THIOCYANATE, SERUM OR PLASMA

Code
000.0000
Name
THIOCYANATE, SERUM OR PLASMA
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Nipride, Nitropress Administration, Rhodanide, Sodium Nitroprusside
CPT Codes
84430
Site
SBMF
Reference Test
44432
ATLAS Test Code

Specimen Information

Type

Red, Plain

Volume

1.0 ml

Transport Info

Centrifuge and immediately transfer serum to separate plastic tube
Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

Nonsmoker: 1-4 µg/mL
Smoker: 3-12 µg/mL
Toxic: > 50 µg/mL
Values seen with nitroprusside therapy: 6-29 µg/mL

Methodology

Quantitative Colorimetric

Clinical Significance

A potential contributor to elevated thiocyanate is therapy for hypertensive emergencies with sodium nitroprusside (SNP). Thiocyanate toxicity may occur with long-term nitroprusside use (longer than seven to 14 days with normal renal function and three to six days with renal impairment at greater than 2 µg/kg/min infusion rates). In patients with renal or hepatic impairment and to whom thiosulfate is administered to convert cyanide to thiocyanate, a greater potential exists. Thiocyanate levels may be monitored on an every-other-day basis to assess potential thiocyanate toxicity and, if levels steadily increase, to indicate a possible reduction in dosage. It is recommended that prior to or immediately after SNP therapy begins, a baseline for thiocyanate be obtained. Thiocyanate in serum has historically been monitored as an assessment of the effectiveness of cigarette smoking cessation programs, although this is being replaced by direct measurement of nicotine and its metabolite cotinine in serum and urine. Thiocyanate has some utility as long as dietary guidelines are included. When consumed in excess, some foods contribute to slight elevations in serum thiocyanate concentrations. These elevations are not clinically significant, but may make it difficult to separate non-smokers from smokers. Common foods that may contribute to increases in thiocyanate levels are milk, almonds, cashews, garlic, onion, leeks, cabbage, and cauliflower. A 24-hour urine thiocyanate determination may be of some benefit for smoking cessation programs; random urine determinations are of little clinical benefit.

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