Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue

Methylene blue is a phenothiazine-related heterocyclic aromatic molecule presently used in the treatment of methemoglobinemia. Recently, it has been implicated in the treatment of severe refractory vasoplegic shock caused by anaphylaxis, sepsis, or postcardiopulmonary bypass. We present a case of a...

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Main Authors: Farheen Manji, Benjamin Wierstra, Juan Posadas
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2017/8747326
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author Farheen Manji
Benjamin Wierstra
Juan Posadas
author_facet Farheen Manji
Benjamin Wierstra
Juan Posadas
author_sort Farheen Manji
collection DOAJ
description Methylene blue is a phenothiazine-related heterocyclic aromatic molecule presently used in the treatment of methemoglobinemia. Recently, it has been implicated in the treatment of severe refractory vasoplegic shock caused by anaphylaxis, sepsis, or postcardiopulmonary bypass. We present a case of a 27-year-old male with profound vasoplegic shock of unknown etiology which was refractory to vasopressors who responded within hours to a single dose of methylene blue. Additionally, we review the evidence of methylene blue’s role in the treatment of shock. This case illustrates a diagnostic approach and treatment options in the setting of undifferentiated vasodilatory shock and outlines a new and emerging role for methylene blue in this clinical setting.
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publishDate 2017-01-01
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series Case Reports in Critical Care
spelling doaj-art-e955ffcae9e142499491caf04efc2f792025-08-20T02:22:15ZengWileyCase Reports in Critical Care2090-64202090-64392017-01-01201710.1155/2017/87473268747326Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene BlueFarheen Manji0Benjamin Wierstra1Juan Posadas2University of Calgary and Alberta Health Services, Calgary, AB, CanadaUniversity of Calgary and Alberta Health Services, Calgary, AB, CanadaUniversity of Calgary and Alberta Health Services, Calgary, AB, CanadaMethylene blue is a phenothiazine-related heterocyclic aromatic molecule presently used in the treatment of methemoglobinemia. Recently, it has been implicated in the treatment of severe refractory vasoplegic shock caused by anaphylaxis, sepsis, or postcardiopulmonary bypass. We present a case of a 27-year-old male with profound vasoplegic shock of unknown etiology which was refractory to vasopressors who responded within hours to a single dose of methylene blue. Additionally, we review the evidence of methylene blue’s role in the treatment of shock. This case illustrates a diagnostic approach and treatment options in the setting of undifferentiated vasodilatory shock and outlines a new and emerging role for methylene blue in this clinical setting.http://dx.doi.org/10.1155/2017/8747326
spellingShingle Farheen Manji
Benjamin Wierstra
Juan Posadas
Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue
Case Reports in Critical Care
title Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue
title_full Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue
title_fullStr Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue
title_full_unstemmed Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue
title_short Severe Undifferentiated Vasoplegic Shock Refractory to Vasoactive Agents Treated with Methylene Blue
title_sort severe undifferentiated vasoplegic shock refractory to vasoactive agents treated with methylene blue
url http://dx.doi.org/10.1155/2017/8747326
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AT juanposadas severeundifferentiatedvasoplegicshockrefractorytovasoactiveagentstreatedwithmethyleneblue