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Balice G, Boksebeld M, Barrier Q, Boccalini S, Kassai-Koupai B, Paret N, Grenet G. Mushroom Poisoning-Related Cardiac Toxicity: A Case Report and Systematic Review. Toxins (Basel) 2024; 16:265. [PMID: 38922159 PMCID: PMC11209194 DOI: 10.3390/toxins16060265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
We encountered a case of mushroom intoxication complicated by "toxic-like" myocarditis. Because of the lack of systematized knowledge on this subject, we performed a systematic review of the literature on cardiac toxicity in mushroom poisoning (MP). The aim of this study was to identify and describe the severity, the causal relationship, and the mushroom species involved in other reported cardiac events associated with MP. We included 39 studies in our review. We found 106 cases of cardiac events associated with MP, including 18 deaths. A wide variety of cardiac manifestations were reported, ranging from the simple elevation of cardiac enzymes (n = 61) to ventricular tachycardia (n = 14), acute heart failure (n = 18), and myocarditis (n = 7). Causal relationship between cardiac manifestations and mushroom poisoning was assessed for 42 patients, applying the algorithm validated by the French Toxicovigilance Coordination Committee. Twenty-three cases (54.8%) had a "possible" causal relationship, eight cases (19%) a "probable" relationship, and ten cases (23.8%) a "very probable" relationship. Several fungal genera were involved in reported cases, including Amanita but also rarer ones like Russula and Tricholoma. In conclusion, we showed that cases of cardiac toxicity following MP have been documented in the existing literature, and for some of them, we assessed a strong causal relationship.
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Affiliation(s)
- Giuseppe Balice
- Service Hospitalo-Universitaire de Pharmacotoxicologie, Hospices Civils de Lyon, 69003 Lyon, France; (M.B.); (B.K.-K.); (N.P.); (G.G.)
| | - Maxime Boksebeld
- Service Hospitalo-Universitaire de Pharmacotoxicologie, Hospices Civils de Lyon, 69003 Lyon, France; (M.B.); (B.K.-K.); (N.P.); (G.G.)
| | - Quentin Barrier
- Fédération de Cardiologie Médicale, Hôpital Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Sara Boccalini
- Service de Radiologie Cardiovasculaire et Thoracique, Hôpital Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Behrouz Kassai-Koupai
- Service Hospitalo-Universitaire de Pharmacotoxicologie, Hospices Civils de Lyon, 69003 Lyon, France; (M.B.); (B.K.-K.); (N.P.); (G.G.)
- Centre d’Investigation Clinique de Lyon (CIC1407 INSERM), Hospices Civils de Lyon, 69500 Bron, France
- Laboratoire de Biométrie et Biologie Evolutive UMR 5558, Université Lyon 1, CNRS, 69100 Villeurbanne, France
| | - Nathalie Paret
- Service Hospitalo-Universitaire de Pharmacotoxicologie, Hospices Civils de Lyon, 69003 Lyon, France; (M.B.); (B.K.-K.); (N.P.); (G.G.)
| | - Guillaume Grenet
- Service Hospitalo-Universitaire de Pharmacotoxicologie, Hospices Civils de Lyon, 69003 Lyon, France; (M.B.); (B.K.-K.); (N.P.); (G.G.)
- Laboratoire de Biométrie et Biologie Evolutive UMR 5558, Université Lyon 1, CNRS, 69100 Villeurbanne, France
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Gong M, Li Z, Xu H, Ma B, Gao P, Wang L, Li J, Wu Q, Wu J, Xie J. Amanitin-induced variable cytotoxicity in various cell lines is mediated by the different expression levels of OATP1B3. Food Chem Toxicol 2024; 188:114665. [PMID: 38641045 DOI: 10.1016/j.fct.2024.114665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/02/2024] [Accepted: 04/11/2024] [Indexed: 04/21/2024]
Abstract
Amanita phalloides is one of the deadliest mushrooms worldwide, causing most fatal cases of mushroom poisoning. Among the poisonous substances of Amanita phalloides, amanitins are the most lethal toxins to humans. Currently, there are no specific antidotes available for managing amanitin poisoning and treatments are lack of efficacy. Amanitin mainly causes severe injuries to specific organs, such as the liver, stomach, and kidney, whereas the lung, heart, and brain are hardly affected. However, the molecular mechanism of this phenomenon remains not understood. To explore the possible mechanism of organ specificity of amanitin-induced toxicity, eight human cell lines derived from different organs were exposed to α, β, and γ-amanitin at concentrations ranging from 0.3 to 100 μM. We found that the cytotoxicity of amanitin differs greatly in various cell lines, among which liver-derived HepG2, stomach-derived BGC-823, and kidney-derived HEK-293 cells are most sensitive. Further mechanistic study revealed that the variable cytotoxicity is mainly dependent on the different expression levels of the organic anion transporting polypeptide 1B3 (OATP1B3), which facilitates the internalization of amanitin into cells. Besides, knockdown of OATP1B3 in HepG2 cells prevented α-amanitin-induced cytotoxicity. These results indicated that OATP1B3 may be a crucial therapeutic target against amanitin-induced organ failure.
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Affiliation(s)
- Mengqiang Gong
- School of Agriculture, Yangtze University, Jingzhou, 434025, China; Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China
| | - Zhi Li
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China
| | - Hua Xu
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China
| | - Bo Ma
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China
| | - Pengxia Gao
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China
| | - Lili Wang
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China
| | - Junkai Li
- School of Agriculture, Yangtze University, Jingzhou, 434025, China
| | - Qinglai Wu
- School of Agriculture, Yangtze University, Jingzhou, 434025, China.
| | - Jianfeng Wu
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China.
| | - Jianwei Xie
- Laboratory of Toxicant Analysis, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China.
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Danaei B, Sharifi A, Mazloom H, Najafi4 I, Farhang Ranjbar M, Safari S. Prevalence of Compartment Syndrome and Disseminated Intravascular Coagulation following Rhabdomyolysis; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2023; 11:e55. [PMID: 37671275 PMCID: PMC10475747 DOI: 10.22037/aaem.v11i1.2083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Abstract. Introduction Rhabdomyolysis (RM) may cause some complications such as compartment syndrome and disseminated intravascular coagulation (DIC), which can affect its prognosis. This systematic review and meta-analysis aimed to investigate the prevalence of the mentioned complications following RM. Methods Medline, Embase, and Scopus databases were searched using keywords related to compartment syndrome, DIC, and rhabdomyolysis with appropriate combination. Cohort and cross-sectional studies that conducted research on the prevalence of compartment syndrome and DIC in patients with RM were included in the present study. The desired data were extracted from the included studies and meta-analysis was conducted on them to calculate pooled prevalence of these complications. Results Twenty articles were included in our systematic review. The rate of compartment syndrome reported in these studies ranged from 0 to 30.7%. Our meta-analysis revealed the pooled prevalence of 4% (95% confidence interval (CI): 2.20 to 7.40) for compartment syndrome in these studies. The pooled prevalence of this complication was 7.1% (95% CI: 2.90 to 16.00) among patients with severe RM and 4.4% (95% CI: 1.80 to 10.00) in traumatic RM. The rate of DIC reported in the included studies ranged from 0 to 40.47%. Our meta-analysis showed the pooled prevalence of 8.3% (95% CI: 03.90 to 16.50) for this complication among RM patients. Conclusion We reported the rates of compartment syndrome and DIC in RM patients based on rhabdomyolysis etiologies through an epidemiologic systematic review and meta-analysis. The rate of compartment syndrome was slightly higher in patients with severe RM and its rate in patients with traumatic RM was close to the overall rate of compartment syndrome.
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Affiliation(s)
- Bardia Danaei
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sharifi
- Assistant Professor of Hepatopancreaticobiliary & Organ Transplantation Surgery, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Mazloom
- Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Iraj Najafi4
- Nephrology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehri Farhang Ranjbar
- Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
| | - Saeed Safari
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
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Liu Y, Lyu X, Yang B, Fang Z, Hu D, Shi L, Wu B, Tian Y, Zhang E, Yang Y. Early Triage of Critically Ill Adult Patients With Mushroom Poisoning: Machine Learning Approach. JMIR Form Res 2023; 7:e44666. [PMID: 36943366 PMCID: PMC10131621 DOI: 10.2196/44666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Early triage of patients with mushroom poisoning is essential for administering precise treatment and reducing mortality. To our knowledge, there has been no established method to triage patients with mushroom poisoning based on clinical data. OBJECTIVE The purpose of this work was to construct a triage system to identify patients with mushroom poisoning based on clinical indicators using several machine learning approaches and to assess the prediction accuracy of these strategies. METHODS In all, 567 patients were collected from 5 primary care hospitals and facilities in Enshi, Hubei Province, China, and divided into 2 groups; 322 patients from 2 hospitals were used as the training cohort, and 245 patients from 3 hospitals were used as the test cohort. Four machine learning algorithms were used to construct the triage model for patients with mushroom poisoning. Performance was assessed using the area under the receiver operating characteristic curve (AUC), decision curve, sensitivity, specificity, and other representative statistics. Feature contributions were evaluated using Shapley additive explanations. RESULTS Among several machine learning algorithms, extreme gradient boosting (XGBoost) showed the best discriminative ability in 5-fold cross-validation (AUC=0.83, 95% CI 0.77-0.90) and the test set (AUC=0.90, 95% CI 0.83-0.96). In the test set, the XGBoost model had a sensitivity of 0.93 (95% CI 0.81-0.99) and a specificity of 0.79 (95% CI 0.73-0.85), whereas the physicians' assessment had a sensitivity of 0.86 (95% CI 0.72-0.95) and a specificity of 0.66 (95% CI 0.59-0.73). CONCLUSIONS The 14-factor XGBoost model for the early triage of mushroom poisoning can rapidly and accurately identify critically ill patients and will possibly serve as an important basis for the selection of treatment options and referral of patients, potentially reducing patient mortality and improving clinical outcomes.
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Affiliation(s)
- Yuxuan Liu
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Xiaoguang Lyu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bo Yang
- Department of Internal Medicine, Renmin Hospital of Xianfeng, Enshi, China
| | - Zhixiang Fang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Dejun Hu
- Department of Internal Medicine, Renmin Hospital of Xianfeng, Enshi, China
| | - Lei Shi
- Department of Nephrology, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Bisheng Wu
- Department of General Surgery, Renmin Hospital of Xianfeng, Enshi, China
| | - Yong Tian
- Department of Internal Medicine, Renmin Hospital of Laifeng, Enshi, China
| | - Enli Zhang
- Department of General Surgery, Central Hospital of Hefeng, Enshi, China
| | - YuanChao Yang
- Department of Gastroenterology, Renmin Hospital of Xuanen, Enshi, China
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Janatolmakan M, Jalilian M, Rezaeian S, Abdi A, Khatony A. Mortality rate and liver transplant in patients with mushroom poisoning: A systematic review & meta-analysis. Heliyon 2022; 9:e12759. [PMID: 36685402 PMCID: PMC9849942 DOI: 10.1016/j.heliyon.2022.e12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Background Mushroom poisoning is raised as a poor food problem that can cause the death of patients or the need for a liver transplant. Objective This study was conducted with the aim of assessment the mortality rate and liver transplantation in people suffering from mushroom poisoning through a systematic review and meta-analysis. Method The study is designed and conducted based on the PRISMA statement. International databases have been checked for articles up to March 1, 2022. The results of the study are presented with the guidance of Garrard's statement. CMA software was used in meta-analysis. Results Thirty-three articles were selected for this study. The mortality rate reported 0-40% and the results of the meta-analysis showed that the mortality rate was 2.87%. in other hand the mortality rate was 1.4% with studies that reported zero death. Overall, 16 patients had liver transplants, that only 2 died after liver transplants and 14 others survived. Conclusion The death in patients with mushroom poisoning is significant. Patients with liver disorders and patients or kidney disorders are more likely to have a poor prognosis. Liver transplant can be lifesaving. Also, quick referral of patients in the early stages reduces the need for liver transplantation.
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Affiliation(s)
- Maryam Janatolmakan
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Milad Jalilian
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran,Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran,Corresponding author. Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Two new Russula species (fungi) from dry dipterocarp forest in Thailand suggest niche specialization to this habitat type. Sci Rep 2022; 12:2826. [PMID: 35181709 PMCID: PMC8857229 DOI: 10.1038/s41598-022-06836-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Dry dipterocarp forests are among the most common habitat types in Thailand. Russulaceae are known as common ectomycorrhizal symbionts of Dipterocarpaceae trees in this type of habitat. The present study aims to identify collections of Russula subsection Amoeninae Buyck from dry dipterocarp forests in Thailand. A multi-locus phylogenetic analysis placed Thai Amoeninae collections in two novel lineages, and they are described here as R. bellissima sp. nov. and R. luteonana sp. nov. The closest identified relatives of both species were sequestrate species suggesting that they may belong to drought-adapted lineages. An analysis of publicly available ITS sequences in R. subsect. Amoeninae did not confirm evidence of any of the new species occurring in other Asian regions, indicating that dry dipterocarp forests might harbor a novel community of ectomycorrhizal fungi. Macromorphological characters are variable and are not totally reliable for distinguishing the new species from other previously described Asian Amoeninae species. Both new species are defined by a combination of differentiated micromorphological characteristics in spore ornamentation, hymenial cystidia and hyphal terminations in the pileipellis. The new Amoeninae species may correspond to some Russula species collected for consumption in Thailand, and the detailed description of the new species can be used for better identification of edible species and food safety in the region.
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Li W, Pires SM, Liu Z, Liang J, Wang Y, Chen W, Liu C, Liu J, Han H, Fu P, Guo Y. Mushroom Poisoning Outbreaks - China, 2010-2020. China CDC Wkly 2021; 3:518-522. [PMID: 34594925 PMCID: PMC8393043 DOI: 10.46234/ccdcw2021.134] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction: Mushroom poisoning was the leading cause of foodborne disease outbreaks and outbreak-associated deaths in China. Mushroom poisoning outbreak surveillance can provide insight into the epidemiological characteristics of mushroom poisonings and guide policymaking and health education to reduce illnesses and deaths. Methods: Foodborne Disease Outbreak Surveillance System was upgraded in 2011 to collect foodborne disease outbreaks in China. Mushroom poisoning outbreaks during 2010-2020 were selected to analyze geographical distribution, seasonal distribution, and setting of food preparation. Results: A total of 10,036 outbreaks, which resulted in 38,676 illnesses and 788 deaths, were reported in this period. Mushroom poisonings occurred all over the country, but with highest incidence in the southwest and central China. Overall, 84.6% outbreaks were associated with food prepared in households, followed by 8.7% in street stalls, and 2.5% in canteens. Mushroom poisoning outbreaks clearly exhibited seasonality, and the peak season was summer through autumn. Outbreaks occurring between May and October accounted for 94.1% of total outbreaks, 92.4% illnesses, and 97.2% deaths. Conclusions: Mushroom poisoning is a food safety issue of higher concern in China. Targeted health education is essential to reduce mushroom poisoning, especially in southwest China. Citizens are advised to not collect or eat wild mushrooms.
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Affiliation(s)
- Weiwei Li
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science; China National Center for Food Safety Risk Assessment, Beijing, China
| | - Sara M. Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Zhitao Liu
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Jinjun Liang
- Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Yafang Wang
- Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Wen Chen
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Chengwei Liu
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Jikai Liu
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science; China National Center for Food Safety Risk Assessment, Beijing, China
| | - Haihong Han
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science; China National Center for Food Safety Risk Assessment, Beijing, China
| | - Ping Fu
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science; China National Center for Food Safety Risk Assessment, Beijing, China
| | - Yunchang Guo
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science; China National Center for Food Safety Risk Assessment, Beijing, China
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Li Y, Qiu Z, Huang L, Cao C. Extracorporeal membrane oxygenation combined with sequential blood purification in the treatment of myocardial damage and cardiac arrest caused by mushroom poisoning. Toxicon 2021; 197:65-69. [PMID: 33872678 DOI: 10.1016/j.toxicon.2021.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/29/2021] [Accepted: 04/14/2021] [Indexed: 01/04/2023]
Abstract
Mushroom poisoning is a common clinical problem. Severe mushroom poisoning often causes liver and kidney failure. Although severe myocardial damage is rare, the fatality rate is extremely high. This case report describes a 56-year-old male suffered severe myocardial damage, multiple organ dysfunction, circulatory failure, recurrent malignant arrhythmia, and cardiac arrest after the ingestion of wild mushrooms. He was administered venoarterial extracorporeal membrane oxygenation (VA-ECMO) combined with hemoperfusion, plasma exchange and continuous renal replacement therapy. The heart rhythm gradually stabilized 3 hours after ECMO surgery. On the 6th day after ECMO, heart function recovered. The patient was then weaned from ECMO, and he ultimately recovered and was discharged. In patients with fatal mushroom poisoning leading to refractory arrhythmia and cardiac arrest, early implementation of VA-ECMO combined with sequential blood purification treatment can improve the prognosis and increase the survival rate.
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Affiliation(s)
- Yang Li
- Department of Emergency Medicine, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
| | - Zhiqiang Qiu
- Department of Emergency Medicine, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
| | - Liang Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
| | - Chunshui Cao
- Department of Emergency Medicine, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.
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