Booth Alexander T, Melmer Patrick D, Tribble Benjamin, Mehaffey J Hunter, Tribble Curt
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.
Heart Surg Forum. 2017 Oct 31;20(5):E234-E238. doi: 10.1532/hsf.1806.
Vasoplegic syndrome is a form of vasodilatory shock that occurs frequently in patients who undergo cardiac surgery requiring cardiopulmonary bypass (CBP). Treatment often demands high doses of vasopressors over sustained periods for hypotension that can be refractory to standard vasoactive medications. Furthermore, the development of vasoplegia greatly contributes to morbidity and mortality following cardiac surgery. Methylene blue (MB) has become a popular therapy for cardiac vasoplegia despite a paucity of prospective data to direct its use. Therefore, the aim of this study was to review available data regarding mechanisms, dosing strategies, and side effects of MB, with a focus on its applications for vasoplegia in cardiac surgery.
血管麻痹综合征是一种血管扩张性休克，常见于接受需要体外循环（CBP）的心脏手术的患者。对于标准血管活性药物难以治疗的低血压，治疗通常需要长期使用高剂量血管升压药。此外，血管麻痹的发生极大地增加了心脏手术后的发病率和死亡率。尽管缺乏指导其使用的前瞻性数据，但亚甲蓝（MB）已成为治疗心脏血管麻痹的常用疗法。因此，本研究的目的是回顾关于MB的作用机制、给药策略和副作用的现有数据，重点关注其在心脏手术血管麻痹中的应用。
