Extracorporeal membrane oxygenation in a patient with yew and escitalopram intoxication

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27283933%3A_____%2F18%3A00006483" target="_blank" >RIV/27283933:_____/18:00006483 - isvavai.cz</a>

Result on the web

<a href="https://api.elsevier.com/content/article/PII:S0010865018300511?httpAccept=text/xml" target="_blank" >https://api.elsevier.com/content/article/PII:S0010865018300511?httpAccept=text/xml</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.crvasa.2018.08.003" target="_blank" >10.1016/j.crvasa.2018.08.003</a>

Result language

angličtina

Original language name

Extracorporeal membrane oxygenation in a patient with yew and escitalopram intoxication

Original language description

Yew intoxication is an uncommon, life-threatening emergency. Patients frequently die due to refractory cardiac shock or pulseless ventricular tachycardia and ventricular fibrillation, both of which do not respond to classical treatment with antiarrhythmics and defibrillation. The cardiac toxicity is driven mainly by taxine B, both sodium and calcium channel blocker. Hemodialysis is ineffective, because of the large molecular size of taxine B. Specific antidote is currently not available, but digoxin-specific FAB antibodies can be used instead, with partial effect. Severe cases of intoxication can profit from initiation of veno-arterial extracorporeal membrane circulation (VA ECMO). We present a case of a 25-year-old patient with yew and escitalopram ingestion in a suicide attempt. He presented to the emergency department of a regional hospital with cardiology center without cardiosurgery clinic, but with VA ECMO team on site. Pulseless ventricular tachycardia and fibrillation unresponsive to usual treatment developed soon after presentation and the patient had to be placed on VA ECMO during ongoing cardiopulmonary resuscitation using Lucas CPR device. Patient survived and was successfully weaned off VA ECMO after 4 days with normalization of cardiac function and without severe liver or kidney dysfunction. Unfortunately, brain death was diagnosed after the discontinuation of sedation two days later and the patient entered the transplantation program as a donor. This propably happened due to inadequate mechanical resuscitation during transportation to the cathlab. VA ECMO is an important option for the treatment of intoxications, with early indication being crucial.

Czech name

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Czech description

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Type

J_SC - Article in a specialist periodical, which is included in the SCOPUS database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Cor et Vasa

ISSN

0010-8650

e-ISSN

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Volume of the periodical

8

Issue of the periodical within the volume

3

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

5

Pages from-to

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UT code for WoS article

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EID of the result in the Scopus database

2-s2.0-85052793281