title: Methylene blue administration in severe systemic inflammatory response syndrome (SIRS) after thoracic surgery.
abstract: 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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Emergency and Intensive Care Medicine, Georg-August University, G ttingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Friedrich
authors.forename: Anselm
authors.initials: A
authors.lastname: Bräuer
authors.forename: Theo
authors.initials: T
authors.lastname: Tirilomis
authors.forename: Shahram
authors.initials: S
authors.lastname: Lotfi
authors.forename: Frank
authors.initials: F
authors.lastname: Mielck
authors.forename: Thomas
authors.initials: T
authors.lastname: Busch
mesh_terms: 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
chemical_list: D004791:Enzyme Inhibitors; D014662:Vasoconstrictor Agents; D008751:Methylene Blue; D009638:Norepinephrine