title: Methylene blue: potential use of an antique molecule in vasoplegic syndrome during cardiac surgery.
abstract: Vasoplegic syndrome is a common complication of cardiopulmonary bypass, appearing with an incidence ranging between 5 and 25%. It is characterized by significant hypotension, high or normal cardiac output and low systemic vascular resistance. This syndrome is hypothesized to be caused by the inflammation-mediated dysregulation of endothelial homeostasis and subsequent endothelial dysfunction. In vasoplegic syndrome, the inhibition of the nitric oxide/cyclic guanosine monophosphate pathway with concomitant administration with traditional ionotropes may represent a promising therapeutic option. Methylene blue, an inhibitor of nitric oxide synthase and guanylate cyclase, may contribute to the improvement of refractory hypotension associated with endothelial dysfunction in vasoplegia. In this article, we will update evidence on the potential therapeutic use of methylene blue in vasoplegic syndrome.
authors: Division of Cardiology, Faculty of Medicine, Foundation for Medical Research, Geneva University Hospitals, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland.
authors: Sébastien
authors: S
authors: Lenglet
authors: François
authors: F
authors: Mach
authors: Fabrizio
authors: F
authors: Montecucco
mesh_terms: D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006162:Guanylate Cyclase / Q000037:antagonists & inhibitors*; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D008751:Methylene Blue / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D016879:Salvage Therapy; D056987:Vasoplegia / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control
chemical_list: D002316:Cardiotonic Agents; D004791:Enzyme Inhibitors; D019001:Nitric Oxide Synthase; D006162:Guanylate Cyclase; D008751:Methylene Blue