Effect of a single bolus of methylene blue prophylaxis on vasopressor and transfusion requirement in infective endocarditis patients undergoing cardiac surgery Full Text
Korean Journal of Anesthesiology, 08/20/2012
Cho JS et al. – In infective endocarditis (IE) patients undergoing valvular heart surgery (VHS), prophylactic Methylene blue (MB) administration before cardiopulmonary bypass (CPB) did not confer significant benefits in terms of vasopressor requirements and hemodynamic parameters, but it was associated with a significant reduction in transfusion requirement.Methods
- Forty-two adult patients were randomly assigned to receive 2mg/kg of MB (MB group, n=21) or saline (control group, n=21) for 20min before the initiation of CPB.
- The primary end points were comparisons of vasopressor requirements serially assessed after weaning from CPB and hemodynamic parameters serially recorded before and after CPB.
- The secondary endpoint was the comparison of transfusion requirements.
- Two patients in the control group received MB after weaning from CPB due to norepinephrine and vasopressin refractory vasoplegia and were thus excluded.
- There were no significant differences in vasopressor requirements and hemodynamic parameters between the two groups.
- The mean number of units of packed erythrocytes transfused per transfused patient was significantly less in the MB group.
- The numbers of patients transfused with fresh frozen plasma and platelet concentrates were less in the MB group.