{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:49:09Z","timestamp":1781329749896,"version":"3.54.1"},"reference-count":16,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2016,7,19]],"date-time":"2016-07-19T00:00:00Z","timestamp":1468886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study evaluated thiocyanate concentrations and factors associated with thiocyanate accumulation in intensive care unit patients receiving nitroprusside with and without sodium thiosulfate coadministration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This retrospective study evaluated critically ill adults who received nitroprusside infusions and had at least one thiocyanate concentration. Patients with thiocyanate accumulation (concentrations \u226530 \u00b5g\/mL) were compared to patients without accumulation. Factors associated with accumulation were determined by Spearman correlation and multivariate regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thiocyanate concentrations (n = 192) were obtained from 87 patients. Fourteen of the 87 (16%) patients experienced thiocyanate accumulation with a mean (SD) thiocyanate concentration of 44 \u00b1 11 \u00b5g\/mL. Patients with accumulation had received greater cumulative nitroprusside doses (28 vs 8.2 mg\/kg, P &lt; .01), greater cumulative sodium thiosulfate doses (16.8 vs 10.1 mg\/kg, P &lt; .01), and longer infusion durations (10.9 vs 6.0 days, P &lt; .01), compared to patients without accumulation. Sodium thiosulfate coadministration resulted in greater thiocyanate concentrations (22.8 \u00b1 16.7 vs 16.8 \u00b1 14.9 \u03bcg\/mL, P = .01), despite utilization of lower cumulative nitroprusside doses (10.2 vs 14.6 mg\/kg, P = .03). Cumulative nitroprusside dose ( r\n                      <jats:sup>2<\/jats:sup>\n                      .44, P &lt; .001) and cumulative sodium thiosulfate dose ( r\n                      <jats:sup>2<\/jats:sup>\n                      .32, P &lt; .001) demonstrated a significant correlation with measured thiocyanate concentrations. Thiocyanate accumulation was independently associated with cumulative nitroprusside dose in mg\/kg (regression coefficient 0.75, 95% CI 0.63-0.89; P &lt; .01). No clinically significant adverse effects of cyanide or thiocyanate toxicity were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Cumulative nitroprusside dose was independently associated with thiocyanate accumulation. Despite elevated thiocyanate levels in 16% of patients, there was no clinical evidence of cyanide or thiocyanate toxicity. Routine monitoring of thiocyanate concentrations appears most warranted in patients receiving higher cumulative doses of nitroprusside.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0885066616657004","type":"journal-article","created":{"date-parts":[[2016,7,19]],"date-time":"2016-07-19T20:43:26Z","timestamp":1468961006000},"page":"547-553","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Thiocyanate Accumulation in Critically Ill Patients Receiving Nitroprusside Infusions"],"prefix":"10.1177","volume":"32","author":[{"given":"Amanda A.","family":"Morris","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Services, University of California San Francisco Medical Center, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Robert L.","family":"Page","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J.","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Touro University California College of Pharmacy, Vallejo, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott W.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"MacLaren","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas N.","family":"Fish","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyree H.","family":"Kiser","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,19]]},"reference":[{"key":"bibr1-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8807"},{"key":"bibr2-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"bibr3-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/48.7.651"},{"key":"bibr4-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1177\/106002809202600413"},{"key":"bibr5-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000264078.34514.32"},{"key":"bibr6-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1L192"},{"key":"bibr7-0885066616657004","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc1992.1.2.19"},{"key":"bibr8-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(83)90307-1"},{"key":"bibr9-0885066616657004","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-198409030-00005"},{"key":"bibr10-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1097\/01.mat.0000227670.39719.ec"},{"key":"bibr11-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/57.2.148"},{"key":"bibr12-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1007\/BF01716244"},{"key":"bibr13-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-198510000-00010"},{"key":"bibr14-0885066616657004","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/25.1.60"},{"issue":"7","key":"bibr15-0885066616657004","first-page":"489","volume":"57","author":"Dwyer MM","year":"1993","journal-title":"Conn Med"},{"key":"bibr16-0885066616657004","unstructured":"Nitropress prescribing information. 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