Trial reportCritical care (London, England)2023
Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial.
Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 49 papers, 7 of them syntheses that pooled it.
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.
Early Use of Methylene Blue in Patients With Septic Shock: a Pilot Randomized Controlled Trial
Intravenous Methylene Blue for Treating Fluid-refractory, Catecholamine-resistant, Neonatal Septic Shock: a Randomized, Placebo-controlled, Superiority Trial
Who cites it
49 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Targeting capillary leak in experimental sepsis and endotoxemia: a systematic review of therapeutic agents, methods and models in animal studies.Critical care (London, England) · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- ADJUNCTIVE VASOPRESSORS AND SHORT-TERM MORTALITY IN ADULTS WITH SEPTIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS.Shock (Augusta, Ga.) · 2025Pooled it
- Non-adrenergic vasopressors for vasodilatory shock or perioperative vasoplegia: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2024Pooled it
- Methylene Blue in Septic Shock: A Systematic Review and Meta-Analysis.Critical care explorations · 2024Pooled it
- Effect of methylene blue on outcomes in patients with distributive shock: a meta-analysis of randomised controlled trials.BMJ open · 2024Pooled it
- Methylene blue in sepsis and septic shock: a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- Comparative study between high and low dose methylene blue infusion in septic cancer patients: a randomized, blinded, controlled study.BMC anesthesiology · 2025Trial
- The Effect of Methylene Blue on Sublingual Microcirculation in Patients with Septic Shock: A Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Lung-Cardiovascular Interactions and Derangements in ARDS.Comprehensive physiology · 2026Review
- Effect of Weight-based versus Absolute Norepinephrine Dosing on Mortality Risk in Obese Patients with Septic Shock: An Observational, Multicohort, Retrospective Study.Anesthesiology · 2026Observational
- A two-center comparison of the efficacy of methylene blue and hydroxocobalamin for the treatment of refractory shock.Perfusion · 2026Observational
- Current and future strategies aiming at reducing catecholamine exposure in septic shock.Critical care (London, England) · 2026Review
- 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
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- A multimodal embedding model for sepsis data representation.NPJ digital medicine · 2026Article
- Early Methylene Blue for Mortality Reduction in High-Dose VasoPREssor-Dependent Septic Shock (EMPRESS): protocol for a multicenter randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Machine learning for prediction of in-ICU mortality in sepsis: an observational study using the MIMIC IV database.Archives of medical science : AMS · 2026Article
- Use of Methylene Blue to Treat Hypotension in Poisoned Patients in the Toxicology Investigators Consortium (ToxIC) Core Registry: 2016-2023.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Article
- Management of post-resuscitation vasoplegic shock: targets, strategies and outcomes.Critical care (London, England) · 2025Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMethylene blue (MB) has been tested as a rescue therapy for patients with refractory septic shock. However, there is a lack of evidence on MB as an adjuvant therapy, its' optimal timing, dosing and safety profile. We aimed to assess whether early adjunctive MB can reduce time to vasopressor discontinuation in patients with septic shock.
methodsIn this single-center randomized controlled trial, we assigned patients with septic shock according to Sepsis-3 criteria to MB or placebo. Primary outcome was time to vasopressor discontinuation at 28 days. Secondary outcomes included vasopressor-free days at 28 days, days on mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days.
resultsAmong 91 randomized patients, forty-five were assigned to MB and 46 to placebo. The MB group had a shorter time to vasopressor discontinuation (69 h [IQR 59-83] vs 94 h [IQR 74-141]; p < 0.001), one more day of vasopressor-free days at day 28 (p = 0.008), a shorter ICU length of stay by 1.5 days (p = 0.039) and shorter hospital length of stay by 2.7 days (p = 0.027) compared to patients in the control group. Days on mechanical ventilator and mortality were similar. There were no serious adverse effects related to MB administration.
conclusionIn patients with septic shock, MB initiated within 24 h reduced time to vasopressor discontinuation and increased vasopressor-free days at 28 days. It also reduced length of stay in ICU and hospital without adverse effects. Our study supports further research regarding MB in larger randomized clinical trials. Trial registration ClinicalTrials.gov registration number NCT04446871 , June 25, 2020, retrospectively registered.
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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.