Linakis J G, Lacouture P G, Woolf A
Program in Clinical Pharmacology/Toxicology, Children's Hospital, Harvard University, Massachusetts Poison Control System, Boston.
Pediatr Cardiol. 1991 Oct;12(4):214-8. doi: 10.1007/BF02310568.
Over a 19-month period, all requests for blood cyanide and/or serum thiocyanate concentrations to the Clinical Laboratory of The Children's Hospital, Boston, were reviewed in order to determine how physicians screen for nitroprusside-related toxicity. During that period, 52 patients receiving nitroprusside were monitored for cyanide and/or thiocyanate toxicity. Overall, there were 62 cyanide and 86 thiocyanate determinations. None of the thiocyanate determinations and five of the cyanide concentrations were within the toxic range as established by the reference laboratory, and no patient displayed signs or symptoms of toxicity which could not also be explained by their underlying illness. Our findings suggest that while physicians are concerned with nitroprusside toxicity in children, there exists no apparent consensus as to how to monitor for this toxicity. The results also indicate that the relationship between blood cyanide or serum thiocyanate concentrations and clinical evidence of toxicity is not straightforward and requires further delineation.
在19个月的时间里，对波士顿儿童医院临床实验室收到的所有血液氰化物和/或血清硫氰酸盐浓度检测请求进行了审查，以确定医生如何筛查硝普钠相关毒性。在此期间，对52名接受硝普钠治疗的患者进行了氰化物和/或硫氰酸盐毒性监测。总体而言，共进行了62次氰化物和86次硫氰酸盐检测。硫氰酸盐检测结果均不在参考实验室确定的毒性范围内，氰化物浓度检测中有5次超出范围，且没有患者表现出无法用其基础疾病解释的毒性体征或症状。我们的研究结果表明，虽然医生关注儿童硝普钠毒性，但对于如何监测这种毒性尚无明显共识。结果还表明，血液氰化物或血清硫氰酸盐浓度与毒性临床证据之间的关系并不直接，需要进一步明确。
