Methylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties
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| Natura: | Artículo científico |
| Lingua: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2009
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| _version_ | 1876427376998481920 |
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| author | Paulo Roberto Barbosa EVORA |
| author_facet | Paulo Roberto Barbosa EVORA |
| contents | Methylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties Paulo Roberto Barbosa EVORA Paulo José de Freitas RIBEIRO Walter Vilella de Andrade VICENTE Celso Luís dos REIS Alfredo José RODRIGUES Antonio Carlos MENARDI Lafaiete ALVES JUNIOR Patrícia Martinez EVORA Solange BASSETTO Medicina drug effects Methylene blue Vascular diseases Vascular resistance Extracorporeal circulation Objective: There is strong evidence that methylene blue (MB), an inhibitor of guanylate cyclase, is an excellent therapeutic option for vasoplegic syndrome (VS) treatment in heart surgery. The aim of this article is to review the MB’s therapeutic function in the vasoplegic syndrome treatment. Methods: Fifteen years of literature review. Results : 1) Heparin and ACE inhibitors are risk factors; 2) In the recommended doses it is safe (the lethal dose is 40 mg/ kg); 3) The use of MB does not cause endothelial dysfunction; 4) The MB effect appears in cases of nitric oxide (NO) up- regulation; 5) MB is not a vasoconstrictor, by blocking of the GMPc system it releases the AMPc system, facilitating the norepinephrine vasoconstrictor effect; 6) The most used dosage is 2 mg/kg as IV bolus followed by the same continuous infusion because plasmatic concentrations strongly decays in the first 40 minutes; 7) There is a possible “window of opportunity” for the MB’s effectiveness. Conclusions: Although there are no definitive multicentric studies, the MB used to treat heart surgery VS, at the present time, is the best, safest and cheapest option, being a Brazilian contribution for the heart surgery. 2009 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941872005 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.24 |
| format | Artículo científico |
| id | redalyc_398941872005 |
| institution | Redalyc |
| language | en |
| publishDate | 2009 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Methylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties Paulo Roberto Barbosa EVORA Medicina drug effects Methylene blue Vascular diseases Vascular resistance Extracorporeal circulation Methylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties Paulo Roberto Barbosa EVORA Paulo José de Freitas RIBEIRO Walter Vilella de Andrade VICENTE Celso Luís dos REIS Alfredo José RODRIGUES Antonio Carlos MENARDI Lafaiete ALVES JUNIOR Patrícia Martinez EVORA Solange BASSETTO Medicina drug effects Methylene blue Vascular diseases Vascular resistance Extracorporeal circulation Objective: There is strong evidence that methylene blue (MB), an inhibitor of guanylate cyclase, is an excellent therapeutic option for vasoplegic syndrome (VS) treatment in heart surgery. The aim of this article is to review the MB’s therapeutic function in the vasoplegic syndrome treatment. Methods: Fifteen years of literature review. Results : 1) Heparin and ACE inhibitors are risk factors; 2) In the recommended doses it is safe (the lethal dose is 40 mg/ kg); 3) The use of MB does not cause endothelial dysfunction; 4) The MB effect appears in cases of nitric oxide (NO) up- regulation; 5) MB is not a vasoconstrictor, by blocking of the GMPc system it releases the AMPc system, facilitating the norepinephrine vasoconstrictor effect; 6) The most used dosage is 2 mg/kg as IV bolus followed by the same continuous infusion because plasmatic concentrations strongly decays in the first 40 minutes; 7) There is a possible “window of opportunity” for the MB’s effectiveness. Conclusions: Although there are no definitive multicentric studies, the MB used to treat heart surgery VS, at the present time, is the best, safest and cheapest option, being a Brazilian contribution for the heart surgery. 2009 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941872005 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.24 |
| title | Methylene blue for vasoplegic syndrome treatment in heart surgery. Fifteen years of questions, answers, doubts and certainties |
| topic | Medicina drug effects Methylene blue Vascular diseases Vascular resistance Extracorporeal circulation |
| url | https://www.redalyc.org/articulo.oa?id=398941872005 |