Methylene Blue Administration in Septic Shock: A Retrospective Cohort Study
Authors' conclusion
Use of MB in septic shock is rare in the United States, but with substantial inter-hospital variability and decreased use over time through 2020.
Study context
- Population
- US adults (≥ 18 yr) with septic shock (sepsis with vasopressor administration), Premier Healthcare Database hospitals, 2008–2021
- Participants
- 859,868 adults · 1,100 centers
- Exposure
- Methylene blue (MB) dose and hospital outcomes
- MBn = 4,082
- Outcome
- Hospital mortality
Methodological detailsmulticentre, mixed-effects multivariable regression, restricted cubic spline
- Multicentre
- Mixed-effects multivariable regression
- Restricted cubic spline
Main finding
As reported in the abstract
Hospital mortality, MB within first 3 hospital days
MB
15.0%
375
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| MB utilization | MB 0.5% |
MB utilization
- Given in 663 hospitals; recipients younger and received major surgery; larger urban teaching hospitals
- After adjustment, MB use lower in 2016-2020 than in 2008
Original publication
Methylene Blue Administration in Septic Shock: A Retrospective Cohort Study. Crit Care Med. Published 31 October 2025. doi:10.
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