Azul de metileno no tratamento da síndrome vasoplégica em cirurgia cardíaca. quinze anos de perguntas, respostas, dúvidas e certezas


Autoria(s): Evora, Paulo Roberto Barbosa; Ribeiro, Paulo José de Freitas; Vicente, Vilella de Andrade; dos Reis, Celso Luís; Rodrigues, Alfredo José; Menardi, Antonio Carlos; Alves Jr., Lafaiete; Evora, Patrícia Martinez; Bassetto, Solange
Contribuinte(s)

Universidade Estadual Paulista (UNESP)

Data(s)

27/05/2014

27/05/2014

01/07/2009

Resumo

Objective: There is strong evidence that methylene blue (MB), an inhibitor of guanylate cyclase, is an excellent therapeutic option for vasoplegic syndrome (VS) treatment in heart surgery. The aim of this article is to review the MB's therapeutic function in the vasoplegic syndrome treatment. Methods: Fifteen years of literature review. Results: 1) Heparin and ACE inhibitors are risk factors; 2) In the recommended doses it is safe (the lethal dose is 40 mg/ kg); 3) The use of MB does not cause endothelial dysfunction; 4) The MB effect appears in cases of nitric oxide (NO) up-regulation; 5) MB is not a vasoconstrictor, by blocking of the GMPc system it releases the AMPc system, facilitating the norepinephrine vasoconstrictor effect; 6) The most used dosage is 2 mg/kg as IV bolus followed by the same continuous infusion because plasmatic concentrations strongly decays in the first 40 minutes; 7) There is a possible window of opportunity for the MB's effectiveness. Conclusions: Although there are no definitive multicentric studies, the MB used to treat heart surgery VS, at the present time, is the best, safest and cheapest option, being a Brazilian contribution for the heart surgery.

Formato

279-288

Identificador

http://dx.doi.org/10.1590/S0102-76382009000400005

Brazilian Journal of Cardiovascular Surgery, v. 24, n. 3, p. 279-288, 2009.

0102-7638

1678-9741

http://hdl.handle.net/11449/71059

10.1590/S0102-76382009000400005

S0102-76382009000400005

2-s2.0-72649091145

2-s2.0-72649091145.pdf

Idioma(s)

por

Relação

Brazilian Journal of Cardiovascular Surgery

Direitos

openAccess

Palavras-Chave #Cardiovascular surgical procedures #Extracorporeal circulation #Methylene blue #Postoperative complications #Vascular diseases #Vascular resistance/drug effects #guanylate cyclase #methylene blue #dose response #drug antagonism #heart surgery #human #vasoplegia #Cardiac Surgical Procedures #Dose-Response Relationship, Drug #Guanylate Cyclase #Humans #Methylene Blue #Vasoplegia
Tipo

info:eu-repo/semantics/article