Effect of Methylene Blue on Resuscitation After Haemorrhagic Shock

• Published in: The European journal of surgery 2001-10, Vol.167 (10), p.742-747
• Main Author: Jeroukhimov, Avi Weinbroum, Ron Ben-Avraham, Subhi Abu-Abid, Moshe Michowitz, Yoram Kluger, Igor
• Format: Article
• Language: English
• ISSN: 1102-4151; 1741-9271
• DOI: 10.3109/11024150152707716

Objective: To compare prehospital hypotensive resuscitation with volume resuscitation, and find out whether reagents that inhibit free-oxygen radical formation, such as methylene blue, can improve resuscitation and survival. Design: Randomised controlled trial. Setting: Animal laboratory, Israel. Animals: 48 adult male Wistar rats. Interventions: After 30 minutes of controlled haemorrhage, rats were subjected to 60 minutes of uncontrolled haemorrhage with simultaneous resuscitation. Hartmann's solution alone, or with blood or with a bolus of methylene blue were infused to maintain the mean arterial pressure (MAP) at 80 or 40 mm Hg. Then haemorrhage was stopped and Hartmann's solution plus whole blood were infused to obtain a MAP that was within normal limits. Main outcome measures: Volumes of shed blood and resuscitation fluids, MAP, packed cell volume, blood pH and base deficit, and survival. Results: During uncontrolled haemorrhage, a MAP of 80 mm Hg could not be reached in animals resuscitated with Hartmann's solution alone, and all died. All the rats given Hartmann's solution with a bolus of methylene blue or with whole blood achieved a higher MAP. MAP of 40 mm Hg was attained in all animals regardless of the resuscitation fluid. Only 15 of 24 animals resuscitated to a MAP of 80 mm Hg survived, compared with 22 survivors of the 24 rats resuscitated to a MAP of 40 mm Hg ( p