methylene blue

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Corilee Watters

Mar 10, 2016, 2:11:20 PM3/10/16

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.

Mar 10, 2016, 2:16:10 PM3/10/16

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.



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
K7L 2V7
Phone 613-549-6666 ext 6335
Fax 613-548-1325


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Corilee Watters

Mar 10, 2016, 2:46:24 PM3/10/16
Thanks Dr. Drover for the timely response,
Much appreciated,

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

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