methylene blue

[Corilee Watters]

Just found out that our trauma surgeons are using blue dye on an occasional basis to detect GI perforations. For example wanting to do a one a time enteral feeding with methylene blue dye for a multiple gunshot wound patient.

Very aware of the 2003 FDA guidelines for methylene blue, however methylene blue is still available in Pharmacy.

UptoDate indicates methylene blue can be used to " identify sentinel lymph nodes"; and  "Dye studies may be useful for evaluating patients with a pleural effusion and a thoracostomy tube who are suspected to have an esophageal leak. Methylene blue introduced cautiously via a nasoesophageal tube will make or confirm the diagnosis by causing blue discoloration of the chest tube drainage. "

Welcome your perspective regarding one time administration of blue dye.

Corilee Watters, PhD, RD| Assistant Director, Food & Nutrition Service

Zuckerberg San Francisco General Hospital & Trauma Center|

1001 Potrero Avenue, Suite Rm 2D4 | San Francisco, CA 94110

Phone: 415-206-4539

[Drover, Dr. John W.]

Hi Corilee,

To be clear methylene blue and the blue dye associated with worsening outcomes in sepsis are 2 different molecules. Methylene blue is not contraindicated and has even been used as an intravenous drug to treat septic shock in small randomized trials. Methylene blue acts as a selective iNOS inhibitor.

Cheers

 

John W. Drover, MD, FRCSC, FACS, CCPE
Professor and Head
Department of Critical Care Medicine
Queen’s University
Program Medical Director, Critical Care Program
Davies 2
Kingston General Hospital
76 Stuart Street
Kingston, Ontario
Canada
K7L 2V7
Phone 613-549-6666 ext 6335
Fax 613-548-1325

 

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[Corilee Watters]

Thanks Dr. Drover for the timely response,

Much appreciated,

Corilee

--

Dr. Corilee Watters, MSc, RD, PhD, CNSC
Asst. Professor Nutrition, University of Hawaii
Department of Human Nutrition, Food and Animal Science
1955 East-West Road, Agricultural Science 314 J,    Honolulu, HI  96822
ph: 808-956-7581  fax:  808-956-4024
e-mail: cwat...@hawaii.edu