Intralipid and haemodialysis in caffeine overdose
| Autor: | Torbert Chan, Rebecca Harsten, Simon John Tetlow, Akshaya Ankuli |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Fat Emulsions Intravenous Bicarbonate Hypokalemia Suicide Attempted 030204 cardiovascular system & hematology Ventricular tachycardia Norepinephrine (medication) Magnesium Sulfate 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Renal Dialysis Caffeine medicine Humans Ingestion Phospholipids Novel Treatment (New Drug/Intervention Established Drug/Procedure in New Situation) business.industry Lethal dose Metabolic acidosis General Medicine medicine.disease Soybean Oil chemistry Respiratory alkalosis Anesthesia Tachycardia Ventricular Emulsions Female Drug Overdose Acidosis business Anti-Arrhythmia Agents 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 26-year-old woman presented after an intentional ingestion of 20 g of caffeine. She suffered a profound respiratory alkalosis with metabolic acidosis, hypokalaemia and sustained polymorphic ventricular tachycardia. She was treated with intravenous intralipid and haemodialysis, and her arrhythmia was controlled using magnesium sulphate. Once invasively ventilated and unable to hyperventilate the patient became acidotic and required intravenous bicarbonate to correct her acid–base status. Two days following the overdose the patient was extubated, haemodialysis was stopped and norepinephrine was weaned off. The patient was discharged after a further 7 days. Serial caffeine levels were taken during this patient’s care; the highest measured caffeine concentration 7 hours after ingestion was 147.1 mg/L. The known lethal dose of caffeine is 80 mg/L. Intralipid and haemodialysis represent a new and viable treatment in life-threatening caffeine overdose. Intravenous magnesium may terminate unstable arrhythmias in caffeine-poisoned patients. |
| Databáze: | OpenAIRE |
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