Vasoplegic Endothelial Dysfunction

This unique work presents one of the most significant organ failure condition – cardiocirculatory shock – and the prominent role of Methylene Blue (MB). Through their extensive experience, the authors’ consider that the lifesaving feature of MB is still underestimated. For this reason they outline key concepts of MB, mentioning essential experimental data, yet focusing mainly on its application in the care of critically ill patients.

In an easy-to-read format, the 18 chapters were organized in a didactically structured order, distributed in four parts. The first part introduces the general conceptual aspects and physiology of the endothelium. The second part presents the particularities of endothelial dysfunction in different types of shock. Methylene blue is discussed in detail in the third part. In the fourth part, particular situations of endothelial dysfunction, such as heart surgery and organ transplantation, are described. Additionally, the two complementary subjects of acid-base balance and the therapeutic use of inhaled nitric oxide are mentioned.

Finally, looking for therapeutic alternatives for what we classify as "vasoplegic endothelial dysfunction", MB remains promising as an adjuvant to sympathomimetic amines. The combination of three recently proposed concepts may be useful in obtaining better results against the high mortality rates in critically ill patients. These three concepts are "wide-spectrum vasopressors", vasopressor economy strategies, and microcirculation protection against the harmful effects of using high concentrations of amines.

This book´s translational approach will appeal to a variety of readers within the health specialties of medicine, biomedicine, physiotherapy, nursing, odontology, and basic science.

Part I - General Conceptual Aspects.- Introduction.- Physiology of the Endothelium.- PART 2– PARTICULARITIES OF ENDOTHELIAL DYSFUNCTION IN DIFFERENT TYPES OF SHOCK.- Circulatory Shock: A Conceptual and Practical Approach.- Circulatory Shock, Ischemia Reperfusion Injury, Inflammatory Response Syndrome (SIRS) and Multiple Organ Failure.- Endothelial Dysfunction in Hemorrhagic Shock.- Endothelial Dysfunction in Cardiogenic Shock.- Endothelial Dysfunction in Distributive Shock.- PART 3– METHYLENE BLUE.- Methylene blue.- The Inhibition of Guanylate Cyclase by Methylene Blue as Therapeutic Proposal for Vasoplegia Associated with Shock.- Methylene Blue in the Treatment of Anaphylaxis.- Methylene Blue in Children and Neonates.- Methylene Blue and Burns.- Cardiac arrest and neuroprotection by methylene blue.- Methylene Blue and Endocarditis.- PART 4 – ENDOTHELIAL DYSFUNCTION IN SPECIFIC SITUATIONS.- Vasoplegic syndrome in heart surgery.- Vasoplegic Endothelial Dysfunction In Orthotopic Liver Transplantation.- Acid-base Balance.- The therapeutic use of inhaled nitric oxide.