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- Hao-Cho Ou, Jou-Fang Deng, Chen-Chang Yang, Chin-Sheng Lin, Yan-Chiao Mao, Shih-Hung Tsai, and Cheng-Hsuan Ho.
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
- Am J Emerg Med. 2022 May 1; 55: 224.e1-224.e4.
AbstractCaffeine poisoning is relatively rare, and a near-fatal caffeine overdose is highly uncommon. We present an 18-year-old male who attempted suicide with 295 mg/kg pure caffeine powder (lethal oral dose: 150-200 mg/kg) and was successfully rescued. He presented with seizures, refractory supraventricular tachycardia and hypertension for 6 h with no response to medications and cardioversion. Even with the high level of caffeine, labetalol, which is seldom administered as a treatment for caffeine poisoning-induced tachycardia, successfully relieved refractory tachycardia. Then, hemodialysis ultimately eliminated serum caffeine and completely alleviated caffeine-related central nervous system toxicity. We discuss the clinical symptoms, management and toxicodynamics based on the concentration of caffeine and its metabolites in serum and urine.Copyright © 2021 Elsevier Inc. All rights reserved.
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