Severe pulmonary embolism often leads to right ventricular failure after surgical embolectomy secondary to ischaemia reperfusion injury and acute lung injury (ALI). Acute right ventricular dysfunction is traditionally treated with inotropes and vasopressors to maintain cardiac output and coronary perfusion as well as selective pulmonary vasodilators to provide right ventricular afterload reduction. We report the first case of utilisation of methylene (MB) in a patient with acute right ventricular failure and vasoplegic shock after surgical pulmonary embolectomy.
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- Methylene blue: the drug of choice for catecholamine refractory vasoplegia after cardiopulmonary bypass?.J Thorac Cardiovasc Surg. 2003; 125: 1426-1431
- Methylene blue administration in severe systemic inflammation response syndrome (SIRS) after thoracic surgery.Ann Thorac Cardiovasc Surg. 2002; 8: 306-310
- Infusion of methylene blue in human septic shock: a pilot, randomized, controlled study.Crit Care Med. 2001; 29: 1860-1867
- Reflex and humoral responses to pulmonary embolism.Prog Cardiovasc Dis. 1974; 17: 167-174
- Pulmonary microembolism.Phystol Rev. 1983; 63: 1114-1207
- Dependence of ventricular distensibility on filling of the opposite ventricle.Am J Physiol. 1967; 213: 711-718
- Right ventricular dysfunction after acute pulmonary embolism: pathophysiologic factors, detection, and therapeutic implications.Am Heart J. 1995; 130: 1276-1282
- Methylene blue administration in septic shock: a clinical trial.Crit Care Med. 1995; 23: 259-264
- Does methylene blue administration to septic shock patients affect vascular permeability and blood volume?.Crit Care Med. 2002; 30: 2271-2277
- Preoperative methylene blue administration in patients at high risk for vasoplegic syndrome during cardiac surgery.Ann Thorac Surg. 2005; 79: 1615-1619
- Methylene blue reduces mortality and morbidity in vasoplegic patients after cardiac surgery.Ann Thorac Surg. 2004; 77: 496-499
- Short-term effects of methylene blue on hemodynamics and gas exchange in humans with septic shock.Intensive Care Med. 1995; 21: 1027-1031
- Reversal of severe vasoplegia with single-dose methylene blue after heart transplantation.J Thorac Cardiovasc Surg. 2001; 122: 823-824
- Inhaled nitric oxide as a screening vasodilator agent in primary pulmonary hypertension. A dose-response study and comparison with prostacyclin.Am J Respir Crit Care Med. 1995; 151: 384-389
- Inhaled nitric oxide for the adult respiratory distress syndrome.N Engl J Med. 1993; 328: 399-405
- Inhaled nitric oxide in patients with pulmonary embolism.Intensive Care Med. 1997; 23: 1089-1092
Accepted: August 30, 2010
Received in revised form: July 17, 2010
Received: April 3, 2010
© 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.