title: Methylene Blue: Magic Bullet for Vasoplegia?
abstract: Methylene blue (MB) has received much attention in the perioperative and critical care literature because of its ability to antagonize the profound vasodilation seen in distributive (also referred to as vasodilatory or vasoplegic) shock states. This review will discuss the pharmacologic properties of MB and review the critical care, liver transplantation, and cardiac anesthesia literature with respect to the efficacy and safety of MB for the treatment of shock. Although improved blood pressure has consistently been demonstrated with the use of MB in small trials and case reports, better oxygen delivery or decreased mortality with MB use has not been demonstrated. Large randomized controlled trials are still necessary to identify the role of MB in hemodynamic resuscitation of the critically ill.
authors.affiliation: From the *Department of Anesthesiology, and †Department of Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Leila
authors.initials: L
authors.lastname: Hosseinian
authors.forename: Menachem
authors.initials: M
authors.lastname: Weiner
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Levin
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Fischer
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008751:Methylene Blue / Q000009:adverse effects / Q000627:therapeutic use*; D012151:Resuscitation / Q000009:adverse effects / Q000379:methods*; D012772:Shock, Septic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects; D056987:Vasoplegia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
chemical_list: D002317:Cardiovascular Agents; D008751:Methylene Blue