• Arq. Bras. Cardiol. · Mar 1994

    [Thiocyanate toxicity arising from prolonged use of sodium nitroprusside in severe heart failure].

    • S G Lage, R T Carvalho, L Kopel, M C Monachini, G Bellotti, and F Pileggi.
    • Instituto do Coração, Hospital das Clínicas, FMUSP.
    • Arq. Bras. Cardiol. 1994 Mar 1;62(3):155-7.

    PurposeTo evaluate the toxicity of thiocyanate induced by the infusion of sodium nitroprusside in patients with severe congestive failure.MethodsWe studied 23 patients with congestive heart failure, in class IV (NYHA) under continuous infusion of sodium nitroprusside with doses varying between 0.5 and 5.5 micrograms/kg/min. Clinical evaluation, thiocyanate serum dosage and laboratorial evaluation of renal, hepatic and pulmonary functions were done.ResultsSeventeen patients (74%) presented toxic levels of thiocyanate (over 10 micrograms/ml), with the average of 29.9 +/- 4.4 micrograms/ml. Only renal function was related to the presence of intoxication. Clinical evaluation was not accurate to diagnose the thiocyanate toxicity in the patients.ConclusionSodium nitroprusside is potentially toxic, especially when the renal function is abnormal. Thiocyanate dosage is useful in diagnosing nitroprusside induced toxicity and then it contributes to an adequate treatment and prevention of clinical toxicity.

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