Methylene blue administration in patients with refractory distributive shock – a retrospective study
| Autor: | Jan Kunstyr, Martin Balik, Michal Lips, Pavel Michalek, Helena Dvorakova, Michal Porizka, Petr Kopecky |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Haemodynamic response lcsh:Medicine Hemodynamics Blood Pressure 030204 cardiovascular system & hematology Article Norepinephrine (medication) 03 medical and health sciences chemistry.chemical_compound Norepinephrine 0302 clinical medicine Refractory Medicine Humans Vasoconstrictor Agents lcsh:Science Aged Retrospective Studies Multidisciplinary business.industry lcsh:R 030208 emergency & critical care medicine Retrospective cohort study Shock Middle Aged medicine.disease Survival Analysis Methylene Blue Oxygen Distributive shock Combination drug therapy Treatment Outcome chemistry Outcomes research Anesthesia lcsh:Q Female Bacterial infection business Anaerobic exercise Methylene blue medicine.drug |
| Zdroj: | Scientific Reports Scientific Reports, Vol 10, Iss 1, Pp 1-8 (2020) |
| ISSN: | 2045-2322 |
| Popis: | Hemodynamic effectiveness of methylene blue (MB) was tested in patients with refractory distributive shock. A retrospective analysis of 20 critically-ill patients who developed refractory shock was performed. Patients were divided into two study groups as responders with positive hemodynamic response to MB administration (defined as 10% decrease of norepinephrine dose) and non-responders. Hemodynamic, outcome data and baseline tissue hypoxia-related parameters including ratio of central venous-to-arterial carbon dioxide tension to arterio-venous oxygen content (P(v-a)CO2/C(a-v)O2) were compared between the groups. There were 9 (45%) responders and 11 (55%) non-responders to single bolus of MB administration. Dose of MB did not differ between responders and non-responders (1.3 ± 0.5 vs. 1.3 ± 0.4 mg/kg respectively, P = 0.979). MB responders had lower baseline P(v-a) CO2/C(a-v)O2 (1.79 ± 0.73 vs. 3.24 ± 1.18, P = 0.007), higher pH (7.26 ± 0.11 vs. 7.16 ± 0.10, P = 0.037) and lower lactate levels at 12 hours post MB administration (3.4 ± 2.7 vs. 9.9 ± 2.2 mmol/L, P = 0.002) compared to non-responders. Methylene blue represents a non-adrenergic vasopressor with only limited effectiveness in patients with refractory distributive shock. Profound tissue hypoxia with high degree of anaerobic metabolism was associated with the loss of hemodynamic responsiveness to its administration. |
| Databáze: | OpenAIRE |
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