| Author | Luis-Silva, Fabio | |
| Author | Menegueti, Mayra Gonçalves | |
| Author | Peres, Leandro Moreira | |
| Author | Sepeda, Corina | |
| Author | Jordani, Maria Cecília | |
| Author | Mestriner, Fabiola | |
| Author | Petroski-Moraes, Bruno Cesar | |
| Author | Brito-de-Sousa, Joaquim Pedro | |
| Author | Costa-Rocha, Ismael Artur | |
| Author | Cruz, Bruna Lemos | |
| Author | Donadel, Mariana Dermínio | |
| Author | Souza, Felipe Barizza de | |
| Author | Reis, Gustavo Henrique Martins | |
| Author | Basile-Filho, Anibal | |
| Author | Becari, Christiane | |
| Author | Evora, Paulo Roberto Barbosa | |
| Author | Martins Filho, Olindo Assis | |
| Author | Auxiliadora-Martins, Maria | |
| Access date | 2024-06-25T19:27:54Z | |
| Available date | 2024-06-25T19:27:54Z | |
| Document date | 2024 | |
| Citation | LUIS-SILVA, Fabio et al. Methylene blue therapy versus standard treatment for acute-phase septic shock: a pilot randomized controlled trial. Research Square, p. 1-24, 2024. Doi: http://dx.doi.org/10.21203/rs.3.rs-3971422/v1 | |
| URI | https://www.arca.fiocruz.br/handle/icict/64664 | |
| Language | eng | en_US |
| Rights | restricted access | |
| Subject in Portuguese | Metileno azul | pt_BR |
| Subject in Portuguese | Oxido nitrico | pt_BR |
| Subject in Portuguese | Citocinas | pt_BR |
| Title | Methylene blue therapy versus standard treatment for acute-phase septic shock: a pilot randomized controlled trial | en_US |
| Type | Preprint | |
| Abstract | Purpose: Methylene blue (MB) has been used to increase blood pressure in patients with septic shock by acting on guanylate cyclase and nitric oxide synthase (NOS). Objective: To determine whether the administration of MB to patients in the initial phase of septic shock leads to a reduction in the use of vasopressors compared to that in the control group. Methods: This was a 1:1 randomized clinical trial of two groups (methylene blue and control). We used MB after uid replacement, vasopressors and antibiotic therapy. Patients received a loading dose of MB (3 mg/kg) and maintenance (0.5 mg/kg/h) for 48 hours. Vasopressor doses, laboratory test results, inammatory and anti-inammatory cytokine levels, and hemodynamic monitoring were recorded before the infusion of MB (T1) and after 20 minutes (T2), 2 hours (T3), 24 hours (T4), 48 hours after the infusion started (T5) and 24 hours after weaning (T6). Results: Methylene blue therapy started within 72 hours of septic shock. The methylene blue group showed na immediate reduction in NOR dosage, earlier reduction in VAS dosage, and higher IL-10 levels compared to the control group. Integrative network analysis highlighted NO and IL-10's roles in coordinating correlations with "Hemodynamic Monitoring" in the control and methylene blue groups, respectively. Conclusion: Early methylene blue (MB) administration alongside standard septic shock treatment reduces vasopressor doses, possibly involving nitric oxide (NO) mechanisms. A possible mechanism of action may involve modulation of inammatory and anti-inammatory mediators, enhancing immune response. However, larger and longer studies are needed for validation. | en_US |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brasil | |
| Affilliation | René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Affilliation | René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brasil | |
| Affilliation | University of São Paulo. São Paulo, SP, Brasil | |
| Subject | Methylene Blue | en_US |
| Subject | Septic Shock | en_US |
| Subject | Lactate | en_US |
| Subject | Nitric Oxide | en_US |
| Subject | Cytokines | en_US |
| Embargo date | 2150-12-31 | |
