Serotonin Syndrome Following Methylene Blue Administration for Vasoplegic Syndrome in Heart and Lung Transplantation – A Case Series

Serotonin syndrome is a potentially life threatening adverse drug reaction caused by excessive activation of postsynaptic serotonin receptors in the central nervous system (CNS). It is typically associated with the simultaneous administration of two or more selective serotonin reuptake inhibitors (SSRI) or as a result of a combination with another drug with similar serotonergic activity. The authors describe two cases of intraoperative vasoplegic syndrome necessitating the use of methylene blue (MB) as rescue therapy and subsequently causing serotonin syndrome in the intensive care unit (ICU).