Methylene blue administration in severe systemic inflammatory response syndrome (SIRS) after thoracic surgery.
A 66-year-old male patient developed significant pleural effusion on the right side six years after coronary bypass grafting and mitral valve replacement. After pleurocentesis, hemo-pneumothorax developed and finally resulted in complete atelectasis of the right lung. Three weeks later, the patient was transferred to our department, and underwent a right lateral thoracotomy. The hematoma was removed and a complete decortication was performed. Four hours postoperatively the patient developed severe SIRS with beginning multiorgan failure. Even extremely high doses of norepinephrine could not raise the systemic vascular resistance. Single intravenous administration of methylene blue lead to significant and permanent improvement of the hemodynamic status.
Friedrich
Martin
M
Department of Thoracic and Cardiovascular Surgery, Emergency and Intensive Care Medicine, Georg-August University, G ttingen, Germany.
Bräuer
Anselm
A
Tirilomis
Theo
T
Lotfi
Shahram
S
Mielck
Frank
F
Busch
Thomas
T
D000368:Aged; D001026:Coronary Artery Bypass; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008751:Methylene Blue / Q000494:pharmacology / Q000627:therapeutic use*; D009638:Norepinephrine / Q000494:pharmacology; D011183:Postoperative Complications; D001261:Pulmonary Atelectasis / Q000150:complications; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000494:pharmacology
D004791:Enzyme Inhibitors; D014662:Vasoconstrictor Agents; D008751:Methylene Blue; D009638:Norepinephrine