Methylene Blue in Severe Sepsis and Septic Shock

Infusion of Methylene Blue in Severe Sepsis and Septic Shock: Randomized, Single Blinded

This study is to see whether the intravenous administration of methylene blue improves the outcome in severe sepsis and septic shock.

The mortality of septic shock is still high ranging from 30 to 50%. Vasopressor is the main part in managing septic shock, but the choice of vasopressor is still under-investigated, and area of uncertainty.

The response to vasopressor is sometimes unsatisfactory, and in that case, the outcome of the patients is poor.

Recently, small size clinical trial has investigated the effect of methylene blue (MB), and showed promising results. However, large sized phase III trial has not been performed yet.

Large sized phase III clinical trial is needed to establish the effect of MB in septic shock.

Inclusion Criteria:

• Septic shock meeting the criteria of 2012 surviving sepsis campaign
• Need the norepinephrine of over 0.2microgram/kg/min

Exclusion Criteria:

• Pregnancy
• Less than 18 years old
• Terminal cancer patients
• Declined consents
• glucose-6-phosphate dehydrogenase deficiency
• Medication of Serotonin modulator