Hydroxocobalamin Versus Methylene Blue for Vasoplegic Syndrome in Cardiothoracic Surgery: A Retrospective Cohort

Furnish, Craig; Mueller, Scott W.; Kiser, Tyree H.; Dufficy, Lisa; Sullivan, Breandan; Beyer, Jacob

doi:10.1053/j.jvca.2020.01.033

Cited by 24 publications

(18 citation statements)

References 27 publications

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“…Five studies described MB as an adjunct agent comparing it to placebo (normal saline), except one study by Furnish et al, 17 which used MB as an adjunct comparing it to hydroxocobalamin. Therefore, we excluded the study and analyzed five studies for quantitative synthesis.…”

Section: Overview Of Literature Searchmentioning

confidence: 99%

Methylene blue for vasoplegic syndrome in cardiopulmonary bypass surgery: A systematic review and meta-analysis

Perdhana

Kloping

Witarto

et al. 2021

Asian Cardiovasc Thorac Ann

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Background To evaluate the benefit of methylene blue as an adjunct treatment by assessing hemodynamic, morbidity rate, intensive care unit length of stay, and mortality rate outcomes in adult patients with vasoplegic syndrome. Methods A systematic search through electronic databases including Pubmed, Embase, Scopus, and Medline for studies assessing the use of methylene blue in patients with vasoplegic syndrome compared to control treatments. The Newcastle–Ottawa Scale tool was used for observational studies, and Jadad Scale was used for controlled trials to assess the risk of bias. Results This systematic review included six studies for qualitative synthesis and five studies for quantitative synthesis. Pooled analysis revealed that mean arterial pressure, systemic vascular resistance, heart rate, and hospital stay were not statistically significant in methylene blue administration compared to control. However, administration of methylene blue in vasoplegic syndrome patients significantly reduces renal failure (OR = 0.25; 95% CI = 0.08–0.75), development of multiple organ failure (OR = 0.09; 95% CI = 0.02–0.51), and mortality rate (OR = 0.12; 95% CI = 0.03–0.46). Conclusion Adjunct administration of methylene blue for vasoplegic syndrome patients significantly reduces renal failure, multiple organ failure, and mortality.

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Section: Overview Of Literature Searchmentioning

confidence: 99%

Methylene blue for vasoplegic syndrome in cardiopulmonary bypass surgery: A systematic review and meta-analysis

Perdhana

Kloping

Witarto

et al. 2021

Asian Cardiovasc Thorac Ann

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“…En este contexto, podría ser razonable la administración de hidrocortisona de 50-100 mg cada 6 h (deficiencia absoluta o relativa de cortisol). En pacientes con riesgo de síndrome serotoninérgico, se considera a la hidroxicobalamina como una alternativa al azul de metileno (9) . Además de este manejo inicial en base a volumen, vasopresores, azul de metileno y corticoides, frente a un cuadro de shock distributivo es pertinente realizar una ronda de cultivos, e iniciar un tratamiento antibiótico empírico.…”

Section: Esquema Terapéuticounclassified

Síndrome vasopléjico en cirugía cardíaca

2020

Rev Urug Cardiol.

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“…Two agents that were developed for quite different purposes other than the treatment of refractory vasoplegic shock were examined by Furnish et al and reported on in the current issue of the Journal of Cardiothoracic and Vascular Anesthesia. 1 The authors performed a retrospective study comparing hydroxocobalamin versus methylene blue as rescue therapy in patients who had vasoplegic syndrome undergoing cardiothoracic surgery.…”

mentioning

confidence: 99%

“…Thus, the retrospective comparison of hydroxocobalamin with methylene blue for cases of refractory shock in the perioperative cardiac surgical period by Furnish et al is novel to the literature. 1 That being said, like many retrospective studies, it leads to many more questions than answers. However, arriving at the questions is the first, and often most difficult, step in finding answers.…”

mentioning

confidence: 99%

“…The study by Furnish et al 1 in the current edition of the Journal of Cardiothoracic and Vascular Anesthesia provides great groundwork for the next steps in identifying how best to use available vasopressor agents to treat refractory vasoplegic syndrome in cardiac surgical patients. Prospective studies can build upon this work, demonstrating safety and potential efficacy in terms of blood pressure support.…”

mentioning

confidence: 99%

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