Yew poisoning – pathophysiology, clinical picture, management and perspective of fat emulsions utilization

Aleksander Rutkiewicz; Paweł Schab; Andrzej Kubicius; Filip Szeremeta; Franciszek Małysz; Janusz Dadok; Agnieszka Misiewska-Kaczur

eISSN: 1731-2515
ISSN: 0209-1712

Anestezjologia Intensywna Terapia

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5/2019
vol. 51

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abstract:

Review paper

Yew poisoning – pathophysiology, clinical picture, management and perspective of fat emulsions utilization

Aleksander Rutkiewicz

¹

,

Paweł Schab

¹

,

Andrzej Kubicius

²

,

Filip Szeremeta

¹

,

Franciszek Małysz

¹

,

Janusz Dadok

¹

,

Agnieszka Misiewska-Kaczur

¹

Department of Anaesthesiology and Intensive Therapy, Silesian Hospital in Cieszyn, Poland
Cardiac Department in Cieszyn, Upper-Silesian Medical Centre in Katowice, Poland

Anestezjologia Intensywna Terapia
2019; 51, 5: 411–415

Online publish date: 2019/12/30

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The article presents pathophysiology, clinical picture and management of yew poisoning. Authors present also their own experiences with treating yew poisoning with fat emulsion.

Plants of the yew genus, of which in Europe predominates Taxus baccata, are well known for their toxic properties. Particularly high concentrations of poisonous alkaloids are present in the needles of this evergreen and highly popular decorative plant. The danger associated with accidental or intentional ingestion of yew is primarily related to the cardiotoxic effects of the alkaloids (taxine A and B). Taxine B shows a much stronger toxic effect on the heart than taxine A. It affects atrio-ventricular conduction, what may result in a widening of the QRS complexes, atrio-ventricular blocks (A-V) of II/ III degree and even in asystole.

Yew poisoning is relative rare and evidence-based treatment guidelines on management of such poisoning is hard to prepare. The first-line treatement should base on suportive therapy. In some cases extracorporeal life support therapies such veno-arterial ECMO should be consider. There are also premise based on case reports and mechanism of action that the use of fat emulsion may be effective rescue treatment.

keywords:

Yew poisoning – pathophysiology, clinical picture, management and perspective of fat emulsions utilization

Aleksander Rutkiewicz 1 , Paweł Schab 1 , Andrzej Kubicius 2 , Filip Szeremeta 1 , Franciszek Małysz 1 , Janusz Dadok 1 , Agnieszka Misiewska-Kaczur 1

yew, poisoning, lipid emulsions, heart arrhythmias

Aleksander Rutkiewicz

¹

,

Paweł Schab

¹

,

Andrzej Kubicius

²

,

Filip Szeremeta

¹

,

Franciszek Małysz

¹

,

Janusz Dadok

¹

,

Agnieszka Misiewska-Kaczur

¹