A review of methylene blue treatment for cardiovascular collapse

J Emerg Med. 2014 May;46(5):670-9. doi: 10.1016/j.jemermed.2013.08.102. Epub 2014 Feb 6.

Abstract

Background: Historically, methylene blue (MB) has been used for multiple purposes, including as an antidote for toxin-induced and hereditary methemoglobinemia, ifosfamide-induced encephalopathy, and ackee fruit and cyanide poisoning; as an aniline dye derivative, antimalarial agent, and antidepressant.

Discussion: Most recently, the use of MB has been advocated as a potential adjunct in the treatment of shock states. Our article reviews the role of MB in septic shock, anaphylactic shock, and toxin-induced shock. MB is proposed to increase blood pressure in these shock states by interfering with guanylate cyclase activity, and preventing cyclic guanosine monophosphate production and vasodilatation.

Summary: MB may be an adjunct in the treatment of septic shock, anaphylactic shock, and toxin-induced shock.

Keywords: anaphylactic shock; methylene blue; septic shock; shock due to toxin.

Publication types

  • Review

MeSH terms

  • Anaphylaxis / drug therapy*
  • Enzyme Inhibitors / therapeutic use*
  • Humans
  • Methylene Blue / therapeutic use*
  • Shock / drug therapy*
  • Shock, Septic / drug therapy

Substances

  • Enzyme Inhibitors
  • Methylene Blue