• Christopher P Holstege, Yvonne Hunter, Alexander B Baer, John Savory, David E Bruns, and James C Boyd.
• Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia, Charlottesville, Virginia 22908-0699, USA. ch2xf@virginia.edu
• J. Toxicol. Clin. Toxicol. 2003 Jan 1; 41 (7): 1003-7.

IntroductionMassive caffeine overdose is associated with life-threatening hemodynamic complications that present challenges for clinicians. We describe the highest-reported serum concentration of caffeine in a patient who survived and discuss the first-reported use of vasopressin and hemodialysis in a caffeine-poisoned patient.Case ReportA 41-yr-old woman presented 3 h after ingesting approximately 50 g of caffeine. She subsequently underwent cardiopulmonary resuscitation and received multiple medications in an attempt to raise her blood pressure and control her heart rate without success. Vasopressin infusion increased her blood pressure to the point where hemodialysis could be performed. Despite ensuing multisystem organ failure, she survived and has made a complete recovery.ConclusionHemodialysis and vasopressin infusions may be of benefit in the management of caffeine-intoxicated patients who fail to respond to standard therapies.

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