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Author Notes:

Address for correspondence: Dr. Michael Mazzeffi, Department of Anesthesiology, University of Maryland School of Medicine, 22 South Greene Street S11C00, Baltimore, MD 21201, USA. E-mail: mmazzeffi@anes.umm.edu

There are no conflicts of interest.

Subjects:

Keywords:

  • Cardiac surgery
  • methylene blue
  • vasoplegia

Methylene blue for postcardiopulmonary bypass vasoplegic syndrome: A cohort study

Tools:

Journal Title:

Annals of Cardiac Anaesthesia

Volume:

Volume 20, Number 2

Publisher:

, Pages 178-181

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. Aims: We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine variables that predicted response to MB. Setting and Design: This was conducted in a tertiary care medical center; this study was a retrospective cohort study. Materials and Methods: Adult cardiac surgery patients who received MB for post-CPB VS over a 2-year period were studied. Mean arterial blood pressure (MAP) and vasopressor doses were compared before and after MB, and logistic regression was used to model which variables predicted response. Results: Eighty-eight patients received MB for post-CPB VS during the study period. MB administration was associated with an 8 mmHg increase in MAP (P = 0.004), and peak response occurred at 2 h. Variables that were associated with a positive drug response were deep hypothermic circulatory arrest during surgery and higher MAP at the time of drug administration (P = 0.006 and 0.02). A positive response had no correlation with in-hospital mortality (P = 0.09). Conclusions: MB modestly increases MAP in cardiac surgery patients with VS. Higher MAP at the time of drug administration and surgery with deep hypothermic circulatory arrest predict a greater drug response.

Copyright information:

© 2017 Annals of Cardiac Anaesthesia

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (http://creativecommons.org/licenses/by-nc-sa/4.0/).

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