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Anesth Analg 2007;104:1296-1297
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000260368.21463.df

LETTER TO THE EDITOR

Section Editor:
Lawrence Saidman

Methylene Blue for CPB

Andrew D. Maslow, MD, Carl S. Schwartz, MD, Gary Stearns, CCP, Parag Batula, BMS, Jeffrey Gough, CCP, and Arun K. Singh, MD

Department of Anesthesiology, amaslow{at}rcn.com (Maslow, Schwartz) Department of Perfusion Therapy (Stearns) Brown Medical School, Rhode Island Hospital, Providence Rhode Island (Batula)

In Response:

We thank Drs. Valchanov and Falter (1) for their interest the timing of methylene blue administration as discussed in our manuscript (2). Three studies have evaluated the benefits of methylene blue in cardiac surgical patients. Two studies examined methylene blue administration after the diagnosis of vasoplegia was made (3, 4). One study administered methylene prophylactically (5). This latter study documented less inotropic support, less fluid administration, fewer blood transfusions, and shorter intensive care unit and hospital stays as well as a 0% incidence of vasoplegia in patients receiving methylene blue compared with 26% incidence in the control group (5). In our investigation we sought any benefits immediately after cardiopulmonary bypass to determine if a beneficial effect could still be seen (2). Consistent with these other studies we demonstrated hemodynamic and metabolic benefits. Together these studies demonstrate the benefit of methylene blue administration prior to, during, and after cardiopulmonary bypass.

REFERENCES

  1. Valchanov K, Falter F. Methylene blue for CPB. Anesth Analg 2007;104:1296.[Free Full Text]
  2. Maslow AD, Stearns G, Batula P, et al. The hemodynamic effects of methylene blue when administered at the onset of cardiopulmonary bypass. Anesth Analg 2006;103:2–8.[Abstract/Free Full Text]
  3. Leyh RG, Kofidis T, Struber M, et al. Methylene blue: the drug of choice for catecholamine-refractory vasoplegia after cardiopulmonary bypass? J Thorac Cardiovasc Surg 2003;125:1426–31.[Abstract/Free Full Text]
  4. Levin RL, Degrange MA, Bruno GF, et al. Methylene blue reduces mortality and morbidity in vasoplegic patients after cardiac surgery. Ann Thorac Surg 2004;77:496–9.[Abstract/Free Full Text]
  5. Ozal E, Kuralay E, Yildirim V, et al. Preoperative methylene blue administration in patients at high risk for vasoplegic syndrome during cardiac surgery. Ann Thorac Surg 2005;79:1615–9.[Abstract/Free Full Text]




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press