Rescue therapy with methylene blue in systemic inflammatory response syndrome after cardiac surgery

Severe unresponsive vasoplegia syndrome following cardiopulmonary bypass is rare. The authors report a case of severe vasoplegia, unresponsive to conventional treatment three days following cardiopulmonary bypass. A single intravenous bolus (2 mg/kg) of methylene blue was administered with normalization of the peripheral resistance. The use of methylene blue as rescue therapy in severe vasoplegia syndrome is discussed.