TY - JOUR
T1 - Methylene blue for vasoplegic syndrome in cardiopulmonary bypass surgery
T2 - A systematic review and meta-analysis
AU - Perdhana, Fajar
AU - Kloping, Nabila A.
AU - Witarto, Andro P.
AU - Nugraha, David
AU - Yogiswara, Niwanda
AU - Luke, Kevin
AU - Kloping, Yudhistira P.
AU - Rehatta, Nancy M.
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021/10
Y1 - 2021/10
N2 - 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.
AB - 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.
KW - Methylene blue
KW - cardiac surgery
KW - cardiopulmonary bypass
KW - nitric oxide
KW - vasoplegic syndrome
UR - http://www.scopus.com/inward/record.url?scp=85102139376&partnerID=8YFLogxK
U2 - 10.1177/0218492321998523
DO - 10.1177/0218492321998523
M3 - Review article
C2 - 33653154
AN - SCOPUS:85102139376
SN - 0218-4923
VL - 29
SP - 717
EP - 728
JO - Asian Cardiovascular and Thoracic Annals
JF - Asian Cardiovascular and Thoracic Annals
IS - 8
ER -