Combination of veno-arterial extracorporeal membrane oxygenation and hypothermia for out-of-hospital cardiac arrest due to Taxus intoxication
- Resource Type
- Authors
- Serge Brimioulle; David Fagnoul; Jean Louis Vincent; Fabio Silvio Taccone; Daniel De Backer; Ahmed Goubella; Aurélie Thooft
- Source
- CJEM. 16(6)
- Subject
- Resuscitation
medicine.medical_treatment
Electrocardiography
Young Adult
Extracorporeal Membrane Oxygenation
Hypothermia, Induced
medicine
Extracorporeal membrane oxygenation
Humans
Asystole
Ejection fraction
business.industry
Hypothermia
medicine.disease
Cardiopulmonary Resuscitation
surgical procedures, operative
Anesthesia
Pulseless electrical activity
Ventricular fibrillation
Emergency Medicine
Dobutamine
Female
medicine.symptom
Taxus
business
Out-of-Hospital Cardiac Arrest
medicine.drug
Follow-Up Studies
- Language
- ISSN
- 1481-8043
A young woman presented with cardiac arrest following ingestion of yew tree leaves of the Taxus baccata species. The toxin in yew tree leaves has negative inotropic and dromotropic effects. The patient had a cardiac rhythm that alternated between pulseless electrical activity with a prolonged QRS interval and ventricular fibrillation. When standard resuscitation therapy including digoxin immune Fab was ineffective, a combination of extracorporeal membrane oxygenation (ECMO) and hypothermia was initiated. The total duration of low flow/no flow was 82 minutes prior to the initiation of ECMO. After 36 hours of ECMO (including 12 hours of electrical asystole), the patient’s electrocardiogram had normalized and the left ventricular ejection fraction was 50%. At this time, dobutamine and the ECMO were stopped. The patient had a full neurologic recovery and was discharged from the intensive care unit after 5 days and from the hospital 1 week later.