SHM Converge Scientific Abstract ePoster Gallery-Can the Use of Methyleneblue in Septic Shock Be Life-Saving?

Pdf Summary

This case report describes a 66-year-old woman with septic shock from an obstructing ureteral stone and urinary tract infection. Despite aggressive treatment—including 3 liters of IV fluids, antibiotics, emergent urologic stenting, stress-dose steroids, bicarbonate for metabolic acidosis, and three vasopressors—her mean arterial pressure (MAP) remained below 60 mmHg and she appeared critically ill.<br /><br />Because she was not responding to standard therapy, methylene blue was given as a rescue agent. Soon after administration, her MAP rose rapidly to above 100 mmHg and her vasopressor needs decreased. She later improved enough to be transferred out of the ICU and discharged back to rehabilitation.<br /><br />The authors explain that methylene blue may help in vasodilatory shock by inhibiting guanylate cyclase and reducing nitric oxide-mediated vasodilation, thereby restoring vascular tone. While studies suggest methylene blue can improve blood pressure and reduce vasopressor requirements, there is no clear evidence that it lowers mortality.<br /><br />Overall, the report argues that methylene blue can be a useful rescue vasopressor in refractory septic shock when conventional measures fail, but it remains an adjunctive therapy rather than a standard first-line treatment.

Asset Subtitle

Sara Hassan

Meta Tag

Author List Dhiren Shah, Jose Iglesias, Sara Hassan

Category Clinical Vignettes

Concept Methylene Blue

Concept Septic Shock

Concept Muscle Tone

Concept Vasopressor

Concept Hypotension

Distinguished Non-Finalist

Presenter Organization Ocean University Medical Center

Presenting Author Sara Hassan

Track Adult

Keywords

septic shock

methylene blue

vasopressor

obstructing ureteral stone

urinary tract infection

refractory hypotension

mean arterial pressure

ICU

vasodilatory shock

rescue therapy

Methylene Blue

Septic Shock

Muscle Tone

Vasopressor

Hypotension