SynthesisPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2020
Methylene Blue for Refractory Shock in Children: A Systematic Review and Survey Practice Analysis.
Synthesis in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06306001 (Intravenous Methylene Blue for Treating Fluid-refractory, Catecholamine-resistant, Neonatal Septic Shock), which is not on this map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Intravenous Methylene Blue for Treating Fluid-refractory, Catecholamine-resistant, Neonatal Septic Shock: a Randomized, Placebo-controlled, Superiority Trial
Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Role of Angiotensin II as a Vasoactive Agent to Treat Distributive Shock With a Focus on Preliminary Data in Pediatric-Aged Patients.Paediatric anaesthesia · 2026Review
- Hemodynamic Effects of Methylene Blue in Pediatric Cardiac Critical Care Patients: A Descriptive Study of Causal Inference and Cluster Analysis Using High-Fidelity Data.Pediatric cardiology · 2026Article
- Septic Cardiomyopathy: Age-Dependent Physiology and Hemodynamic Aspects-A Narrative Review.Children (Basel, Switzerland) · 2026Review
- Management of arterial hypotension in critically Ill children: a narrative review and practical approach.Frontiers in pediatrics · 2026Review
- Fifty shades of green and blue: autopsy findings after administration of xenobiotics.Forensic science, medicine, and pathology · 2025Review
- Medication and Fluid Management of Pediatric Sepsis and Septic Shock.Paediatric drugs · 2022Review
- Methylene blue for the treatment of refractory septic shock secondary to listeriosis in a paediatric patient.BMJ case reports · 2022Article
- Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology.Italian journal of pediatrics · 2021Review
- Refractory Shock in Pediatric Emergency Departments: Challenges and Innovations in Early Escalation: A Narrative Review.Sage open pediatricsReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectivesShock refractory to fluid and catecholamine therapy has significant morbidity and mortality in children. The use of methylene blue to treat refractory shock in children is not well described. We aim to collect and summarize the literature and define physicians' practice patterns regarding the use of methylene blue to treat shock in children.
designWe conducted a systematic search of MEDLINE, Embase, PubMed, Web of Science, Cochrane for studies involving the use of methylene blue for catecholamine-refractory shock from database inception to 2019. Collected studies were analyzed qualitatively. To describe practice patterns of methylene blue use, we electronically distributed a survey to U.S.-based pediatric critical care physicians. We assessed physician knowledge and experience with methylene blue. Survey responses were quantitatively and qualitatively evaluated.
settingPediatric critical and cardiac care units. PATIENTS OR SUBJECTS: Patients less than or equal to 25 years old with refractory shock treated with methylene blue.
interventionsNone. MEASUREMENTS AND MAIN
resultsOne-thousand two-hundred ninety-three abstracts met search criteria, 139 articles underwent full-text review, and 24 studies were included. Studies investigated refractory shock induced by a variety of etiologies and found that methylene blue was generally safe and increased mean arterial blood pressure. There is overall lack of studies, low number of study patients, and low quality of studies identified. Our survey had a 22.5% response rate, representing 125 institutions. Similar proportions of physicians reported using (40%) or never even considering (43%) methylene blue for shock. The most common reasons for not using methylene blue were unfamiliarity with this drug, its proper dosing, and lack of evidentiary support.
conclusionsMethylene blue appears safe and may benefit children with refractory shock. There is a stark divide in familiarity and practice patterns regarding its use among physicians. Studies to formally assess safety and efficacy of methylene blue in treating pediatric shock are warranted.
Indexed as
Identifiers
What OpenQuestion holds
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.