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Methylene blue in the critical care setting
Praveen Reddy Elmati1, Teja Nagaradona2, Vikas Raghove3
1Department of Anesthesiology, Saint Clair Hospital, Dover, NJ 07801, United States.
World Journal of Critical Care Medicine
|August 29, 2025
Summary
Methylene blue (MB) shows promise in intensive care units (ICUs) for treating refractory shock, particularly septic and vasoplegic shock. Further research is needed to confirm its long-term safety and optimal use in critical care settings.
Area of Science:
- Pharmacology and Critical Care Medicine.
Background:
- Methylene blue (MB) is a multifaceted compound with historical applications as a dye, antiseptic, and treatment for methemoglobinemia.
- Its known mechanisms include vasoconstriction, methemoglobin reduction, guanylate cyclase inhibition, and anti-inflammatory properties.
Purpose of the Study:
- To review existing literature on the use of Methylene blue (MB) in the intensive care unit (ICU).
- To evaluate the efficacy and application of MB in managing various forms of refractory shock.
Main Methods:
- A comprehensive literature search was conducted using PubMed and Google Scholar.
- Search terms included "Methylene blue," "critical care," "intensive care," "sepsis," "surgery," "pharmacokinetics," and "pharmacodynamics."
- Relevant English-language articles were analyzed.
Main Results:
- Methylene blue (MB) has demonstrated utility in managing patients with refractory shock, such as septic shock and vasoplegic shock.
- Its application extends to surgical patients and cases of drug-induced hypotension.
Conclusions:
- Methylene blue (MB) presents as a promising therapeutic option for sepsis and vasoplegic shock in the ICU.
- Further randomized controlled trials are essential to establish long-term safety, optimal timing, dosage, and duration of MB administration in critical care.
