ACMT Toxicology Visual Pearl: Is the Silver Bullet for Refractory Vasoplegia Really Blue?

catecholamine-resistant vasoplegia methylene blue

What is the proposed mechanism for the pictured antidote when used as a pressor for refractory vasoplegic shock?

  1. Alpha-1-adrenergic agonist
  2. Angiotensin II receptor antagonist
  3. Nitric oxide/cyclic GMP pathway inhibition
  4. Vasopressin-1 receptor agonist