الفهرس 
Methylene Blue in Septic ShockOnly 14 pages are availabe for public view
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Abstract
Abstract
Background: Despite all current available treatment for refractory septic shock in neonates, it is still associated with high mortality, which necessitate the need for an alternative therapy. The purpose of this study was to assess the effects of methylene blue (MB) in comparison to terlipressin (TP) as an adjuvant therapy for refractory septic shock in preterm neonate.
Methods: Double blinded randomized controlled trial conducted in the Neonatal Intensive Care Units at Ain Shams University, Egypt. Thirty preterm neonates with refractory septic shock were randomized to receive either MB or TP as an adjuvant to the conventional therapy. Both MB and TP were administered as an intravenous loading dose followed with continuous iv infusion. The Hemodynamic variables, functional echocardiographic variables and oxidant stress marker were assessed over a 24-hr period, together with side effects of MB.
Results: MB cause significant improvement in mean arterial blood pressure with significant decrease of the norepinephrine requirements (1.15 ± 0.21 mic/kg/min at baseline vs 0.55 ± 0.15 mic/kg/min at 24-hour). MB infusion cause increase of the pulmonary pressure from (44.73 ± 8.53 mmHg at baseline vs. 47.27 ± 7.91 mmHg after 24 hours) without affecting the cardiac output. Serum malonaldehyde decreased from 5.45 ± 1.30 nmol/ ml at baseline to 4.40 ± 0.90 nmol/ ml at 24 hours in MB group.
Conclusion: Administration of methylene blue to preterm infants with refractory septic shock showed rapid increases in systemic vascular resistance and arterial blood pressure with minimal side effects.