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A Reminder of Methylene Blue's Effectiveness in Treating Vasoplegic Syndrome after On-Pump Cardiac Surgery
Authors:Joshua Manghelli  Lisa Brown  Hany B Tadros  Nabil A Munfakh
Abstract:The inflammatory response induced by cardiopulmonary bypass decreases vascular tone, which in turn can lead to vasoplegic syndrome. Indeed the hypotension consequent to on-pump cardiac surgery often necessitates vasopressor and intravenous fluid support. Methylene blue counteracts vasoplegic syndrome by inhibiting the formation of nitric oxide.We report the use of methylene blue in a 75-year-old man who developed vasoplegic syndrome after cardiac surgery. After the administration of methylene blue, his hypotension improved to the extent that he could be weaned from vasopressors. The use of methylene blue should be considered in patients who develop hypotension refractory to standard treatment after cardiac surgery.
Keywords:Cardiopulmonary bypass/adverse effects  hemodynamics/drug effects  hypotension/drug therapy  methylene blue/administration &  dosage/therapeutic use  nitric oxide/antagonists &  inhibitors  shock  vasodilatory/physiopathology  vasoconstrictor agents/therapeutic use  vasodilation/physiology  vasoplegia/etiology/therapy  vasopressors/therapeutic use
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