Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Clinics (Sao Paulo). 2022 Nov 24;77:100139. doi: 10.1016/j.clinsp.2022.100139. eCollection 2022.
The authors design an animal model of neonatal sepsis to analyze the treatment of neonatal septic shock with Methylene Blue (MB) in a swine model.
The study design included twenty male newborn pigs divided into four groups: 1) The control group; 2) The sepsis group (induced with lipopolysaccharide); 3) The MB group, and 4) The MB-treated sepsis group. Septic shock was defined as Blood Pressure (BP) dropping 20% below the baseline value. Continuous Blood Pressure (BP), Nitric Oxide (NO) levels, cyclic Guanosine Monophosphate (cGMP), malondialdehyde acid, base excess, lactate, arterial blood gases, hematocrit, and echocardiography were analyzed.
The BP of the sepsis group treated with MB showed a slight improvement in the first hour after treatment; however, a significant difference was not observed compared to the untreated sepsis group. Besides hemodynamic stability, the current study did not show symptomatic pulmonary hypertension, suggesting that MB was safe in neonates and children. An improvement in Base Excel (BE) levels after MB administration in septic animals may indicate a possible improvement in microcirculation.
The MB improved biomarkers related to septic shock prognosis, although an improvement in the blood levels could not be detected. MB might be a beneficial drug for hemodynamic instability in infants.
作者设计了一种新生儿败血症动物模型，旨在分析亚甲蓝（MB）在猪模型中治疗新生儿败血性休克的效果。
本研究设计包括 20 只雄性新生仔猪，分为四组：1）对照组；2）败血症组（用脂多糖诱导）；3）MB 组；4）MB 治疗败血症组。败血症性休克定义为血压（BP）比基线值下降 20%。分析连续血压（BP）、一氧化氮（NO）水平、环鸟苷酸（cGMP）、丙二醛酸、碱剩余、乳酸、动脉血气、血细胞比容和超声心动图。
MB 治疗的败血症组在治疗后第一个小时的血压略有改善，但与未治疗的败血症组相比，差异无统计学意义。除了血流动力学稳定外，本研究未发现有症状性肺动脉高压，表明 MB 在新生儿和儿童中是安全的。败血症动物 MB 给药后 Base Excel（BE）水平的改善可能表明微循环的可能改善。
MB 改善了与败血症性休克预后相关的生物标志物，尽管未检测到血液水平的改善。MB 可能是治疗婴儿血流动力学不稳定的有益药物。
