Methylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties
| Autor: | Evora, Paulo Roberto Barbosa, Ribeiro, Paulo José de Freitas, Vicente, Vilella de Andrade, dos Reis, Celso Luís, Rodrigues, Alfredo José, Menardi, Antonio Carlos, Alves Jr., Lafaiete, Evora, Patrícia Martinez [UNESP], Bassetto, Solange |
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| Přispěvatelé: | Universidade de São Paulo (USP), Center of Heart and Lung of Ribeirão Preto, Universidade Estadual Paulista (Unesp) |
| Jazyk: | portugalština |
| Rok vydání: | 2009 |
| Předmět: |
drug antagonism
Methylene blue Dose-Response Relationship Drug heart surgery guanylate cyclase Postoperative complications Vascular resistance/drug effects dose response Vasoplegia Cardiovascular surgical procedures Humans human Extracorporeal circulation Cardiac Surgical Procedures Vascular diseases |
| Zdroj: | Scopus Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| Popis: | Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:23:55Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:41:00Z : No. of bitstreams: 1 2-s2.0-72649091145.pdf: 146337 bytes, checksum: f4ca5c85aff2515849894e1541510414 (MD5) Made available in DSpace on 2014-05-27T11:23:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-07-01 Objective: There is strong evidence that methylene blue (MB), an inhibitor of guanylate cyclase, is an excellent therapeutic option for vasoplegic syndrome (VS) treatment in heart surgery. The aim of this article is to review the MB's therapeutic function in the vasoplegic syndrome treatment. Methods: Fifteen years of literature review. Results: 1) Heparin and ACE inhibitors are risk factors; 2) In the recommended doses it is safe (the lethal dose is 40 mg/ kg); 3) The use of MB does not cause endothelial dysfunction; 4) The MB effect appears in cases of nitric oxide (NO) up-regulation; 5) MB is not a vasoconstrictor, by blocking of the GMPc system it releases the AMPc system, facilitating the norepinephrine vasoconstrictor effect; 6) The most used dosage is 2 mg/kg as IV bolus followed by the same continuous infusion because plasmatic concentrations strongly decays in the first 40 minutes; 7) There is a possible window of opportunity for the MB's effectiveness. Conclusions: Although there are no definitive multicentric studies, the MB used to treat heart surgery VS, at the present time, is the best, safest and cheapest option, being a Brazilian contribution for the heart surgery. Head of the Surgery and Anatomy Department Ribeirão Preto Medical School - USP Center of Heart and Lung of Ribeirão Preto Division of the Surgery and Anatomy Department FMRP-USP Veterinary Medical School of Jaboticabal UNESP Veterinary Medical School of Jaboticabal UNESP |
| Databáze: | OpenAIRE |
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