Methylene Blue For Post-Cardioplumonary Bypass Vasoplegic Syndrome

First, in the author’s study methylene blue was administered in a dose of 1–2 mg/kg bolus over 10 min and the median time until a maximum hemodynamic response was 2 h after drug administration. Out of 88 patients who received methylene blue, only 39 (44.3%) showed a positive hemodynamic response to the drug. We believe that if the bolus of methylene blue was followed by a continuous infusion of the drug, it would have produced even better results. Evora et al. have reviewed 20 years of vasoplegic syndrome treatment in heart surgery and found that the most used dosage of methylene blue is 2 mg/kg as an intravenous bolus, followed by the same dose in continuous infusion because its plasma concentration sharply decreases in the first 40 min.[2,3]