Table 1 Use of methylene blue in septic shock: pros and cons
From: Administration of methylene blue in septic shock: pros and cons
PROS | CONS |
|---|---|
Different mechanism of action than adrenergic agents (blocks sGC activity) | Neutral effect or increased mortality in clinical trials of non-selective NO inhibitors in septic shock |
Effectively increases vascular tone and arterial pressure | Other agents can also achieve this |
Enables other vasopressor (norepinephrine) doses to be reduced | Lack of evidence that this is truly a beneficial effect |
Easy application with a continuous infusion | No clear understanding of dosage and timing of administration in relation to norepinephrine administration |
Maintains cardiac contractility | Lack of increase in cardiac output and oxygen delivery |
Low-cost | Catecholamines are quite cheap too |
Widely available | No clear safety profile |