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Gachot B, Bedos JP, Veber B, et al. Short-term effects of methylene blue on hemodynamics and gas exchange in humans with septic shock. Intensive Care Med. 1995;21(12):1027-31doi: 10.1007/BF01700666.
Gachot, B., Bedos, J. P., Veber, B., Wolff, M., & Regnier, B. (1995). Short-term effects of methylene blue on hemodynamics and gas exchange in humans with septic shock. Intensive care medicine, 21(12), 1027-31. https://doi.org/10.1007/BF01700666
Gachot, B, et al. "Short-term effects of methylene blue on hemodynamics and gas exchange in humans with septic shock." Intensive care medicine vol. 21,12 (1995): 1027-31. doi: https://doi.org/10.1007/BF01700666
Gachot B, Bedos JP, Veber B, Wolff M, Regnier B. Short-term effects of methylene blue on hemodynamics and gas exchange in humans with septic shock. Intensive Care Med. 1995 Dec;21(12):1027-31. doi: 10.1007/BF01700666. PMID: 8750129.
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Intensive Care Med. 1995 Dec;21(12):1027-31. doi: 10.1007/BF01700666.

Short-term effects of methylene blue on hemodynamics and gas exchange in humans with septic shock.

Intensive care medicine

B Gachot, J P Bedos, B Veber, M Wolff, B Regnier

Affiliations

  1. Clinique de Reanimation des Maladies Infectieuses, Hopital Bichat-Claude Bernard, Paris, France.

PMID: 8750129 DOI: 10.1007/BF01700666

Abstract

OBJECTIVE: The aim of this study was to investigate the acute effects of methylene blue (MB), an inhibitor of the L-arginine nitric oxide pathway, in patients with septic shock.

DESIGN: A prospective, open, single-dose study.

SETTING: The medical ICU of a university hospital.

PATIENTS: Six patients with severe septic shock.

INTERVENTIONS: Complete hemodynamic values were recorded before and 20 min after the infusion of intravenous MB (3 mg kg(-1)). Arterial pressure was then monitored during the next 24 h or until death.

MEASUREMENTS AND RESULTS: Methylene blue increased the mean arterial pressure from 69.7 +/- 4.5 to 83.7 +/- 5.1 mmHg (p = 0.028) and the mean pulmonary artery pressure, from 34.3 +/- 7.2 to 38.7 +/- 8.0 mmHg (p = 0.023). Systemic vascular resistance index was increased from 703.1 +/- 120.6 to 903.7 +/- 152.2 dyne.s.cm(-5).m(-2) (p = 0.028) and pulmonary vascular resistance index, from 254.6 +/- 96.9 to 342.2 +/- 118.9 dyne.s.cm(-5) .m(-2) (p = 0.027). The PaO2/FIO2 decreased from 229.2 +/- 54.4 to 162.2 +/- 44.1 mmHg (p = 0.028), without significant modification of intrapulmonary shunting. Heart rate, cardiac index, right atrial pressure, DO2, VO2, oxygen extraction and arterial lactate were essentially unchanged. Sequential measurements of arterial pressure demonstrated a return to baseline level in 2-3 h. All but one patients died, three in shock and two in multiple organ failure.

CONCLUSIONS: MB induces systemic and pulmonary vasoconstriction in patients with septic shock, without significant decrease in cardiac index. The worsening of arterial oxygenation following MB injection may limit its use in patients with the adult respiratory distress syndrome. Larger studies are required to determine whether MB improves the outcome of patients with septic shock.

References

  1. Lancet. 1991 Dec 21-28;338(8782-8783):1590 - PubMed
  2. Crit Care Med. 1993 May;21(5):759-67 - PubMed
  3. Biochem Pharmacol. 1993 Jan 26;45(2):367-74 - PubMed
  4. Crit Care Med. 1987 Oct;15(10):923-9 - PubMed
  5. Am Rev Respir Dis. 1988 Sep;138(3):720-3 - PubMed
  6. Br J Anaesth. 1967 May;39(5):388-92 - PubMed
  7. FASEB J. 1993 Sep;7(12):1124-34 - PubMed
  8. Biochem Biophys Res Commun. 1990 Sep 14;171(2):562-8 - PubMed
  9. Ann Surg. 1985 Dec;202(6):685-93 - PubMed
  10. N Engl J Med. 1993 Feb 11;328(6):399-405 - PubMed
  11. J Exp Med. 1992 Oct 1;176(4):1175-82 - PubMed
  12. Cardiovasc Res. 1994 Jan;28(1):34-9 - PubMed
  13. Biochem Biophys Res Commun. 1991 Aug 15;178(3):1135-40 - PubMed
  14. J Clin Invest. 1992 Nov;90(5):1718-25 - PubMed
  15. J Surg Res. 1994 Jul;57(1):93-8 - PubMed
  16. Anaesthesia. 1990 Oct;45(10):884-5 - PubMed
  17. Am J Physiol. 1990 Oct;259(4 Pt 2):H1038-43 - PubMed
  18. Br J Pharmacol. 1990 Dec;101(4):815-20 - PubMed
  19. Ann Intern Med. 1994 Feb 1;120(3):227-37 - PubMed
  20. N Engl J Med. 1993 Dec 30;329(27):2002-12 - PubMed
  21. Chest. 1992 Jun;101(6):1644-55 - PubMed
  22. Intensive Care Med. 1993;19(4):227-31 - PubMed
  23. Am Rev Respir Dis. 1993 Dec;148(6 Pt 1):1474-8 - PubMed
  24. J Cardiovasc Pharmacol. 1993 Jun;21(6):926-30 - PubMed
  25. Intensive Care Med. 1992;18(5):309-11 - PubMed
  26. Crit Care Med. 1993 Sep;21(9):1287-95 - PubMed
  27. Cardiovasc Res. 1992 Jan;26(1):48-57 - PubMed
  28. Crit Care Med. 1992 Nov;20(11):1568-74 - PubMed
  29. Med Toxicol. 1986 Jul-Aug;1(4):253-60 - PubMed
  30. Crit Care Med. 1984 Nov;12(11):975-7 - PubMed
  31. Crit Care Med. 1990 May;18(5):474-9 - PubMed

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