Methylene Blue in Preventing Hemodynamic and Metabolic Derangement Following Superior Mesenteric Artery Clamping/Unclamping: An Intratracheal vs. Intraperitoneal Dose-Response Study

Intestinal ischemia-reperfusion affects hemodynamics. We studied intratracheal vs. intraperitoneal methylene blue (MB) attenuation of hemodynamic and metabolic deterioration following superior mesenteric artery (SMA) clamping/unclamping. Murine SMAs (5/group) were clamped for 1 h. MB (2, 6, 20, or 60 mg/kg [MB-2, MB-6, MB-20, and MB-60]) was administered intraperitoneally or intratracheally 10 min before unclamping. Observation continued for another 3 h. Circulating xanthine oxidase and base deficit levels doubled among ischemia non-treated and ischemia MB-2- and MB-60-treated groups, blood pressure decreased by 50%, and heart rate increased by 35%, compared to controls (non-clamped/unclamped and non-MB-treated rats, P < 0.01). These three ischemia groups needed 3-fold the amount of fluid to maintain systolic pressure > or =60 mmHg than controls (P < 0.01). Only the MB-6 and MB-20 intraperitoneal and intratracheal regimens similarly afforded hemodynamic stability in ischemic animals; base deficit and resuscitation volumes normalized as well. No drug regimen affected heart rate. We concluded that intraperitoneal and intratracheal MB at specific doses prevented systemic derangement following SMA clamping/unclamping.