Green heart: Methylene blue administration in a hemodynamically unstable infant following cardiac arrest due to parental co-sleeping.

We report the autopsy case of a female 10-month-old infant who presented with cardiocirculatory arrest due to hypoxia secondary to compressive asphyxia due parental co-sleeping on the sofa. Despite advanced life support, vasoactive therapy, and rescue administration of methylene blue for refractory vasoplegic shock, no hemodynamic improvement was achieved, and death occurred following recurrent cardiac arrest. Autopsy revealed a bluish-green discoloration of the myocardium with no structural cardiac abnormalities. To our knowledge, this is the first pediatric case describing the autoptic findings following the use of methylene blue.