) | 2146-4626 |
| ISSN | 2146-4618 |
| DOI | 10.1055/s-0042-1760297 |
| Database | Thieme publisher's database |
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Critical care (London, England)
2023 Volume 27, Issue 1, Page(s) 110
Abstract: Purpose: Methylene blue (MB) has been tested as a rescue therapy for patients with refractory ... septic shock. However, there is a lack of evidence on MB as an adjuvant therapy, its' optimal timing, dosing ... discontinuation in patients with septic shock.: Methods: In this single-center randomized controlled trial ...
| Abstract | Purpose: Methylene blue (MB) has been tested as a rescue therapy for patients with refractory septic shock. However, there is a lack of evidence on MB as an adjuvant therapy, its' optimal timing, dosing and safety profile. We aimed to assess whether early adjunctive MB can reduce time to vasopressor discontinuation in patients with septic shock. Methods: In this single-center randomized controlled trial, we assigned patients with septic shock according to Sepsis-3 criteria to MB or placebo. Primary outcome was time to vasopressor discontinuation at 28 days. Secondary outcomes included vasopressor-free days at 28 days, days on mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days. Results: Among 91 randomized patients, forty-five were assigned to MB and 46 to placebo. The MB group had a shorter time to vasopressor discontinuation (69 h [IQR 59-83] vs 94 h [IQR 74-141]; p < 0.001), one more day of vasopressor-free days at day 28 (p = 0.008), a shorter ICU length of stay by 1.5 days (p = 0.039) and shorter hospital length of stay by 2.7 days (p = 0.027) compared to patients in the control group. Days on mechanical ventilator and mortality were similar. There were no serious adverse effects related to MB administration. Conclusion: In patients with septic shock, MB initiated within 24 h reduced time to vasopressor discontinuation and increased vasopressor-free days at 28 days. It also reduced length of stay in ICU and hospital without adverse effects. Our study supports further research regarding MB in larger randomized clinical trials. Trial registration ClinicalTrials.gov registration number NCT04446871 , June 25, 2020, retrospectively registered. |
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| MeSH term(s) | Humans ; Shock, Septic ; Methylene Blue/pharmacology ; Methylene Blue/therapeutic use ; Vasoconstrictor Agents/therapeutic use ; Sepsis/complications |
| Chemical Substances | Methylene Blue (T42P99266K) ; Vasoconstrictor Agents |
| Language | English |
| Publishing date | 2023-03-13 |
| Publishing country | England |
| Document type | Randomized Controlled Trial ; Journal Article |
| ZDB-ID | 2041406-7 |
| ISSN | 1466-609X ; 1364-8535 |
| ISSN (online) | 1466-609X |
| ISSN | 1364-8535 |
| DOI | 10.1186/s13054-023-04397-7 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 5517: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG) |
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Canadian journal of anaesthesia = Journal canadien d'anesthesie
2011 Volume 58, Issue 4, Page(s) 401–405
Abstract: ... protocols for the treatment of septic shock, the patient's hemodynamic status was refractory 80 hr post admission ... Purpose: Methylene blue (MB) has been advocated for the treatment of refractory hemodynamic ... instability in patients with septic shock. However, the use of MB infusions in septic shock is not considered ...
| Abstract | Purpose: Methylene blue (MB) has been advocated for the treatment of refractory hemodynamic instability in patients with septic shock. However, the use of MB infusions in septic shock is not considered standard treatment, and the available literature describes infusions of short duration, typically less than six hours. Clinical features: We report a case of septic shock in a 67-yr-old male who required maximal vasopressor support with norepinephrine, epinephrine, and vasopressin. Despite standard protocols for the treatment of septic shock, the patient's hemodynamic status was refractory 80 hr post admission. However, initiation of a MB infusion resulted in the rapid restoration of hemodynamic stability and a subsequent decrease in vasopressor requirements. Multiple attempts to discontinue the MB infusion resulted in immediate and repeated increases in vasopressor requirements, necessitating a continuous infusion with a slow taper of MB for 120 hr. Ultimately, the patient survived the illness and was discharged home. We observed no adverse events that could be attributed to the use of MB. Conclusion: In our patient, the use of MB resulted in hemodynamic stability unattained with standard vasopressor support. Further research is warranted on the use of MB in patients with septic shock. |
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| MeSH term(s) | Aged ; Hemodynamics/drug effects ; Humans ; Infusions, Intravenous ; Male ; Methylene Blue/administration & dosage ; Methylene Blue/pharmacology ; Methylene Blue/therapeutic use ; Shock, Septic/drug therapy ; Shock, Septic/physiopathology |
| Chemical Substances | Methylene Blue (T42P99266K) |
| Language | English |
| Publishing date | 2011-04 |
| Publishing country | United States |
| Document type | Case Reports ; Journal Article |
| ZDB-ID | 91002-8 |
| ISSN | 1496-8975 ; 0832-610X |
| ISSN (online) | 1496-8975 |
| ISSN | 0832-610X |
| DOI | 10.1007/s12630-011-9458-x |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 109: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
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Case reports in anesthesiology
2021 Volume 2021, Page(s) 6610754
Abstract: The use of methylene blue for vasoplegia in cardiac cases with cardiopulmonary bypass, septic shock ... hypotension following reperfusion. Administration of methylene blue to each patient resulted in a significant ... should be considered as a treatment option for refractory hypotension. ...
| Abstract | The use of methylene blue for vasoplegia in cardiac cases with cardiopulmonary bypass, septic shock, and acute liver failure is well documented. Use of MB for liver transplantation has been largely limited to case reports. We describe three separate liver transplantation patients with significant hypotension following reperfusion. Administration of methylene blue to each patient resulted in a significant decrease in vasopressor medication and two patients weaned completely. We argue that the use of MB should be considered as a treatment option for refractory hypotension. |
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| Language | English |
| Publishing date | 2021-06-23 |
| Publishing country | United States |
| Document type | Case Reports |
| ZDB-ID | 2659087-6 |
| ISSN | 2090-6390 ; 2090-6382 |
| ISSN (online) | 2090-6390 |
| ISSN | 2090-6382 |
| DOI | 10.1155/2021/6610754 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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