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Schwere Intoxikationen mit dem Gift der Eibe (Taxus) – Fallbericht und Literaturübersicht

  • J. L. Lohmeyer,
  • C. Enneking,
  • P. Mammen,
  • T. Horlacher,
  • M. Roiss,
  • G. N. Schmidt,
  • M. W. Bergmann,
  • T. Spangenberg

摘要

Background

Severe yew (Taxus) intoxication is a rare condition that can lead to life-threatening cardiac arrhythmia. The survival of patients requires highly specialized emergency and intensive care treatment.

Objectives

Systematic overview of the clinical picture and important treatment options.

Methods

Case report of severe yew intoxication with subsequent literature review of comparable case reports. Analysis of 33 case reports with a total of 37 critically intoxicated patients from the years 2000–2024 from Europe and North America.

Results

Severe yew intoxications were almost exclusively the result of suicidal intent. Patients average age was 33 (± 14.5) years. The use of antiarrhythmic drugs and electrical stimulation of the heart often proved to be ineffective or deteriorating in its effect over time. The use of lipid emulsion and/or digoxin-specific Fab fragments has little evidence. The average duration of a clinically relevant arrhythmogenic effect was 22±11.7 h.

Conclusions

The management of yew intoxication is primarily limited to symptomatic treatment. The availability of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in a “bridge-to-recovery” concept appears to be of utmost importance.