This is EMKases, EM Quick Hits podcast.

Quick. Let's get on with it.

EM cases is part of Shremie, the Schwartz-Riseman Emergency Medicine Institute.

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Over the last two decades, there has been a ton of work on sepsis and septic shock,

a ton of data that has come out, and it has been a real focus of our management to improve

care in sepsis and septic shock in order to reduce mortality and morbidity.

There are some core pieces to our management, including early antibiotics after recognition,

source identification and control, IV fluids, although we know there's a lot of debate on

exactly how much and what kind, but I think most people are okay with giving some fluids,

and then vasopressers to maintain perfusion.

While there's a host of research on improving those pieces, there's also continued focus

on additional interventions that may be useful. And one that's starting to get a lot of attention

is methylene blue. Most of us are familiar with Methylene Blue as the antidote for

hemoglobinemia, but this is a very different use. Methylene Blue has a number of

interesting physiologic effects, which is why it's being investigated for this use.

It inhibits inducible nitric oxide synthase as well as its downstream enzyme soluble guanolate cyclase.

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