Role of Methylene Blue Nebulisation in Post COVID-19 patients for Improving Lung Function and Oxygenation; A Pilot Study | ||
| Ain-Shams Journal of Anesthesiology | ||
| Volume 16, Issue 1, 2024 PDF (297.58 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asja.2024.301102.1121 | ||
| Authors | ||
| Manoj Tripathi* 1; Deepak Malviya2; Smarika Mishra3; Sujeet Rai4; Shilpi Mishra5; Praveen Kumar Das6; Virendra Kumar7 | ||
| 1Department of Anesthesia & Critical Care, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India | ||
| 2Department of Anaesthesia & Critical Care, HIMS, Lucknow, UP, India | ||
| 3Department of Anaesthesia & Critical Care, Dr Ram Manohar Lohia Institute of Medical Sciences , Lucknow, UP India | ||
| 4Department of Anaesthesia & Critical Care, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP India | ||
| 5, Department of Anaesthesia & Critical Care, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India | ||
| 6Department of Anaesthesia & Critical Care, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow,UP, India | ||
| 7Department of Anaesthesia & Critical Care, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India | ||
| Abstract | ||
| Background- In covid-19 pneumonia, due to excessive formation of cytokines and hypercoagulability, lung damage occurs and may progress to multiorgan failure and vasoplegic shock. There have been studies where methylene blue, when given intravenously to treat covid patients, showed positive outcomes. Still, no study or case report has shown its effect when given via nebulization. Methods- In this pilot study, In all patients, Routine blood investigations, Arterial blood gas (ABG), serum lactate dehydrogenase (LDH) level, coagulation profile, d-dimer and chest x-ray were sent. As a standard of care protocol, the patient received supplemental oxygen support, intravenous fluids, antiviral agent, antibiotics, anticoagulants and steroid therapy if neededwe have used methylene blue nebulisation in Post COVID-19 patients to improve oxygenation. All post covid patients were nebulized with methylene blue [1ml (10mg) + 4ml Normal Saline] 12 hourly and an ABG sample was obtained after 1 hour of nebulization with standard of care ICU management. Results-Four of six patients improved and were discharged from ICU, while two patients expired. Their bad outcome may be due to comparatively worse conditions at admission, having high SOFA scores and APACHE II scores that themselves predict high mortality. HRCT has been improved in all four survived patients and this improvement was found statistically significant (P< 0.001). Conclusion- In our study we concluded that Methylene blue nebulisation seems to be effective novel method for post covid patients in reducing fibrosis and increasing oxygenation with better intensive care outcome. | ||
| Keywords | ||
| APACHE II; Covid-19 ARDS; Methylene blue; SOFA score; Covid-19 Lung fibrosis | ||
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