Fortunately, there are many drugs that can help treat septic shock. A clinical trial has investigated one such drug known as methylene blue as an add-on therapy for the management of septic shock.
Septic shock is a medical emergency that can happen when an infection in your body triggers a dangerous inflammatory response. It is a life-threatening condition that happens when your blood pressure drops to a dangerously low level after an infection. This can lead to organ damage and even death. Antibiotics, fluid resuscitation, and vasopressor drugs such as norepinephrine are the standard first-line treatment for septic shock. Recently methylene blue has been proposed as an adjunct therapy for septic shock patients, however, strong clinical trials justifying its use have been limited.
Methylene blue is a medication that has been used for many years to treat a variety of conditions, including methemoglobinemia (a blood disorder) and cyanide poisoning. More recently, researchers have been exploring its potential use in sepsis. Its proposed mechanism for treating shock is by constriction of the blood vessels resulting in increased blood pressure.
Clinical TrialA clinical trial has found that early treatment with methylene blue may improve outcomes for patients with septic shock.
The trial involved 91 patients who were randomly assigned to receive either the methylene blue treatment or a placebo (a harmless substance with no therapeutic effect). 45 patients received methylene blue in addition to standard septic shock treatment while 46 patients received a placebo.
The primary outcome was time to vasopressor discontinuation at 28 days. Secondary outcomes included vasopressor-free days at 28 days, days on a mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days.
ResultsThe results of the clinical study showed that the methylene blue group had a shorter time to vasopressor discontinuation (69 h) compared to the control group (94 h). Additionally, the methylene blue group had more vasopressor-free days, a shorter length of ICU stay by 1.5 days, and a shorter duration of hospital stay by 2.7 days at the 28-day interval. The mortality rate and the days on the ventilator were similar in both groups.
These findings suggest that early treatment with methylene blue may be associated with better clinical outcomes. Patients who received the drug within the first 24 hours of developing septic shock had a significantly shorter duration of ICU and hospital stay compared to those who did not receive it.
The findings have important implications for the treatment of septic shock, which is a major cause of death in critically ill patients. They are significant as they add a new adjunct therapy option for septic shock management.
ConclusionThe clinical trial suggests that early adjunctive methylene blue treatment may improve outcomes for patients with septic shock. The drug has been used for many years for other medical conditions and may have the potential as an effective and safe treatment option for sepsis.
BMC Critical Care journal, Mar-13-23