ReviewRevista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular
Twenty years of vasoplegic syndrome treatment in heart surgery. Methylene blue revised.
Review in Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed.
- Prophylactic Administration with Methylene Blue Improves Hemodynamic Stabilization During Obstructive Jaundice-Related Diseases' Operation: a Blinded Randomized Controlled Trial.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Trial
- Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial.Critical care (London, England) · 2023Trial
- Potential molecular targets on which methylene blue acts to promote its effects on cardiac electrophysiology, myocardial injury, and oxidative stress in spontaneously hypertensive rats submitted to cardiac ischemia and reperfusion.Acta cirurgica brasileira · 2026Article
- Article
- Vasoplegic Syndrome Following Bypass: A Comprehensive Review of Pathophysiology and Proposed Treatments.Cureus · 2025Review
- Cardiotoxic and Cardioprotective Effects of Methylene Blue in the Animal Model of Cardiac Ischemia and Reperfusion.Biomedicines · 2024Article
- Celebrating 50 Years of Excellence: The Legacy of Cardiovascular Surgery in Brazil and the Role of BJCVS.Brazilian journal of cardiovascular surgery · 2024Article
- Methylene blue therapy in addition to standard treatment for acute-phase septic shock: a pilot randomized controlled trial.Frontiers in medicine · 2024Article
- Methylene blue: a controversial diagnostic acid and medication?Toxicology research · 2022Review
- Early Use of Methylene Blue in Vasoplegic Syndrome: A 10-Year Propensity Score-Matched Cohort Study.Journal of clinical medicine · 2022Article
- Vasoplegia: Mechanism and Management Following Cardiopulmonary Bypass.The Eurasian journal of medicine · 2022Article
- Methylene Blue to Neonatal Septic Shock treatment in neonate pigsClinics (Sao Paulo, Brazil) · 2022Article
- The additional use of methylene blue has a decatecholaminisation effect on cardiac vasoplegic syndrome after cardiac surgery.Journal of cardiothoracic surgery · 2021Article
- Why Methylene Blue Is the Only Option for Blocking the cGMP/NO Pathway in The Treatment of Vasoplegic Shock? "Reasons That Reason Itself Does Not Know…".Brazilian journal of cardiovascular surgery · 2021Article
- After Thirty Years, We Still Cannot Understand Why Methylene Blue is not a Reference to Treat Vasoplegic Syndrome in Cardiac Surgery.Brazilian journal of cardiovascular surgery · 2021Article
- Successful treatment of intravenous drug abuser with refractory vasoplegic syndrome after mitral valve repair for infective endocarditis.SAGE open medical case reports · 2021Article
- Vasopressor-Sparing Action of Methylene Blue in Severe Sepsis and Shock: A Narrative Review.Advances in therapy · 2020Review
- COVID-19 should be a methylene blue "promoter".Brazilian journal of cardiovascular surgery · 2020Article
- In-line filtration of intravenous infusion may reduce organ dysfunction of adult critical patients.Critical care (London, England) · 2019Article
- Vasoresponsiveness in patients with heart failure (VASOR): protocol for a prospective observational study.Journal of cardiothoracic surgery · 2019Observational
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study was conducted to reassess the concepts established over the past 20 years, in particular in the last 5 years, about the use of methylene blue in the treatment of vasoplegic syndrome in cardiac surgery.
methodsA wide literature review was carried out using the data extracted from: MEDLINE, SCOPUS and ISI WEB OF SCIENCE.
resultsThe reassessed and reaffirmed concepts were 1) MB is safe in the recommended doses (the lethal dose is 40 mg/kg); 2) MB does not cause endothelial dysfunction; 3) The MB effect appears in cases of NO up-regulation; 4) MB is not a vasoconstrictor, by blocking the cGMP pathway it releases the cAMP pathway, facilitating the norepinephrine vasoconstrictor effect; 5) The most used dosage is 2 mg/kg as IV bolus, followed by the same continuous infusion because plasma concentrations sharply decrease in the first 40 minutes; and 6) There is a possible "window of opportunity" for MB's effectiveness. In the last five years, major challenges were: 1) Observations about side effects; 2) The need for prophylactic and therapeutic guidelines, and; 3) The need for the establishment of the MB therapeutic window in humans.
conclusionMB action to treat vasoplegic syndrome is time-dependent. Therefore, the great challenge is the need, for the establishment the MB therapeutic window in humans. This would be the first step towards a systematic guideline to be followed by possible multicenter studies.
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Registered trials
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