Publication Name	World Journal of Clinical Cases
Manuscript ID	117947
Country	India

Category	Critical Care Medicine
Manuscript Type	Minireviews
Article Title	Methylene blue - an emerging vasopressor
Manuscript Source	Invited Manuscript
All Author List	Tapesh Bansal
Funding Agency and Grant Number
Corresponding Author	Tapesh Bansal, Consultant, Head, MRCP, President, Department of Intensive Care and Medicine, Paras Hospitals, C 43 Sushant lok, Gurgaon 122002, Haryāna, India. tapeshbansal1@gmail.com
Key Words	Methylene blue; Vasodilatory shock; Septic shock; Nitric oxide pathway; Vasoplegia; Adjunctive vasopressor therapy; Ifosamide
Core Tip	Methylene blue (MB) is a mechanistically rational adjunct vasopressor that targets nitric oxide (NO)-mediated vasodilation in septic shock. When used early and within safe cumulative dose (≤ 4 mg/kg), it consistently reduces vasopressor requirements without toxicity. Unlike non-selective NO synthase inhibitors, MB selectively modulates the NO-guanylate cyclase-cyclic guanosine monophosphate pathway by inhibiting only the inducible NO synthase isoform of NO synthase, preserving physiological constitutive functions. Current evidence supports its use as an adjunct rather than rescue therapy, pending results from ongoing randomized trials. In this narrative review we present the facts and data on MB with no fluff!
Citation	Bansal T. Methylene blue - an emerging vasopressor. World J Clin Cases 2026; In press

Received	2025-12-22 01:51
Peer-Review Started	2025-12-23 00:22
First Decision by Editorial Office Director	2025-12-31 07:52
Return for Revision	2025-12-31 07:52
Revised	2026-02-14 02:08
Publication Fee Transferred
Second Decision by Editor	2026-04-01 02:39
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-01 07:36
Articles in Press	2026-04-01 07:36
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2307-8960 (online)
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