Korean J Anesthesiol.  2008 Jun;54(6):677-681. 10.4097/kjae.2008.54.6.677.

Methylene Blue for Vasoplegic Syndrome after Cardiopulmonary Bypass: A case report

Affiliations
  • 1Department of Anesthesology and Pain Medicine, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
  • 2Department of Anesthesology and Pain Medicine, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.
  • 3Department of Anesthesology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. jhanes@yuhs.ac

Abstract

Vasoplegic syndrome (VS) occurs in 8-10% of patients following cardiac surgery and is associated with increased morbidity and mortality. Nitric oxide and guanylate cyclase play an important role in this response. Methylene blue, an inhibitor of guanylate cyclase, has recently been advocated as an adjunct in the treatment of catecholamine-refractory VS. We experienced a case of VS after aortic arch replacement surgery, presenting severe hypotension refractory to high-dose norepinephrine and vasopressin. Administration of methylene blue 100 mg led to immediate recovery of arterial pressure. We report this case and review the role of methylene blue in the treatment of catecholamine-refractory VS.

Keyword

cardiac surgery; methylene blue; vasoplegic syndrome

MeSH Terms

Aorta, Thoracic
Arterial Pressure
Guanylate Cyclase
Humans
Hypotension
Methylene Blue
Nitric Oxide
Norepinephrine
Thoracic Surgery
Vasoplegia
Vasopressins
Guanylate Cyclase
Methylene Blue
Nitric Oxide
Norepinephrine
Vasopressins
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