Volume 1 Supplement 1

17th International Symposium on Intensive Care and Emergency Medicine

Open Access

Effects of methylene blue on gas exchange and myocardial function in refractory septic shock with acute lung injury

  • M Andresen1,
  • A Dougnac1,
  • M Alvarez1,
  • G Hernandez1,
  • O Diaz1,
  • G Bugedo1,
  • L Castillo1,
  • J Dagnino1 and
  • C Cofre1
Critical Care19971(Suppl 1):P076

DOI: 10.1186/cc68

Published: 1 March 1997

An important number of patients died in refractory hypotension during the course of septic shock. Methylene blue (MB) increases mean arterial pressure, however cardiac output can decrease and also some effect on gas exchange has been observed.

Objective

The aim of this study was to evaluate the potential side effects on myocardial function and respiratory parameters in patients with refractory septic shock associated to severe acute lung injury (ALI).

Methods

Six consecutive patients with refractory septic shock, mechanically ventilated developing ALI were studied. MB was infused iv (1 mg/kg) in 15 min. Hemodynamics and gasometric values were collected before (baseline) and at 30 min, 60 min, 90 min, 120 min and 180 min after the end of the infusion.

Data = mean ± SE. Statistics: Anova and Student–Newman–Keuls.

Results

See table.

Conclusions

Short-term effects of MB are not deleterious on cardiac performance during refractory septic shock and its use is not limited in patients that developed ALI.

Table

 

Baseline

30 min

60 min

90 min

120 min

180 min

P

PaO2 mmHg

85 ± 8

82 ± 7

83 ± 8

80 ± 8

78 ± 8

77 ± 7

NS

SaO2 %

94 ± 2

95 ± 1

94 ± 1

94 ± 1

93 ± 2

94 ± 2

NS

PaO2/FiO2

184 ± 35

1 79 ± 30

176 ± 30

168 ± 27

169 ± 32

171 ± 33

NS

PA-aO2

255 ± 88

255 ± 86

255 ± 86

255 ± 85

257 ± 85

  277 ± 100

NS

Qs/Qt %

15 ± 5

17 ± 2

19 ± 2

22 ± 3

21 ± 4

25 ± 5

NS

ICI/min/m2

  4.6 ± 0.5

  4.5 ± 0.4

  4.5 ± 0.4

4.6 ± 0.5

  4.5 ± 0.5

  4.4 ± 0.5

NS

IDO2 ml/min/m2

581 ± 85

556 ± 62

553 ± 65

555 ± 63

536 ± 62

537 ± 60

NS

IVO2 ml/min/m2

175 ± 30

143 ± 26

132 ± 22

128 ± 25

160 ± 38

144 ± 36

NS

O2 extraction %

31 ± 5

27 ± 5

25 ± 4

23 ± 4

31 ± 7

28 ± 7

NS

No important differences were observed on gas exchange parameters and myocardial function.

Authors’ Affiliations

(1)
Intensive Care Unit, Catholic University of Chile, Medical School

Copyright

© Current Science Ltd 1997

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