Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial

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dc.catalogadorcrc
dc.contributor.authorIbarra-Estrada, Miguel
dc.contributor.authorKattan Tala, Eduardo José
dc.contributor.authorAguilera-González, Pavel
dc.contributor.authorSandoval-Plascencia, Laura
dc.contributor.authorRico-Jauregui, Uriel
dc.contributor.authorGómez-Partida, Carlos A.
dc.contributor.authorOrtiz-Macías, Iris X.
dc.contributor.authorLópez-Pulgarín, José A.
dc.contributor.authorChávez-Peña, Quetzalcóatl
dc.contributor.authorMijangos-Méndez, Julio C.
dc.contributor.authorAguirre-Avalos, Guadalupe
dc.contributor.authorHernández P., Glenn
dc.date.accessioned2023-03-27T16:31:36Z
dc.date.available2023-03-27T16:31:36Z
dc.date.issued2023
dc.date.updated2023-03-19T01:03:11Z
dc.description.abstractPurpose Methylene blue (MB) has been tested as a rescue therapy for patients with refractory septic shock. However, there is a lack of evidence on MB as an adjuvant therapy, its’ optimal timing, dosing and safety profile. We aimed to assess whether early adjunctive MB can reduce time to vasopressor discontinuation in patients with septic shock. Methods In this single-center randomized controlled trial, we assigned patients with septic shock according to Sepsis-3 criteria to MB or placebo. Primary outcome was time to vasopressor discontinuation at 28 days. Secondary outcomes included vasopressor-free days at 28 days, days on mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days. Results Among 91 randomized patients, forty-five were assigned to MB and 46 to placebo. The MB group had a shorter time to vasopressor discontinuation (69 h [IQR 59–83] vs 94 h [IQR 74–141]; p < 0.001), one more day of vasopressor-free days at day 28 (p = 0.008), a shorter ICU length of stay by 1.5 days (p = 0.039) and shorter hospital length of stay by 2.7 days (p = 0.027) compared to patients in the control group. Days on mechanical ventilator and mortality were similar. There were no serious adverse effects related to MB administration. Conclusion In patients with septic shock, MB initiated within 24 h reduced time to vasopressor discontinuation and increased vasopressor-free days at 28 days. It also reduced length of stay in ICU and hospital without adverse effects. Our study supports further research regarding MB in larger randomized clinical trials.
dc.fechaingreso.objetodigital2023-03-27
dc.fuente.origenAutoarchivo
dc.identifier.citationIbarra-Estrada, M., Kattan, E., Aguilera-González, P. et al. Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial. Crit Care 27, 110 (2023). https://doi.org/10.1186/s13054-023-04397-7
dc.identifier.doi10.1186/s13054-023-04397-7
dc.identifier.issn1364-8535
dc.identifier.urihttps://doi.org/10.1186/s13054-023-04397-7
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/66665
dc.information.autorucEscuela de Medicina; Kattan Tala, Eduardo José;s/i; 172152
dc.information.autorucEscuela de Medicina; Hernández P., Glenn; 0000-0002-3032-4087;98874
dc.issue.numero110
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final10
dc.pagina.inicio1
dc.revistaCritical Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseAttribution 4.0 International (CC BY 4.0)
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectMethylene blue
dc.subjectRandomized controlled trial
dc.subjectSeptic shock
dc.subjectNorepinephrine
dc.subjectVasopressin
dc.subjectCatecholamine sparing
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleEarly adjunctive methylene blue in patients with septic shock: a randomized controlled trial
dc.typeartículo
dc.volumen27
sipa.codpersvinculados98874
sipa.codpersvinculados172152
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