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World J Crit Care Med. Sep 9, 2025; 14(3): 105350
Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.105350
Methylene blue in the critical care setting
Praveen Reddy Elmati, Teja Nagaradona, Vikas Raghove, Gowthami Sai Kogilathota Jagirdhar, Salim Surani
Praveen Reddy Elmati, Department of Anesthesiology, Saint Clair Hospital, Dover, NJ 07801, United States
Teja Nagaradona, Department of Medicine, St George University, School of Medicine, Granada SW17 0BD, West Indies
Vikas Raghove, Department of Anesthesia, IU Health Ball Memorial Hospital, Munice, IN 47303, United States
Gowthami Sai Kogilathota Jagirdhar, Department of Gastroenterology, Saint Michaels Medical Center, Newark, NJ 07107, United States
Salim Surani, Department of Medicine and Pharmacology, Texas AM University, College Station, TX 77843, United States
Author contributions: Elmati PR and Jagirdhar GSK designed the overall concept and outline of the manuscript; Elmati PR, Raghove V, Jagirdhar GSK, and Nagaradona T performed the research and analyzed the data; Elmati PR, Raghove V, Jagirdhar GSK, Nagaradona T, and Surani S contributed to the manuscript’s writing and editing; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, MD, Professor, Department of Medicine and Pharmacology, Texas AM University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: January 20, 2025
Revised: March 21, 2025
Accepted: April 21, 2025
Published online: September 9, 2025
Processing time: 181 Days and 0.3 Hours
Core Tip

Core Tip: Methylene blue is a promising medication with various benefits due to its inhibition of guanylate cyclase, anti-inflammatory effects, and nitric oxide inhibition. It has been researched in septic shock, distributive shock in cardiac procedures, anaphylaxis, and organ transplant procedures. It is a safe medication based on literature with rare documented adverse events at lower doses. Its role as an adjunct to vasopressors needs to be further researched, including the definition of the dose, initiation time, and usage duration.