A Case of Fatal Caffeine Overdose

Abstract

A female in her twenties who took 15 g of anhydrous caffeine in a suicide attempt, was transferred to our hospital. Ventricular fibrillation (VF) occurred upon arrival at our hospital, and cardiopulmonary resuscitation including veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was performed. Blood tests showed marked acidosis and hypokalemia. She was admitted to the intensive care unit (ICU), and continuous hemodiafiltration (CHDF) and continuous intravenous administration of potassium were started. Return of spontaneous circulation and normal sinus rhythm were obtained 286 and 356 min after arrival at our hospital, respectively. Brain computed tomography performed on the 2nd hospital day showed loss of gray-white matter differentiation, and electroencephalography performed on the same day showed a flattening. On the 3rd hospital day, we informed her family about her severe prognosis because of hypoxic encephalopathy, and it was decided not to intervene further. She died on the 8th hospital day.

It is important for physicians at hospitals that accept patients who ingested a lethal dose of caffeine to improve the environment to be able to respond to sudden changes in the patient’s general condition.