Mexico: A study published in BMC Critical Care entitled "Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial" by Miguel Ibarra-Estrada, evaluated the effectiveness of methylene blue (MB) in patients with septic shock. They found that the MB group had a shorter time to vasopressor discontinuation, one more day of vasopressor-free days at day 28, a...
Mexico: A study published in BMC Critical Care entitled "Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial" by Miguel Ibarra-Estrada, evaluated the effectiveness of methylene blue (MB) in patients with septic shock. They found that the MB group had a shorter time to vasopressor discontinuation, one more day of vasopressor-free days at day 28, a shorter ICU and hospital stay, and no serious adverse effects related to MB administration.
It is already known that MB has been tested as a rescue therapy for refractory septic shock patients. More data must be collected for optimal timing, dosing and safety.
Researchers assessed whether early adjunctive MB reduces the time to vasopressor discontinuation in septic shock.
Patients were assigned based on Sepsis-3 criteria to MB or placebo. The time to vasopressor discontinuation at 28 days was the primary outcome studied. The secondary results measured in the study were the vasopressor-free days at 28 days, days on a mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days.
The study results could be summarised as follows:
• There were 91 patients in the study.
• MB and placebo had forty-five, and 46 were assigned to MB and placebo, respectively.
• Among MB patients, there was a shorter time to vasopressor discontinuation (69 h vs 94 h), one more day of vasopressor-free days at day 28, a shorter ICU length of stay by 1.5 days and a shorter hospital length of stay by 2.7 days than control group patients.
• There were similar Days on a mechanical ventilator and mortality.
• No serious adverse effects tied to MB were reported.
Concluding further, they said among septic shock patients, MB, if administered early, reduces vasopressor duration, cumulative fluid balance, and ICU and hospital stay without adverse effects in septic shock patients.
However, continual research is required for confirmation of potential benefits.
Further reading
Ibarra-Estrada, M., Kattan, E., Aguilera-González, P. et al. Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial. Crit Care 27, 110 (2023).
https://doi.org/10.1186/s13054-023-04397-7
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