NEAR-FATAL YEW BERRY INTOXICATION TREATED WITH EXTERNAL CARDIAC PACING AND DIGOXIN-SPECIFIC FAB ANTIBODY FRAGMENTS

被引：47

作者：

CUMMINS, RO ^{[1
]}

HAULMAN, J ^{[1
]}

QUAN, L ^{[1
]}

GRAVES, JR ^{[1
]}

PETERSON, D ^{[1
]}

HORAN, S ^{[1
]}

机构：

[1] KING CTY DEPT PUBL HLTH,CTR EVALUAT EMERGENCY MED SERV,DIV EMERGENCY MED SERV,SEATTLE,WA

来源：

ANNALS OF EMERGENCY MEDICINE | 1990年 / 19卷 / 01期

关键词：

digoxin; yew ingestion; transcutaneous pacing; yew; ingestion;

D O I：

10.1016/S0196-0644(05)82138-9

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The case of a 5-year-old girl who survived a near-fatal ingestion of yew plant leaves after treatment with CPR, transcutaneous pacing, and digoxin-specific FAB antibody fragments is presented. Multiple rhythm disturbances, including profound bradycardia, occurred. She required endotracheal intubation, external chest compressions, and application of a transcutaneous pacemaker. Paced cardiac contractions produced a dramatic improvement in her blood pressure and clinical condition. Two empiric injections of digoxin-specific FAB antibody fragments were administered, after which cardiac function and rhythm gradually improved. She was discharged in her normal state of health three days later. Yew leaves and berries contain several alkaloids that can produce fatal conduction disturbances. Transcutaneous cardiac pacemakers may be lifesaving for patients with transient cardiac toxicity from drug or toxin ingestions. In addition, cross-reactivity between digoxin-specific FAB antibodies and the alkaloids in the yew plant may exist and may have therapeutic importance, although this mechanism was unlikely to have helped our patient. © 1990 American College of Emergency Physicians.

引用

页码：38 / 43

页数：6

共 35 条

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