OK, maybe not 101 uses, but more than I had been previously aware of. I was idly watching CCM-L e-mails drift past me and on into the Deleted folder, when a thread caught my attention. One of the regular participants wanted information on the use of Methylene Blue for refractory vasoplegia following on-pump cardiac surgery. The evidence for its benefit is limited, but here are some trials that were posted to the group to support its use (Thanks to Flavio Nacul, an intensivist practicing in Rio de Janeiro): |
- Kofidis T, Struber M, Wilhelmi M, Anssar M, Simon A, HarringerW, Haverich A. Reversal of severe vasoplegia with single-dose methylene blue after heart transplantation. J Thorac Cardiovasc Surg 2001;122:823—4.
- Pagni S, Austin EH. Use of intravenous methylene blue for the treatment of refractory hypotension after cardiopulmonary bypass. J Thorac Cardiovasc Surg 2000;119:1297—8.
A quick Google search also revealed several other uses for methylene blue beyond its familiar role in treating methaeoglobinaemia (See the previous article “Doctor … this man is blue“):
- It was previously used as an anti-malarial agent, but has since been superceded
- In combination with light therapy, it has been used in dermatology for Kaposi’s sarcoma and plaque psoriasis, as anti-viral therapy and as an investigational therapy in some cancers
- It is used in cancer surgery for sentinel node tracking and in general surgery to look for fistulas and anastomotic leaks.
- It is used in prophylaxis and therapy for ifosamide neurotoxicity (Br J Cancer. 2000 Jan;82(2):291-4. and Ann Pharmacother. 2006 Feb)
- It is used by keepers of tropical fish to treat fungal and parasitic infections of their floating darlings
- In the pre drink spiking era, it was a common university prank used to turn a victims urine blue-breen.
Just remember to check for G6PD deficiency (It can precipitate a haemolytic crisis) and severe renal failure before turning it on.