Ordering Recommendation

Monitor cyanide exposure.

Mnemonic
CYAN
Methodology

Quantitative Colorimetry

Performed

Sun, Tue, Fri

Reported

1-5 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation

Timing of specimen collection: Dependent on time of exposure - test upon presentation to hospital.

Collect

Green (sodium or lithium heparin). Also acceptable: Lavender (EDTA) or pink (K2EDTA or K3EDTA).

Specimen Preparation

Do not freeze. Transport 4 mL whole blood in original collection container. (Min: 3 mL) Also acceptable: Transfer specimen to an ARUP Standard Transport Tube.

Storage/Transport Temperature

Room temperature.

Unacceptable Conditions

Serum or plasma. Frozen or refrigerated specimens. Clotted or hemolyzed specimens.

Remarks
Stability

Ambient: 72 hours (if tightly capped); Refrigerated: Unacceptable; Frozen: Unacceptable

Reference Interval

Effective February 19, 2013

Non-smokers Less than 20 µg/dL
Smokers Less than 40 µg/dL
Toxic Level Greater than 100 µg/dL

Interpretive Data

Cyanide poisoning can cause hypoxia, dizziness, weakness and mental and motor impairment. Elevated cyanide concentrations rarely indicate toxicity for patients on nitroprusside therapy. Thiocyanate should be monitored in patients on nitroprusside therapy for potential toxicity.

No compliance statements are in use for this test.

Note

No laboratory test is available to assess cyanide toxicity in patients on nitroprusside therapy. However, thiocyanate toxicity may occur with long-term nitroprusside use (longer than 7-14 days with normal renal function and 3-6 days with renal impairment at greater than 2 µg/kg/min infusion rates). Thiocyanate levels may be monitored on an every other day basis to assess potential thiocyanate toxicity and to indicate possible adjustments in dosage.  Refer to Thiocyanate, Serum or Plasma (ARUP test code 2011575).

Hotline History
N/A
CPT Codes

82600

Components
Component Test Code* Component Chart Name LOINC
0090060 Cyanide 5634-1
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Amygdalin
  • Hydrocyanic acid
  • Laetrile
Cyanide