Lenglet Sébastien, Mach François, Montecucco Fabrizio
Division of Cardiology, Faculty of Medicine, Foundation for Medical Research, Geneva University Hospitals, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland.
Expert Rev Cardiovasc Ther. 2011 Dec;9(12):1519-25. doi: 10.1586/erc.11.160.
Vasoplegic syndrome is a common complication of cardiopulmonary bypass, appearing with an incidence ranging between 5 and 25%. It is characterized by significant hypotension, high or normal cardiac output and low systemic vascular resistance. This syndrome is hypothesized to be caused by the inflammation-mediated dysregulation of endothelial homeostasis and subsequent endothelial dysfunction. In vasoplegic syndrome, the inhibition of the nitric oxide/cyclic guanosine monophosphate pathway with concomitant administration with traditional ionotropes may represent a promising therapeutic option. Methylene blue, an inhibitor of nitric oxide synthase and guanylate cyclase, may contribute to the improvement of refractory hypotension associated with endothelial dysfunction in vasoplegia. In this article, we will update evidence on the potential therapeutic use of methylene blue in vasoplegic syndrome.
血管麻痹综合征是体外循环常见的并发症，发病率在5%至25%之间。其特征为显著低血压、心输出量高或正常以及全身血管阻力低。该综合征被认为是由炎症介导的内皮稳态失调及随后的内皮功能障碍所致。在血管麻痹综合征中，使用传统正性肌力药物同时抑制一氧化氮/环磷酸鸟苷途径可能是一种有前景的治疗选择。亚甲蓝作为一氧化氮合酶和鸟苷酸环化酶的抑制剂，可能有助于改善血管麻痹中与内皮功能障碍相关的难治性低血压。在本文中，我们将更新关于亚甲蓝在血管麻痹综合征中潜在治疗用途的证据。
