Elbayomi M, Dewald O, Pathare P, Kondruweit M, Tandler R, Weyand M, Heim C (2025)
Publication Type: Journal article
Publication year: 2025
Book Volume: 57
Article Number: 2460770
Journal Issue: 1
DOI: 10.1080/07853890.2025.2460770
Background: Vasoplegic syndrome is associated with high mortality. Methylene blue (MB) is a guanylate cyclase inhibitor that ameliorates this re-distributive type of shock. This study aims to investigate the outcome in patients who received MB early postoperatively. Methods: 2753 patients who underwent cardiac surgery utilizing cardiopulmonary bypass at our institution in a time interval of two years were identified. The incidence of vasoplegic syndrome was 7.2% (n = 200). Pharmacy records identified 84 patients (group 1, MB group) who received methylene blue and 116 patients (group 2, Control group) who didn’t receive the drug. This single-center retrospective cohort study’s primary outcome was in-hospital mortality. Secondary outcomes were postoperative hemodialysis, serum lactate levels at 24 h postoperatively, and intensive care unit stay length in days. Results: MB patients have a shorter ICU stay as compared to the control group (9 ± 8 days vs. 16 ± 6.9; p-value <.001). In the control group, postoperative hemodialysis was higher (20% in the MB group and 40% in the control group; p-value <.05). At 24 h post-op, the methylene blue group had reduced serum lactate levels (1.8 ± 1.2 vs. 4 ± 1.8 in the control group; p-value <.001). The methylene blue group had a decreased 24-hour norepinephrine dose (1.5 ± 1.2 vs. 2.8 ± 2 in the control group; p-value <.05). In-hospital mortality was not significantly different between the two groups (38% in the MB group vs. 43% in the control group). Conclusion: Early postoperative administration of methylene blue in patients with vasoplegic syndrome shortens intensive care unit stay and contributes to less end-organ damage.
APA:
Elbayomi, M., Dewald, O., Pathare, P., Kondruweit, M., Tandler, R., Weyand, M., & Heim, C. (2025). The mystery of methylene blue and its role in managing post-cardiac surgery vasoplegic shock. Annals of Medicine, 57(1). https://doi.org/10.1080/07853890.2025.2460770
MLA:
Elbayomi, Mohamed, et al. "The mystery of methylene blue and its role in managing post-cardiac surgery vasoplegic shock." Annals of Medicine 57.1 (2025).
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