. Author manuscript; available in PMC: 2023 Oct 10.

Published in final edited form as: Pediatr Crit Care Med. 2020 Jun;21(6):e378–e386. doi: 10.1097/PCC.0000000000002295

Table 2:

Non-case reports of the use of methylene blue to treat refractory shock in patients less than 25 years old. MB: methylene blue, B: bolus dose, I: infusion, ECMO; extracorporeal membrane oxygenation, MB; methylene blue, CO; cardiac output, BP; blood pressure, MAP; mean arterial blood pressure, HR; heart rate, CVP; central venous pressure, CPB; cardiopulmonary bypass, CHD; congenital heart disease, SVRI; systemic vascular resistance index, SBP; systolic blood pressure, DBP; diastolic blood pressure (*) Indicates conference abstracts

Study, year, country	Design	Critically ill patients	Control patients	MB Dose	Major findings
*Scheffer et al. 2018, United States(45)	Retrospective cohort	28	0	Not specified	Cohort of patient with vasoplegic shock from cardiac failure (n=7), CPB (n=16), ECMO decannulation (n=2) and sepsis (n=3). MB administration resulted in MAP increase of 0.9 mmHg/hr
Abdelazim et al. 2016, Egypt(46)	Randomized controlled trial	20	20	B: 1.5 mg/kg	Series of infants and children with vasoplegic shock coming off CPB for repair of CHD. Randomized to Methylene Blue or Norepinephrine. BP, SVRI and CVP increased and HR and CO decreased significantly after MB
Hassan et al. 2014, Egypt(47)	Case series	20	0	B: 1.5mg/kg	Series of patients with norepinephrine refractory shock coming off CPB. Administration of MB was associated with decreases in HR (13 bpm), CI (0.8L/min/m²) and norepinephrine infusion (0.57 to 0.11 mcg/Kg/min) and increases in MAP (17 mmHg) and SVRI (791 dyn×sec×cm⁻⁵×m⁻²)
*Banille et al. 2011, Argentina(48)	Retrospective cohort	35 with 5 receiving MB	0	Not specified	Study of hemodynamic profiles of children with septic shock. Improvement in 5 patients is noted after MB administration.
Oberpaur et al. 1997, Chile(49)	Case series	5	0	B: 2 mg/kg	Series of patient with septic shock. After bolus of MB, SBP increased by 61%, DBP increased 94%, and MAP increased 77% after MB. Repeat MB bolus dosing did not improve patient status
Evora 1997, Brazil(50)	Case series	2	0	B: 1.5 mg/kg	Case series of 2 children with anaphylactic shock. Immediate clinical improvement with MB
Driscoll et al. 1996, United States(51)	Case series	5	0	B: 1mg/kg and unspecified	Case series of neonates with septic shock. BP increased by 33% and inotropic and vasopressor agents weaned after MB. Repeat MB bolus dosing did improve patient status.