Sodium-nitroprusside-induced cyanide toxicity in pediatric patients.
BACKGROUND
Sodium nitroprusside (SNP) is often used as a continuous infusion intravenous vasodilator in pediatric patients. However, cyanide toxicity can occur with SNP therapy. Scant literature is available determining the safety of SNP therapy, the incidence of cyanide toxicity or the risk factors for cyanide toxicity in pediatric patients.


OBJECTIVE
To review the literature concerning the safety of intravenous SNP with regard to cyanide toxicity in the pediatric patient population.


METHODS
A MedLine search was used to identify articles pertaining to SNP therapy and cyanide toxicity in pediatric patients.


CONCLUSIONS
Sodium nitroprusside seems to be safe when used in critically ill pediatric patients. Cyanide toxicity may occur in patients with specific risk factors. Routine monitoring of cyanide levels may not be warranted.
Thomas
Christopher
C
Texas Children's Hospital, Department of Pharmacy, 6621 Fannin Street, MC 2-2510, Houston, TX 77030, USA. bsmoffet@texaschildrenshospital.org
Svehla
Lindsay
L
Moffett
Brady S
BS
D000138:Acidosis / Q000139:chemically induced; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D003486:Cyanides / Q000097:blood / Q000506:poisoning*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007674:Kidney Diseases / Q000139:chemically induced; D008708:Methemoglobinemia / Q000139:chemically induced; D020030:Nitric Oxide Donors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D009599:Nitroprusside / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011183:Postoperative Complications / Q000139:chemically induced; D011446:Prospective Studies; D013861:Thiocyanates / Q000097:blood / Q000506:poisoning; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use
D003486:Cyanides; D020030:Nitric Oxide Donors; D013861:Thiocyanates; D014665:Vasodilator Agents; D009599:Nitroprusside