Author Of 1 Presentation
METHYLENE BLUE ADMINISTRATION FOR DISTRIBUTIVE SHOCK STATES IN CRITICALLY-ILL CHILDREN
Abstract
Background
Methylene Blue (MB), an inhibitor of Nitric Oxide synthesis and its effects, is a potential effective treatment in distributive shock states such as septic shock, vasoplegic syndrome and during or after cardiopulmonary bypass. MB has been shown to alleviate the vasoplegia, promote an increase in mean arterial pressure (MAP) and might even reduce mortality. However, in the pediatric population, there are only a few case reports on administration of MB in sepsis or shock in general.
Objectives
We present a collection of seven pediatric cases treated with MB for vasoplegic shock, comprising the largest case series published so far in children.
Methods
A retrospective review of charts of patients treated with MB in our pediatric intensive care unit during the past 5 years.
Results
We observed a favorable hemodynamic response with an increase in blood pressure and a reduction in the vasopressor and inotropic support needed following methylene blue administration for most patients (figure 1). Of note, no side effects were encountered in our case series.
Conclusion
Our results add to the small body of evidence in the pediatric population supporting the use of MB for distributive shock states and emphasize the need for larger, randomized trials to test its treatment potential in this context.
Brown, SM, MJ Lanspa, JP Jones, et al., Survival after shock requiring high-dose vasopressor therapy. Chest, 2013 143(3): p. 664-671.10.1378/chest.12-1106
Eytan, D, AJ Goodwin, R Greer, AM Guerguerian,PC Laussen, Heart Rate and Blood Pressure Centile Curves and Distributions by Age of Hospitalized Critically Ill Children. Front Pediatr 2017. 5: p. 52.10.3389/fped.2017.00052