Methylene Blue to Neonatal Septic Shock treatment in neonate pigs^,

Abstract

Objective

The authors design an animal model of neonatal sepsis to analyze the treatment of neonatal septic shock with Methylene Blue (MB) in a swine model.

Methods

The study design included twenty male newborn pigs divided into four groups: 1) The control group; 2) The sepsis group (induced with lipopolysaccharide); 3) The MB group, and 4) The MB-treated sepsis group. Septic shock was defined as Blood Pressure (BP) dropping 20% below the baseline value. Continuous Blood Pressure (BP), Nitric Oxide (NO) levels, cyclic Guanosine Monophosphate (cGMP), malondialdehyde acid, base excess, lactate, arterial blood gases, hematocrit, and echocardiography were analyzed.

Results

The BP of the sepsis group treated with MB showed a slight improvement in the first hour after treatment; however, a significant difference was not observed compared to the untreated sepsis group. Besides hemodynamic stability, the current study did not show symptomatic pulmonary hypertension, suggesting that MB was safe in neonates and children. An improvement in Base Excel (BE) levels after MB administration in septic animals may indicate a possible improvement in microcirculation.

Conclusion

The MB improved biomarkers related to septic shock prognosis, although an improvement in the blood levels could not be detected. MB might be a beneficial drug for hemodynamic instability in infants.

Keywords
Methylene blue; Septic shock; Vasoplegic syndrome; Nitric oxide; Infants; Newborn

Highlights

• MB improved septic shock biomarkers associated with microcirculation, however, did not improve blood pressure.

• The MB was not associated with pulmonary hypertension and respiratory clinical repercussions.

• The MB did not decrease the heart inotropic or chronotropic aspects.