"Chaotic Arrhythmia" During Successful Resuscitation After Ingestion of Yew (Taxus baccata) Needles.
Adolescent
Anti-Arrhythmia Agents
/ therapeutic use
Arrhythmias, Cardiac
/ drug therapy
Bradycardia
/ physiopathology
Cardiopulmonary Resuscitation
/ adverse effects
Eating
Electric Countershock
/ methods
Female
Humans
Out-of-Hospital Cardiac Arrest
/ chemically induced
Plant Leaves
/ poisoning
Plant Poisoning
/ diagnosis
Suicide, Attempted
/ psychology
Tachycardia, Ventricular
/ physiopathology
Taxus
/ poisoning
Treatment Outcome
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
pubmed:
8
6
2017
medline:
1
5
2020
entrez:
8
6
2017
Statut:
ppublish
Résumé
The study aims to describe the management of a case of life-threatening yew (Taxus baccata) intoxication. The needles of the yew tree contain highly cardiotoxic taxines. Intoxication with taxines, typically as part of suicide attempts, may lead to potentially lethal arrhythmias which often require prolonged cardiopulmonary resuscitation and other supportive measures. No specific therapy has been described. In some cases, extracorporeal life support has been used. After an attempted suicide with yew needles and out-of-hospital cardiac arrest, a female adolescent was resuscitated for 6 hours according to Advanced Cardiovascular Life Support guidelines. Complex ventricular tachycardias were treated by repeated direct current shocks and broad complex bradycardia managed with transvenous cardiac pacing. Antiarrhythmic drugs (amiodarone, lidocaine), magnesium sulfate, and supportive measures (intravenous lipids, sodium bicarbonate) were provided. The arrhythmias finally resolved, and the patient did not show any significant neurological or cardiac short-term sequelae after 24 hours. The authors describe the successful management of a case of severe taxine intoxication by prolonged conventional advanced cardiac life support lasting for more than 6 hours. In life-threatening yew intoxication, prolonged cardiopulmonary resuscitation is absolutely essential owing to the long duration of the cardiotoxic action of taxines and can lead to an outcome without cardiac or neurological sequelae.
Sections du résumé
OBJECTIVE
OBJECTIVE
The study aims to describe the management of a case of life-threatening yew (Taxus baccata) intoxication.
BACKGROUND
BACKGROUND
The needles of the yew tree contain highly cardiotoxic taxines. Intoxication with taxines, typically as part of suicide attempts, may lead to potentially lethal arrhythmias which often require prolonged cardiopulmonary resuscitation and other supportive measures. No specific therapy has been described. In some cases, extracorporeal life support has been used.
CASE
METHODS
After an attempted suicide with yew needles and out-of-hospital cardiac arrest, a female adolescent was resuscitated for 6 hours according to Advanced Cardiovascular Life Support guidelines. Complex ventricular tachycardias were treated by repeated direct current shocks and broad complex bradycardia managed with transvenous cardiac pacing. Antiarrhythmic drugs (amiodarone, lidocaine), magnesium sulfate, and supportive measures (intravenous lipids, sodium bicarbonate) were provided. The arrhythmias finally resolved, and the patient did not show any significant neurological or cardiac short-term sequelae after 24 hours.
RESULTS
RESULTS
The authors describe the successful management of a case of severe taxine intoxication by prolonged conventional advanced cardiac life support lasting for more than 6 hours.
CONCLUSIONS
CONCLUSIONS
In life-threatening yew intoxication, prolonged cardiopulmonary resuscitation is absolutely essential owing to the long duration of the cardiotoxic action of taxines and can lead to an outcome without cardiac or neurological sequelae.
Identifiants
pubmed: 28590987
doi: 10.1097/PEC.0000000000001196
doi:
Substances chimiques
Anti-Arrhythmia Agents
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM