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[Inhibition of the nitric oxide pathway in refractory septic shock]
M Andresen1, A Dougnac, G Hernández
1Unidade de Terapia Intensiva Médica, Hospital Clínico, Universidad Católica, Santiago de Chile.
Aim:
To assess the acute effects of methylene blue infusion, an inhibitor of nitric oxide synthesis, on hemodynamic parameters in patients with refractory septic shock.
Patients And Methods:
Fourteen patients admitted to intensive care units with septic shock of diverse etiologies and unable to maintain median arterial pressures over 60 mm Hg with the use of at least 2 vasoactive drugs, were studied. All received a 1 mg/kg bolus of methylene blue Hemodynamic parameters were measured before and 30, 60, 120 and 180 min after the bolus.
Results:
Systolic and diastolic blood pressure and systemic vascular resistance increased in all patients. There were no significant changes in cardiac output, oxygen consumption or extraction.
Conclusions:
Methylene blue has an acute pressor effect in patients with septic shock.