Role of Methylene Blue Nebulisation in Post COVID-19 patients for Improving Lung Function and Oxygenation; A Pilot Study
Tripathi, M., Malviya, D., Mishra, S., Rai, S., Mishra, S., Das, P., Kumar, V. (2024). Role of Methylene Blue Nebulisation in Post COVID-19 patients for Improving Lung Function and Oxygenation; A Pilot Study. EKB Journal Management System, 16(1), -. doi: 10.21608/asja.2024.301102.1121
Manoj Tripathi; Deepak Malviya; Smarika Mishra; Sujeet Rai; Shilpi Mishra; Praveen Kumar Das; Virendra Kumar. "Role of Methylene Blue Nebulisation in Post COVID-19 patients for Improving Lung Function and Oxygenation; A Pilot Study". EKB Journal Management System, 16, 1, 2024, -. doi: 10.21608/asja.2024.301102.1121
Tripathi, M., Malviya, D., Mishra, S., Rai, S., Mishra, S., Das, P., Kumar, V. (2024). 'Role of Methylene Blue Nebulisation in Post COVID-19 patients for Improving Lung Function and Oxygenation; A Pilot Study', EKB Journal Management System, 16(1), pp. -. doi: 10.21608/asja.2024.301102.1121
Tripathi, M., Malviya, D., Mishra, S., Rai, S., Mishra, S., Das, P., Kumar, V. Role of Methylene Blue Nebulisation in Post COVID-19 patients for Improving Lung Function and Oxygenation; A Pilot Study. EKB Journal Management System, 2024; 16(1): -. doi: 10.21608/asja.2024.301102.1121

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  XML PDF (297.58 K)
Document Type: Original Article
DOI: 10.21608/asja.2024.301102.1121
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Authors
Manoj Tripathi email orcid 1; Deepak Malviyaorcid 2; Smarika Mishraorcid 3; Sujeet Raiorcid 4; Shilpi Mishraorcid 5; Praveen Kumar Dasorcid 6; 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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