• Teri M Kozik, Sachin Shah, Mouchumi Bhattacharyya, Teresa T Franklin, Therese Farrell Connolly, Walter Chien, George S Charos, and Michele M Pelter.
• St. Joseph's Medical Center, Stockton CA -Clinical Research Department. Electronic address: teri.kozik@dignityhealth.org.
• Am J Emerg Med. 2016 Jul 1; 34 (7): 1205-9.

BackgroundEnergy drink consumption has increased significantly over the past decade and is associated with greater than 20,000 emergency department visits per year. Most often these visits are due to cardiovascular complaints ranging from palpitations to cardiac arrest.ObjectiveTo determine if energy drinks alter; blood pressure, electrolytes, activated bleeding time (ACT), and/or cardiac responses measured with a 12-lead electrocardiographic (ECG) Holter.MethodsContinuous ECG data was collected for five hours (30 minutes baseline and 4 hours post consumption [PC]). Subjects consumed 32 ounces of energy drink within one hour and data (vital signs and blood samples) was collected throughout the study period. Paired students t-test and a corresponding non-parametric test (Wilcoxon signed rank) were used for analysis of the data.ResultsFourteen healthy young subjects were recruited (mean age 28.6 years). Systolic blood pressure (baseline=132, ±7.83; PC=151, ±11.21; P=.001); QTc interval (baseline=423, ±22.74; PC=503, ±24.56; P<.001); magnesium level (baseline 2.04, ± 0.09; PC=2.13, ±0.15; P=.05); and calcium level (baseline=9.31, ±.28; PC=9.52, ±.22; P=.018) significantly increased from baseline. While potassium and ACT fluctuated (some subjects increased their levels while others decreased) these changes were not significant. Eight of the fourteen subjects (57%) developed a QTc >500 milliseconds PC. Other T-wave changes were noted in 9/14 (64.3%) subjects PC.ConclusionsEnergy drinks increased systolic blood pressure, altered electrolytes, and resulted in repolarization abnormalities. These physiological responses can lead to arrhythmias and other abnormal cardiac responses highlighting the importance that emergency room personnel assess for energy drink consumption and potential toxicity.Copyright © 2016. Published by Elsevier Inc.

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