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Methylene Blue for the Treatment of Septic Shock
Author(s) -
Paciullo Christopher A.,
Horner Deanna McMahon,
Hatton Kevin W.,
Flynn Jeremy D.
Publication year - 2010
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.30.7.702
Subject(s) - septic shock , methylene blue , medicine , observational study , intensive care unit , shock (circulatory) , anesthesia , vasodilation , intensive care medicine , sepsis , chemistry , catalysis , biochemistry , photocatalysis
Septic shock is a major cause of morbidity and mortality in the intensive care unit, and effective therapies are limited. Methylene blue is a selective inhibitor of guanylate cyclase, a second messenger involved in nitric oxide‐mediated vasodilation. The use of methylene blue in the treatment of septic shock has been repeatedly evaluated over the past 20 years, but data remain scarce. To evaluate the safety and efficacy of methylene blue for the treatment of septic shock, we conducted a literature search of the EMBASE (1974‐June 2009), MEDLINE (1966‐June 2009), and International Pharmaceutical Abstracts (1970‐June 2009) databases. All available studies published in English were reviewed. Observational studies with methylene blue have demonstrated beneficial effects on hemodynamic parameters and oxygen delivery, but use of methylene blue may be limited by adverse pulmonary effects. Methylene blue administration is associated with increases in mean arterial pressure while reducing catecholamine requirements in patients experiencing septic shock; however, its effects on morbidity and mortality remain unknown. Well‐designed, prospective evaluations are needed to define the role of methylene blue as treatment of septic shock.