12/14/2023 0 Comments Systemic shock wiki![]() randomized twenty patients with septic shock to methylene blue versus normal saline in addition to standard ionotropes. In low concentrations methylene blue can hasten the conversion of methemoglobin to hemoglobin Methylene blue may restore vascular tone by inhibition of endothelial nitric oxide synthase. Nitric oxide, produces by nitric oxide synthase induces smooth muscle relaxation via production of cGMP. Metabolism: Likely undergoes first pass metabolism or distribution peripheral reduction to leukomethylene blue Interference with pulse oximeter sensor.If given with medications causing increased serotonin, it may precipitate serotonin syndrome Methylene blue can also function as a monoamine oxidase inhibitor (MAOI).Pregnancy: currently class X rating secondary to intestinal atresia.Glucose-6-phosphate dehydrogenase deficiency due to susceptibility of hemolytic anemia.History of hypersensitivity or anaphylaxis to methylene blue. ![]() Purported uses include vasoplegia in the setting of cardiac surgery, liver transplantation, and septic shock.Ĭontraindications Absolute contraindications Methylene blue can antagonize the profound vasodilation seen in such states. Increasing vascular tone via the many vasoconstricting agents available can assist in increasing organ perfusion. However the ultimate result if inadequate end organ perfusion pressure secondary to lack of vascular tone. Additional it is proposed to have vasoconstrictive effects that lend utility in vasodilatory states including distributive shock.ĭistributive shock can include multiple different etiologies such as sepsis, neurogenic, and anaphylactic. It has also been utilized in the treatment of methemoglobinemia. ![]() It can aid in the identification of various structures during surgical procedures, for example urological surgery to identify ureter. Methylene blue is a heterocyclic aromatic molecule that produces a blue color when mixed with water. However, methylene blue has also been increasingly utilized in the setting of vasoplegic/distributive shock Classically methylene blue is utilized as a dye in various procedures in aid in identification of anatomic structures. ![]()
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