Effect of methylene blue on refractory neonatal hypotension

W. Driscoll, S. Thurin, V. Carrion, Robin H Steinhorn, F. C. Morin

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Excess nitric oxide is a mediator of the hypotension in septic shock. Nitric oxide dilates vascular smooth muscle through activation of soluble guanylate cyclase. We report the increase in blood pressure caused by methylene blue (MB), a soluble guanylate cyclase inhibitor, in five neonates with presumed septic shock unresponsive to colloids, inotropic agents, and corticosteroids. MB was given intravenously at a dose of 1 mg/kg during a 1- hour period. MB increased blood pressure in each patient (average, 33% ± 20%). Blood pressure subsequently decreased to near baseline values in three patients, who then received a second infusion of MB. Blood pressure again increased in these patients. Three of five patients were weaned from inotropic support within 72 hours. Three of five patients survived and were discharged home. We suggest that MB increased blood pressure in these neonates with refractory hypotension.

Original languageEnglish (US)
Pages (from-to)904-908
Number of pages5
JournalJournal of Pediatrics
Issue number6
StatePublished - 1996
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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