Goyushova Tarana, Ahmadova Afaq, Aliyev Agshin
Intensive Care Unit, Liv Bona Dea Hospital, Baku, AZE.
Critical Care Medicine, Liv Bona Dea Hospital, Baku, AZE.
Cureus. 2025 Jun 22;17(6):e86559. doi: 10.7759/cureus.86559. eCollection 2025 Jun.
Refractory shock is a life-threatening condition characterized by persistent hypotension and tissue hypoperfusion despite adequate fluid resuscitation and high-dose vasopressors. It frequently progresses to multiorgan failure and has a high mortality rate. We report the case of a 68-year-old male with metastatic prostate adenocarcinoma who developed refractory shock shortly after receiving docetaxel chemotherapy. Despite maximal vasopressor and steroid therapy, the patient remained hypotensive with rising lactate levels. Administration of methylene blue (MB) resulted in rapid hemodynamic improvement, normalization of lactate, and recovery of renal and respiratory function. This case highlights the potential role of MB as an adjunct in managing vasoplegic shock unresponsive to standard therapies.
难治性休克是一种危及生命的状况，其特征是尽管进行了充分的液体复苏和大剂量血管升压药治疗，但仍持续存在低血压和组织灌注不足。它常进展为多器官功能衰竭，死亡率很高。我们报告了一例68岁转移性前列腺腺癌男性患者，其在接受多西他赛化疗后不久发生了难治性休克。尽管给予了最大剂量的血管升压药和类固醇治疗，患者仍处于低血压状态，乳酸水平不断升高。给予亚甲蓝（MB）后，患者血流动力学迅速改善，乳酸水平恢复正常，肾脏和呼吸功能也得以恢复。该病例突出了亚甲蓝作为辅助治疗对标准治疗无反应的血管麻痹性休克的潜在作用。
