title: Guanylate cyclase inhibition by methylene blue as an option in the treatment of vasoplegia after a severe burn. A medical hypothesis.
abstract: Today it is known that severe burns can be accompanied by the phenomenon of vasoplegic syndrome (VS), which is manifested by persistent and diffuse vasodilation, hypotension and low vascular resistance, resulting in circulatory and respiratory failure. The decrease in systemic vascular resistance observed in VS is associated with excessive production of nitric oxide (NO). In the last 2 decades, studies have reported promising results from the administration of an NO competitor, methylene blue (MB), which is an inhibitor of the soluble guanylate cyclase (sGC), in the treatment of refractory cases of vasoplegia. This medical hypothesis rationale is focused on the tripod of burns/vasoplegia catecholamine resistant/methylene blue. This article has 3 main objectives: 1) to study the guanylate cyclase inhibition by MB in burns; 2) to suggest MB as a viable, safe and useful co-adjuvant therapeutic tool of fluid resuscitation, and; 3) to suggest MB as burns hypotensive vasoplegia amine-resistant treatment.<br />
authors.affiliation: Department of Surgery and Anatomy, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Jayme A
authors.initials: JA
authors.lastname: Farina Junior
authors.forename: Andrea Carla
authors.initials: AC
authors.lastname: Celotto
authors.forename: Marcelo Felix
authors.initials: MF
authors.lastname: da Silva
authors.forename: Paulo Roberto B
authors.initials: PR
authors.lastname: Evora
mesh_terms: D000818:Animals; D002056:Burns / Q000150:complications* / Q000503:physiopathology; D004791:Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006162:Guanylate Cyclase / Q000037:antagonists & inhibitors*; D006801:Humans; D008751:Methylene Blue / Q000494:pharmacology* / Q000627:therapeutic use; D012720:Severity of Illness Index; D056987:Vasoplegia / Q000188:drug therapy* / Q000209:etiology
chemical_list: D004791:Enzyme Inhibitors; D006162:Guanylate Cyclase; D008751:Methylene Blue