This systematic review and meta-analysis evaluated the effect of MB in three RCTs. They found that MB treatment significantly reduced time to vasopressor discontinuation, days on mechanical ventilation, and length of ICU stay.

MB is an interesting approach in reducing fluid overload and vasoactive drug administration.

The inhibition of guanylate cyclase induced by MB infusion reduces nitric oxide production and improves vasoconstriction.

Based on this rationale, MB was administered in different scenarios, mainly in patients with vasodilatory shock. However, contradictory results were observed regarding improving systemic vascular resistance and mortality.

Moreover, MB was only administered to patients with sepsis and septic shock in the three selected RCTs for this study.

Although more studies are necessary in the future, the findings of this meta-analysis suggest that MB could be a promising sparing vasopressor agent in patients with sepsis and septic shock.

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