Improvement in Hemodynamics After Methylene Blue Administration in Drug-Induced Vasodilatory Shock: A Case Report
| Autor: | JoAn R. Laes, David M. Williams, Jon B. Cole |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Mean arterial pressure Health Toxicology and Mutagenesis Hemodynamics Toxicology chemistry.chemical_compound medicine Humans Amlodipine business.industry Shock Middle Aged Atenolol Methylene Blue Vasodilation medicine.anatomical_structure chemistry Valsartan Anesthesia Shock (circulatory) Vascular resistance Toxicology Observation medicine.symptom business Methylene blue medicine.drug |
| Zdroj: | Journal of Medical Toxicology. 11:460-463 |
| ISSN: | 1937-6995 1556-9039 |
| DOI: | 10.1007/s13181-015-0500-1 |
| Popis: | The purpose of this study is to describe a case where methylene blue improved hemodynamics in a poisoned patient. This is a single case report where a poisoned patient developed vasodilatory shock following ingestion of atenolol, amlodipine, and valsartan. Shock persisted after multiple therapies including vasopressors, high-dose insulin, hemodialysis, and 20% intravenous fat emulsion. Methylene blue (2 mg/kg IV over 30 min) was administered in the ICU with temporal improvement as measured by pulmonary artery catheter hemodynamic data pre- and post-methylene blue administration. Within 1 h of methylene blue administration, systemic vascular resistance improved (240 dyn s/cm5 increased to 1204 dyn s/cm5), and vasopressor requirements decreased with maintenance of mean arterial pressure 60 mmHg. Methylene blue may improve hemodynamics in drug-induced vasodilatory shock and should be considered in critically ill patients poisoned with vasodilatory medications refractory to standard therapies. |
| Databáze: | OpenAIRE |
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