ArticleThe Annals of thoracic surgery2017
Methylene Blue for Vasoplegic Syndrome After Cardiac Operation: Early Administration Improves Survival.
Article in The Annals of thoracic surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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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
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 113 citations in OpenAlex.
- Efficacy and safety of methylene blue in patients with vasodilatory shock: A systematic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- 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
- Insulin augments vasodilatory response elicited by amlodipine via nitric oxide-dependent vasodilation in isolated rat aortas.Korean journal of anesthesiology · 2026Article
- The Effectiveness of Methylene Blue in Adult Shock: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2026Review
- Methylene Blue Rescue Therapy for Vasoplegic Shock After Antihypertensive Drug Overdose.The American journal of case reports · 2026Article
- Role of Non-catecholamines Vasopressors in the Management of Vasoplegic Syndrome after Cardiopulmonary Bypass: A Scoping Review.Annals of cardiac anaesthesia · 2026Article
- The mystery of methylene blue and its role in managing post-cardiac surgery vasoplegic shock.Annals of medicine · 2025Article
- Methylene blue in the critical care setting.World journal of critical care medicine · 2025Review
- Methylene Blue Mitigates Doxorubicin-Induced Cardiotoxicity via KEAP1/NRF2/GPX-4/Caspase3 Modulation.International journal of molecular sciences · 2025Article
- Association between timing of angiotensin II administration and outcomes in vasoplegia after cardiac surgery.JTCVS open · 2025Article
- Prevalence of Serotonergic Drug Use in Patients Exposed to Perioperative Methylene Blue: A Cross-Sectional Study.Cureus · 2025Article
- Vasoplegic Syndrome Following Bypass: A Comprehensive Review of Pathophysiology and Proposed Treatments.Cureus · 2025Review
- Does methylene blue improve outcomes in patients with post-cardiac surgery vasoplegic syndrome?Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Cardiotoxic and Cardioprotective Effects of Methylene Blue in the Animal Model of Cardiac Ischemia and Reperfusion.Biomedicines · 2024Article
- A Patient With Symptomatic Pheochromocytoma and Very Severe Aortic Valve Stenosis: Diagnostic and Management Approach.JACC. Case reports · 2024Article
- Vasoplegia Following Complex Spine Surgery: Incidence and Risk.Global spine journal · 2024Article
- Anticholinergic Toxidrome as a Possible Explanation for Methylene Blue Toxicity.The American journal of case reports · 2023Article
- Alterations to Kidney Physiology during Cardiopulmonary Bypass-A Narrative Review of the Literature and Practical Remarks.Journal of clinical medicine · 2023Review
- Can Use of Intravenous Methylene Blue Improve the Hemodynamics and Outcome of the Patients with Refractory Septic Shock? An Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Vasoplegic Syndrome and Anaesthesia: A Narrative Review.Turkish journal of anaesthesiology and reanimation · 2023Article
Corrections and comments
- Commented on by
- Commented on byReply.2019
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundVasoplegic syndrome, defined by hypotension despite normal or increased cardiac output, is associated with high mortality rate after cardiopulmonary bypass. Methylene blue (MB) is reported to ameliorate vasoplegic syndrome through the nitric oxide pathway. We hypothesized that early administration of MB would improve outcomes in patients with vasoplegic syndrome after cardiopulmonary bypass.
methodsAll patients that underwent cardiopulmonary bypass at our institution (Jan 1, 2011 to Jun 30, 2016) were identified through our Society of Thoracic Surgery database. Pharmacy records identified patients receiving MB within 72 hours of cardiopulmonary bypass. Multivariate logistic regression identified predictors of major adverse events among patients receiving MB.
resultsA total of 118 cardiopulmonary bypass patients (3.3%) received MB for vasoplegic syndrome. These patients had a higher incidence of comorbidities, and these cases were more commonly reoperative (76.1% versus 41.2%, p < 0.0001) and complex (70.3% versus 31.8%, p < 0.0001). The only difference in preoperative medications was that MB patients had a higher rate of amiodarone use (15.3% versus 2.2%, p < 0.0001). MB patients had significantly higher rates of postoperative complications, except atrial fibrillation. Early (operating room, 40.7%) versus late (intensive care unit, 59.3%) administration of MB was associated with significantly reduced operative mortality rate (10.4% versus 28.6%, p = 0.018) and risk-adjusted major adverse events (odd ratio 0.35, p = 0.037).
conclusionsOperative mortality rate is high in patients receiving MB for the treatment of vasoplegia after cardiopulmonary bypass. Early administration of MB improves survival and reduces the risk-adjusted rate of major adverse events in these patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.