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首页> 外文期刊>Journal of Clinical Medicine Research >Use of Methylene Blue in the Treatment of Refractory Vasodilatory Shock After Cardiac Assist Device Implantation: Report of Four Consecutive Cases
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Use of Methylene Blue in the Treatment of Refractory Vasodilatory Shock After Cardiac Assist Device Implantation: Report of Four Consecutive Cases

机译：亚甲基蓝在心脏辅助装置植入后难治性血管扩张性休克的治疗中：连续四例报道

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摘要

Vasodilatory shock frequently occurs after cardiac surgery, particularly after cardiac assist device implantation. This complication is often associated with high mortality, especially if refractory to conventional vasoconstrictor treatment. Methylene blue, a guanylate cyclase inhibitor, has been successfully used in the management of vasodilatory shock associated with cardiopulmonary bypass. We present four successive cases after implantation of cardiac assist devices suffering from norepinephrine and vasopressin refractory severe vasodilatory shock. In all patients, administration of a single dose of methylene blue (2 mg/kg body weight) resulted in an immediate and persistent decrease in vasoconstrictor dosages and serum lactate concentrations. Despite of this benefit, all patients deceased during hospital stay, however, this was not related to the methylene blue treatment. Methylene blue seems to be a promising therapeutical option in patients with otherwise resistant vasodilatory shock after cardiac assist device implantation. However, controlled clinical trials are necessary to substantiate safety and efficacy.doi:10.4021/jocmr804w
机译：在心脏手术后，尤其是在心脏辅助装置植入后，经常发生血管舒张性休克。这种并发症通常与高死亡率有关，尤其是对常规血管收缩药难以治疗时。亚甲基蓝，一种鸟苷酸环化酶抑制剂，已成功用于治疗与体外循环有关的血管舒张性休克。我们介绍了连续四例植入去甲肾上腺素和加压素难治性严重血管舒张性休克的心脏辅助装置后的病例。在所有患者中，单次服用亚甲蓝（2 mg / kg体重）都会导致血管收缩药剂量和血清乳酸浓度立即持续下降。尽管有这种好处，所有患者在住院期间都会死亡，但这与亚甲蓝治疗无关。亚甲基蓝似乎是在心脏辅助装置植入后具有其他抵抗性血管舒张性休克的患者中有希望的治疗选择。但是，必须通过对照临床试验来证实安全性和有效性。doi：10.4021 / jocmr804w

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