A successful experience using labetalol and hemodialysis to treat near-fatal caffeine poisoning: A case report with toxicodynamics

Caffeine 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. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This article reports a case of an 18-year-old male who attempted suicide with a high dose of pure caffeine powder. The patient was successfully rescued through the administration of labetalol and hemodialysis. The article discusses the clinical symptoms, management, and toxicodynamics of caffeine poisoning.