Abstract:

Septic shock is life-threatening, and noradrenaline is a first-line vasoactive drug for its treatment.High-dose administration of noradrenaline is associated with increased mortality. According to the 2016 Surviving Sepsis Campaign (SSC) guidelines, it is recommended to combine with other drugs to reduce its dosage when necessary.The 2021 SSC guidelines further suggest early administration in combination with other vasopressors instead of escalating the dose of norepinephrine. Methylene blue (MB) can increase mean arterial pressure (MAP) and systemic vascular resistance (SVR) and reduce the dosage of catecholamine vasoactive drugs, thereby reducing mortality rates and shortening ICU and hospital stays. MB is cost-effective domestically with no severe adverse reactions, making it a potential clinical option. However, further high-level research is required to confirm its role and enhance its position in combined medication. This article, based on existing literature reports, summarizes the timing, dosage, and administration methods of methylene blue in the treatment of sepsis shock, aiming to provide a reference for clinical treatment.

Key words: Septic shock, Methylene blue, Norepinephrine, Nitric oxide, Nitric oxide synthase