The 25-year-old man, believed to have eaten berries, was found comatose in a park and was taken to hospital. Doctors tried electric shocks, heart-stimulating drugs and a pacemaker, to no avail. They kept his circulation going, maintaining oxygen to the brain, by constant external massage of his heart. Normally, brain damage occurs within minutes of the heart stopping or ceasing to pump properly.
After seven hours, a normal heart rhythm was restored and the man gradually regained consciousness. A nurse found in his pockets pine needles and small red berries, which he recognised as from the yew tree. The man later said he often ate berries and leaves because he believed natural foods were healthy. Yew plants are highly toxic,known for more than a century to cause poisoning. They contain alkaloids that interfere with the contraction of cardiac muscle cells. The man suffered no ill-effects, a year later he was doing well.
The incident, which happened in Berlin, is reported in the current issue of The Lancet. The chief author, Professor Friederich Luft, of the Franz Volhard Clinic of the Humboldt University of Berlin, said itraised questions over whether enough effort was made to resuscitate young, otherwise fit patients suffering cardiac arrest.
"I have worked in the US and I am sure they would have given up there after one and a half hours," he says. "In this case, the German team were very good physicians and they wouldn't give up. They saved his life. In an 80-year-old with heart disease it would be a different matter, but in a younger person with a cardiac arrest of unknown cause you shouldn't give up. That is the message."
In Britain there are no clear guidelines on when to stop resuscitation, said Dr John Ryan, consultant at the Royal Sussex County Hospital and a spokesman for the British Association of Accident and Emergency Medicine. "If someone is elderly, has an irreversible illness and is unlikely to return to an independent life there is no case for prolonging resuscitation attempts. But in someone who has taken poison, or in drowning and hypothermia cases, it is important to continue for a prolonged time."Reuse content