Does methylene blue improve outcomes in patients with post-cardiac surgery vasoplegic syndrome?

The summation of the best available evidence, which was limited to small clinical trials and observational studies, suggests that the adjunctive administration of methylene blue for refractory post-CPB vasoplegic syndrome is safe and may provide benefits in terms of improved haemodynamic stability, reduction in vasopressor requirements and reduced mortality. Questions surrounding the optimal timing of methylene blue administration, as prophylactic, adjunctive, or rescue therapy for vasoplegic syndrome, require further investigation.