According to information from the Poison Control Center - Bach Mai Hospital, on May 31, 2023, a 44-year-old female patient from Thai Nguyen was admitted here in a coma, metabolic acidosis, on a ventilator, rhabdomyolysis, and myocardial damage. According to information from the patient's family and frontline doctors, at 4:00 p.m. the same day, the patient and her husband drank sour bamboo shoot juice from a jar of sour bamboo shoots that the family had soaked themselves. The jar contained about 1kg of fresh pickled bamboo shoots that had been kept for 1 year and the family was gradually eating.
Five minutes after the patient drank about 200ml, the patient complained of headache, severe vomiting, generalized convulsions, coma, blood test showed severe metabolic acidosis, high blood lactate. The patient was given emergency treatment at the front line, endotracheal intubation, sedation, mechanical ventilation, intravenous fluids and consultation with the remote Poison Control Center, then transferred to the Poison Control Center due to suspected cyanide poisoning with a severe prognosis or possible complicated developments.
Drinking too much sour bamboo shoot juice caused a patient to suffer from critical cyanide poisoning. (Illustration photo).
The samples brought by the patient were tested for toxins, the test results showed that all samples contained cyanide, including the bamboo shoot juice sample and the patient's body samples, especially the cyanide content in the samples as follows: gastric juice 0.5 mg/L; blood 1 mg/L; urine 2 mg/L. After emergency treatment, the patient continued to receive intensive resuscitation treatment, his condition gradually improved, he became conscious, the tests returned to normal and the endotracheal tube was removed. After 4 days, the patient was discharged from the hospital.
Dr. Nguyen Trung Nguyen - Director of the Poison Control Center said that cyanide is an extremely toxic substance, the lowest dose that can cause death in humans is 0.56 mg/kg of body weight, with the patient's weight, drinking 30mg of cyanide can cause death. In addition, the husband drank about 30ml with the patient so he was not poisoned.
According to Dr. Nguyen Trung Nguyen, some plants contain precursors of cyanide, called cyanogenic glycosides. When eaten, these substances will turn into cyanide, most typically cassava and bamboo shoots (bamboo shoots, rattan, bamboo, etc.). Bamboo shoots contain a cyanogenic glycoside called taxiphyllin. At the same time, bamboo shoots also contain an enzyme called B-glycosidase that can convert taxiphyllin into cyanide.
However, when the bamboo shoot is intact, the B-glycosidase enzyme is in a state where it cannot contact taxiphyllin and therefore does not produce cyanide. When the bamboo shoot is broken, crushed or chewed, or the bamboo shoot is sliced and soaked, the B-glycosidase enzyme contacts taxiphyllin and converts it into cyanide. The human intestine also has the B-glycosidase enzyme, so when the food is bamboo shoots down to the intestine, this enzyme will convert taxiphyllin into cyanide and absorb it into the body.
Bamboo shoots contain precursors of cyanide. (Illustration: bachmai.gov.vn).
In fact, the amount of toxins in bamboo shoots is quickly reduced through processing such as boiling, soaking, and fermenting. In nature, some animals also seem to have ways to adapt and protect themselves so that they can eat bamboo shoots without being poisoned, for example, pandas can eat a lot of bamboo as a daily food source.
When soaking bamboo shoots, a certain amount of cyanide is also produced, both cyanide and taxiphyllin diffuse into the water, the amount of toxins in bamboo shoots can be reduced but the toxins in the water can increase, so if you drink too much bamboo shoot juice, you can be poisoned. Cyanide poisoning from eating bamboo shoots in humans is very rare and only occurs when eating too much to the point of being full or eating too much like "eating instead of rice", and especially with fresh bamboo shoots because the amount of toxins is still high. Under normal eating conditions, people can safely scoop a few small spoons of bamboo shoot juice as a seasoning without any problem.
To prevent cyanide poisoning from eating bamboo shoots and cassava, the Poison Control Center recommends that people prepare bamboo shoots and cassava thoroughly before eating. Bamboo shoots should be boiled thoroughly, if possible, for 1-2 hours. Fresh bamboo shoots should be cut into small, thin pieces before being soaked in a jar and then soaked in water for 24 hours to remove toxins.
When boiling or soaking bamboo shoots, users should note to change the water many times to effectively remove toxins because the old water has toxins from the bamboo shoots diffused. People should also avoid extreme situations of eating too much bamboo shoots, for example, eating bamboo shoots mainly until full, or "eating instead of rice". The water soaked in bamboo shoots can be used as a seasoning but should not be drunk too much. With cassava, it is necessary to peel off all the skin, then wash off the resin and soak thoroughly in a lot of water or change the water many times and should not eat too much.
Le Trang
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