Methylene Blue

Case: 65 yo male with septic endocarditis and septic emboli with + valve vegetations.  Severe MR, mod AI, mod TR, no PFO, EF 60-70%. Mild pericardial effusion. Large bilateral pleural effusions.

 

Vasoplegic syndrome—the role of methylene blue. European Journal of Cardio-Thoracic Surgery, Volume 28, Issue 5, 1 November 2005, Pages 705–710.

OpenAnesthesia: Methylene Blue

Dose:
2 mg/kg bolus –> 0.5 mg/kg/hr x 12 hours
Worked wonderfully for vasoplegia unresponsive to levophed or vasopressin.
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