Fatal caffeine overdose

February 23, 2010, 8:11 pm

★★½☆☆

A case of fatal caffeine poisoning. Rudolph T et al Acta Anaesthesiol Scand 2010 Jan 21. (Epub ahead of print).

This case report, from Sweden, describes a 21-year-old woman who overdosed on 10,000 mg of caffeine (the equivalent of approximately 83 cups of brewed coffee.)  She suffered multiple occurrences of v. fib arrest which initially responded to countershock, epinephrine, and amiodarone.  On arrival at hospital she was found to have a profound metabolic acidosis (pH 6.47, lactate 33 mmol/l) and a serum potassium of 2.3 mmol/l.  Despite supportive care, potassium repletion, and hemodialysis, she suffered permanent anoxic brain damage and died on the 11th hospital day.

This potentially interesting case reported is weakened by the lack of any serum caffeine level, and the apparent inevitability of a fatal outcome by the time the patient arrived at the emergency department.  Fatalities from caffeine have been reported after ingestions of 5 – 50 g (mean 10 g).  Since the effects of caffeine are quite analogous to those of theophylline, profound hypokalemia was not unexpected.

To calculate the fatal dose of various coffees, sodas, and energy drinks, go to the website “Death by Caffeine“.

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