Use of Methylene Blue to Treat Vasoplegia Syndrome in Cystic Fibrosis Patients Undergoing Lung Transplantation: A Case Series

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dc.contributor.authorWashington, Gabriel Cen_US
dc.contributor.authorO扗onnell, Christian Ten_US
dc.contributor.authorJai, Madhoken_US
dc.contributor.authorWilliams, Kiah Men_US
dc.contributor.authorHill, Charles Cen_US
dc.date.accessioned2023-07-14T08:01:18Z
dc.date.available2023-07-14T08:01:18Z
dc.date.issued2023-03
dc.description.abstractBackground: Several studies have demonstrated the utility of methylene blue (MB) to treat vasoplegic syndrome (VS), but some have cautioned against its routine use in lung transplantation with only two cases described in prominent literature. Cystic fibrosis patients commonly have chronic infections which predispose them to a systemic inflammatory syndrome-like vasoplegic response during lung transplantation. We present 13 cystic fibrosis patients who underwent lung transplantation and received MB for vasoplegic syndrome while on cardiopulmonary bypass, with or without inhaled pulmonary vasodilator therapy. Methods: Single?center, retrospective, case series analysis of cystic fibrosis patients who underwent lung transplant and received MB for vasoplegia. We defined the primary outcome as 30-day mortality, and secondary outcomes as primary graft failure, 1-year mortality, postoperative complications, and hemodynamic response to MB. Results: MB was associated with a significant increase in mean arterial pressure (MAP) (P < 0.001) in all patients, and 84.6% (11/13) of the patients had either a decrease or no change in vasopressor requirement. No patients developed acute primary graft dysfunction and there was 100% 30?day and 1?year survival. One patient required Extracorporeal membrane oxygenation (ECMO) for hypoxemia and 69% (9/13) of the patients had evidence of postoperative right ventricular dysfunction, but no patients required a right ventricular assist device. Conclusion: This case series demonstrates the effectiveness of MB in treating vasoplegia in cystic fibrosis patients during lung transplantation, without evidence of primary graft dysfunction, 30?day or 1?year mortality. The safety of MB regarding hypoxemia and increased pulmonary vascular resistance requires further investigation.en_US
dc.identifier.affiliationsDepartment of Cardiac Anesthesia, Stanford University School of Medicine, Stanford, CA, USAen_US
dc.identifier.citationWashington Gabriel C, O扗onnell Christian T, Jai Madhok, Williams Kiah M, Hill Charles C. Use of Methylene Blue to Treat Vasoplegia Syndrome in Cystic Fibrosis Patients Undergoing Lung Transplantation: A Case Series. International Journal of Medical Research & Health Sciences. 2023 Mar; 26(1): 36-41en_US
dc.identifier.issn0974-5181
dc.identifier.issn0971-9784
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/219308
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber1en_US
dc.relation.volume26en_US
dc.source.urihttps://doi.org/10.4103/aca.aca_276_20en_US
dc.subjectCystic fibrosisen_US
dc.subjectlung transplanten_US
dc.subjectmethylene blueen_US
dc.subjectprimary graft dysfunctionen_US
dc.subjectpulmonary transplanten_US
dc.subjectvasoplegia syndromeen_US
dc.subjectvasoplegiaen_US
dc.titleUse of Methylene Blue to Treat Vasoplegia Syndrome in Cystic Fibrosis Patients Undergoing Lung Transplantation: A Case Seriesen_US
dc.typeJournal Articleen_US
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