Methylene blue administration in refractory distributive shock

Abstract

Refractory distributive shock is associated with excessive mortality in critically ill patients. Non-adrenergic vasopressors, including methylene blue, are often considered as an adjuvant therapy to the usual, catecholamine-based vasopressor treat-ment. In this narrative review we summarize the current scientific evidence on the use of methylene blue in the treatment of refractory distributive shock in different clinical situations.