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Methylene Blue for Refractory Shock in Polytraumatized Patient: A Case Report
Leila Costa Volpon1, Paulo Roberto Barbosa Evora2, Gisele Douradinho Teixeira1
1Department of Pediatrics, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
The Journal of Emergency Medicine
|August 21, 2018
Summary
Methylene blue (MB) effectively treated refractory shock in a pediatric trauma case. This intervention aided in weaning vasopressors, suggesting MB as a potential adjuvant therapy for trauma-induced hypoperfusion.
Area of Science:
- Pharmacology
- Critical Care Medicine
- Trauma Surgery
Background:
- Methylene blue (MB) is explored for treating refractory shock by inhibiting guanylate cyclase and nitric oxide synthase (NOS).
- While studied in septic shock, its use in trauma patients remains less documented.
Observation:
- A pediatric trauma patient presented with severe injuries and persistent hypotension despite maximal standard medical therapy.
- Intravenous administration of a low dose of methylene blue (0.5 mg/kg) was initiated.
Findings:
- Following MB administration, the patient showed improved hemodynamics, allowing for weaning from norepinephrine and reduction of other vasoactive agents.
- The patient was successfully discharged from the pediatric intensive care unit (PICU) in good condition.
Implications:
- Methylene blue may serve as a valuable adjuvant therapy for managing refractory shock in pediatric trauma patients.
- Early consideration of MB could mitigate risks associated with persistent systemic hypoperfusion and multiple organ dysfunction in trauma survivors.
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