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Taxine alkaloid poisoning successfully supported with venoarterial extracorporeal membrane oxygenation: a case report
Catherine Ward1, Daveena Meeks1, Richard Trimlett2
1Department of Critical Care, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.
Background:
Ingestion of the berries of the European yew tree can result in fatal cardiac arrhythmias.
Case Summary:
A 53-year-old female presented to our emergency department following ingestion of ∼200 European yew tree berries. At presentation, she was in cardiogenic shock due to a mixture of tachy- and bradyarrhythmias including ventricular tachycardia, atrial fibrillation with slow ventricular response and prolonged ventricular conduction, and periods of asystole. She was referred to a specialist cardiac centre and promptly established on mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (V-A ECMO) by a retrieval team. Following resolution of her arrhythmias, she was weaned from V-A ECMO after 4 days of support and was discharged home with full neurological recovery on Day 12.
Discussion:
Poisoning can lead to acute reversible but potentially fatal cardiogenic shock. We believe that access to prompt initiation of V-A ECMO was key to this patient's survival.
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