Advanced Search

Study Preview



Study Title and Description

Massive caffeine overdose requiring vasopressin infusion and hemodialysis.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on acute toxicity*?
  • Comments Comments (
    0
    ) |

Primary Publication Information
  • Comments Comments (
    0
    ) |
TitleData
Title Massive caffeine overdose requiring vasopressin infusion and hemodialysis.
Author CP Holstege,Y Hunter,AB Baer,J Savory,DE Bruns,JC Boyd,
Country
Year 2003
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Acute Toxicity - Study Design Details
Arms
No arms have been defined in this extraction form.

Design Details
Question... Follow Up Answer Follow-up Answer
Refid 14705850
  • Comments Comments (
    0
    ) |
What outcome is being evaluated in this paper? Acute
  • Comments Comments (
    0
    ) |
What is the objective of the study (as reported by the authors)? to report on an unusual case of a 41 year old woman who ingested 50 grams of caffeine and survived after hemodyalsis and vasopressin treatment
  • Comments Comments (
    0
    ) |
Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) case presented to emergency room, caffeine measured in serum (405 mg/L), other vital signs noted in quite good detail
  • Comments Comments (
    0
    ) |
How many outcome-specific endpoints are evaluated? 4
  • Comments Comments (
    0
    ) |
What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) serum caffeine evaluated as 405 mg/L
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately).
  • Comments Comments (
    0
    ) |
List additional health endpoints (separately)
  • Comments Comments (
    0
    ) |
Notes I listed these as these end points (CV-changes/seizure/serum caffeine) are all common to caffeine acute toxicity in overdose
  • Comments Comments (
    0
    ) |
Clinical Clinical
  • Comments Comments (
    0
    ) |
Physiological
  • Comments Comments (
    0
    ) |
Other
  • Comments Comments (
    0
    ) |
What is the study design? Case report
  • Comments Comments (
    0
    ) |
Randomized or Non-Randomized?
  • Comments Comments (
    0
    ) |
What were the diagnostics or methods used to measure the outcome? Both
  • Comments Comments (
    0
    ) |
Optional: Name of Method or short description emergency room procedures (blood drawn/analyzed by hospital lab, ECG measured tachycardia, tonic clonic seizure would have been objective noted by doctor
  • Comments Comments (
    0
    ) |
Caffeine (general)
  • Comments Comments (
    0
    ) |
Coffee
  • Comments Comments (
    0
    ) |
Chocolate
  • Comments Comments (
    0
    ) |
Energy drinks
  • Comments Comments (
    0
    ) |
Gum
  • Comments Comments (
    0
    ) |
Medicine/Supplement Medicine/Supplement
  • Comments Comments (
    0
    ) |
Soda
  • Comments Comments (
    0
    ) |
Tea
  • Comments Comments (
    0
    ) |
Measured
  • Comments Comments (
    0
    ) |
Self-report Self-report
  • Comments Comments (
    0
    ) |
Children
  • Comments Comments (
    0
    ) |
Adolescents
  • Comments Comments (
    0
    ) |
Adults Adults
  • Comments Comments (
    0
    ) |
Pregnant Women
  • Comments Comments (
    0
    ) |
What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) none this is a case report
  • Comments Comments (
    0
    ) |
What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) they mentioned alcohol intake but ruled it out based on blood chemistry no ethanol or other drugs
  • Comments Comments (
    0
    ) |
Provide a general description of results (as reported by the authors). 41 year suicidal female ingest 50 g caffeine 3 hours prior to admittance, serum caffeine was 405 mg/L ethanol, salicylate and acetaminophen not detected. Blood pressure dropped to 90 systolic then 80s, tachycardia degenerated into 3rd degree AV block, after receiving CaCl2 and MgSO4 she developed a tonic-clonic seizure. Vasopressin was begun hemodialysis performed 10 hr after arrival , blood pressure improved. Intubated for 17 days , 24 days after arrival returned home made full recovery
  • Comments Comments (
    0
    ) |
Did the authors perform a dose-response analysis (or trend/related analysis)? No
  • Comments Comments (
    0
    ) |
What were the authors's observations re: trend analysis?
  • Comments Comments (
    0
    ) |
What were the author's conclusions? This massive caffeine overdose is remarkable for a number of reasons. This is the first reported use of either vasopressin or hemodialysis in caffeine overdose. This is the highest serum caffeine level reported to have survived. This case also stresses the importance of continued resuscitation despite dire clinical situations in drug overdose patients.
  • Comments Comments (
    0
    ) |
What were the sources of funding? none listed
  • Comments Comments (
    0
    ) |
What conflicts of interest were reported? none listed - this is a case report of near fatality
  • Comments Comments (
    0
    ) |
Does the exposure (dose) need to be standardized to the SR? No
  • Comments Comments (
    0
    ) |
Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest).
  • Comments Comments (
    0
    ) |
List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  50g caffeine associated with adverse effects (tachycardia, AV block, seizure, low systolic bp) but patient survived after treated with vasopressin and hemodialysis
  • Comments Comments (
    0
    ) |
Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. 50 g oral exposure equated to 405mg/L; acute toxicity nearly lethal but medically treatable.
  • Comments Comments (
    0
    ) |
What is the importance of the study with respect to the adverseness of the outcome? Critcal
  • Comments Comments (
    0
    ) |


Baseline Characteristics
No baseline characteristics have been defined for this extraction form.



Results & Comparisons

No Results found.
Adverse Events
Arm or Total Title Description Comments

Quality Dimensions
No quality dimensions were specified.

Quality Rating
No quality rating data was found.