In patients with septic shock, methylene blue (MB) initiated within 24 h reduced time to vasopressor discontinuation and increased vasopressor-free days at 28 days. It also reduced length of stay in ICU and hospital without adverse effects.

Our study supports further research regarding MB in larger randomized clinical trials.

Among 91 randomized patients, forty-five were assigned to MB and 46 to placebo.

The MB group had a shorter time to vasopressor discontinuation, one more day of vasopressor-free days at day 28 (p = 0.008), a shorter ICU length of stay by 1.5 days (p = 0.039) and shorter hospital length of stay by 2.7 days (p = 0.027) compared to patients in the control group.

Days on mechanical ventilator and mortality were similar.

There were no serious adverse effects related to MB administration.

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