<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092016000200102</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Eficacia del azul de metileno como coadyuvante en el tratamiento de pacientes con choque séptico]]></article-title>
<article-title xml:lang="en"><![CDATA[Methylene blue&#8217;s effectiveness as an adjuvant in the treatment of patients with septic shock]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar Arzápalo]]></surname>
<given-names><![CDATA[Mario Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López Avendaño]]></surname>
<given-names><![CDATA[Víctor Gabriel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escalante Castillo]]></surname>
<given-names><![CDATA[Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Góngora Mukul]]></surname>
<given-names><![CDATA[Jimmy José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Franco Herrera]]></surname>
<given-names><![CDATA[Benjamín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cetina Cámara]]></surname>
<given-names><![CDATA[Marco Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General «Agustín O&#8217;Horán»  ]]></institution>
<addr-line><![CDATA[Mérida Yucatán]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>30</volume>
<numero>2</numero>
<fpage>102</fpage>
<lpage>110</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092016000200102&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092016000200102&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092016000200102&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Antecedentes: La vasodilatación generalizada con hipotensión que no responde al tratamiento convencional se encuentra presente en la mitad de los pacientes que mueren de septicemia. El azul de metileno puede ser un valioso complemento en el tratamiento de la hipotensión refractaria. En este estudio se determina la eficacia del azul de metileno como coadyuvante en el tratamiento del choque séptico.  Material y métodos:  Se realizó un ensayo clínico controlado, aleatorizado, doble ciego. Se estudiaron dos grupos de 30 individuos cada uno: el grupo A recibió azul de metileno en dosis única de 2 mg/kg de peso en 100 cm3 de solución glucosada al 5% infundida en 60 minutos, y el grupo C (control) recibió 100 cm3 de solución glucosada al 5% infundida en 60 minutos. Se realizaron mediciones basales de las variables de estudio (TAM, lactato, déficit de base, saturación venosa central y delta de CO2) antes de la administración y posteriormente horarias hasta que remitió el estado de hipoperfusión, manteniendo una TAM &gt; 65 mmHg sin el uso de vasopresores, o se cumplieron 72 horas desde el inicio del estado de choque. Se contabilizó la dosis acumulada de vasopresor convertida a miligramos equivalentes de noradrenalina, días de estancia, días ventilación mecánica y mortalidad.  Resultados:  La TAM presentó aumento progresivo en las primeras seis horas tras la infusión de azul de metileno en el grupo A de 22% y en el grupo C de 9.2% (p: &lt; 0.05), manteniéndose hasta las 72 horas de monitoreo. La dosis de noradrenalina a las seis horas se redujo en el grupo A 86%; en el grupo C fue de 56% (p: &lt; 0.05). El aclaramiento del lactato a las seis horas en el grupo A fue de 62%; en contraste, en el grupo C se halló un aclaramiento de 33% (p: &lt; 0.05). La mortalidad al egreso en el grupo A fue de 20.0% y en el grupo C fue de 36.6% (p: &lt; 0.05), sin variación a 21 días.  Conclusión:  El azul de metileno es eficaz como coadyuvante en el tratamiento de sujetos con choque séptico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background: Generalized vasodilation with nonresponding hypotension is present in half of death cases due to septicemia. Methylene blue could be used as a valuable adjuvant in the treatment of refractory hypotension. The aim of this study was to determine the effectiveness of methylene blue as a contributory treatment in patients with septic shock.  Material and methods:  A controlled, randomized, double-blinded, clinical trial was performed. Sixty patients were divided in two groups. Group A received a single dose of methylene blue calculated 2 mg/kg per body weight diluted in 100 cm3 of 5% dextrose infused in 60 minutes, and group C (control) received 100 cm3 of 5% dextrose infused in 60 minutes. Basal measurements of the study variables were taken (MBP, lactate, base deficit, central venous saturation and CO2 delta) prior to the administration of methylene blue and every hour afterwards, until MBP &gt; 65 mmHg without vasopressor or 72 hours had passed after shock began. Data about total noradrenaline dose in mg, length of stay, length of mechanical ventilation and mortality was recorded.  Results:  MBP increased progressively the first six hours after the methylene blue infusion in group A, 22%, and in group C, 9.2% (p: &lt; 0.05), steadily during the 72-hour follow-up. The noradrenaline dose decreased in the first six hours, in group A 86%, in group C, 56% (p: &lt; 0.05). Lactate clearance in the first six hours was 62% in group A; in contrast, group C had a 33% clearance (p: &lt; 0.05). Mortality at ICU discharge on group A was 20.0% and on group C was 36.6% (p: &lt; 0.05), without variation on 21 days.  Conclusion:  Methylene blue is effective as an adjuvant in the treatment of septic shock.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Azul de metileno]]></kwd>
<kwd lng="es"><![CDATA[choque séptico]]></kwd>
<kwd lng="en"><![CDATA[Methylene blue]]></kwd>
<kwd lng="en"><![CDATA[septic shock]]></kwd>
</kwd-group>
</article-meta>
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