{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:01Z","timestamp":1787016901965,"version":"build-2736575974"},"reference-count":17,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,30]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>A 26-year-old woman presented after an intentional ingestion of 20\u2009g 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\u2013base 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\u2019s care; the highest measured caffeine concentration 7\u2009hours after ingestion was 147.1\u2009mg\/L. The known lethal dose of caffeine is 80\u2009mg\/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.<\/jats:p>","DOI":"10.1136\/bcr-2020-234256","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T05:33:24Z","timestamp":1589520804000},"page":"e234256","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Intralipid and haemodialysis in caffeine overdose"],"prefix":"10.1136","volume":"13","author":[{"given":"Rebecca","family":"Harsten","sequence":"first","affiliation":[{"name":"Critical Care, Queen Elizabeth Woolwich, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-1125","authenticated-orcid":false,"given":"Simon John","family":"Tetlow","sequence":"additional","affiliation":[{"name":"Critical Care, Queen Elizabeth Woolwich, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbert","family":"Chan","sequence":"additional","affiliation":[{"name":"Critical Care, Queen Elizabeth Woolwich, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshaya","family":"Ankuli","sequence":"additional","affiliation":[{"name":"Critical Care, Queen Elizabeth Woolwich, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"2025082803265246000_13.5.e234256.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2004.10.027"},{"key":"2025082803265246000_13.5.e234256.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00613933"},{"key":"2025082803265246000_13.5.e234256.3","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.toxrep.2018.11.002","article-title":"The clinical toxicology of caffeine: a review and case study","volume":"5","author":"Willson","year":"2018","journal-title":"Toxicol Rep"},{"key":"2025082803265246000_13.5.e234256.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2005.04.016"},{"key":"2025082803265246000_13.5.e234256.5","doi-asserted-by":"publisher","DOI":"10.1111\/1556-4029.12387"},{"key":"2025082803265246000_13.5.e234256.6","doi-asserted-by":"crossref","DOI":"10.3390\/nu10050611","article-title":"Caffeine-Related deaths: manner of deaths and categories at risk","volume":"10","author":"Cappelletti","year":"2018","journal-title":"Nutrients"},{"key":"2025082803265246000_13.5.e234256.7","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.3390\/ijms15022024","article-title":"Adenosine receptors: expression, function and regulation","volume":"15","author":"Sheth","year":"2014","journal-title":"Int J Mol Sci"},{"key":"2025082803265246000_13.5.e234256.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.173526"},{"key":"2025082803265246000_13.5.e234256.9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1089\/caff.2017.0011","article-title":"Kinetic and dynamic description of caffeine","volume":"8","author":"Alsabri","year":"2018","journal-title":"J Caffeine Adenosine Res"},{"key":"2025082803265246000_13.5.e234256.10","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-13443-2_3"},{"key":"2025082803265246000_13.5.e234256.11","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.53.2882"},{"key":"2025082803265246000_13.5.e234256.12","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.115.003088","article-title":"Electrocardiogram abnormalities of caffeine overdose","volume":"9","author":"Fabrizio","year":"2016","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2025082803265246000_13.5.e234256.13","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s00540-016-2198-x","article-title":"Intralipid in acute caffeine intoxication: a case report","volume":"30","author":"Muraro","year":"2016","journal-title":"J Anesth"},{"key":"2025082803265246000_13.5.e234256.14","doi-asserted-by":"publisher","DOI":"10.1124\/pr.117.014407"},{"key":"2025082803265246000_13.5.e234256.15","doi-asserted-by":"publisher","DOI":"10.1007\/BF00606637"},{"key":"2025082803265246000_13.5.e234256.16","doi-asserted-by":"publisher","DOI":"10.1007\/BF00544361"},{"key":"2025082803265246000_13.5.e234256.17","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-224185","article-title":"Dangerous mistake: an accidental caffeine overdose","volume":"2018","author":"Andrade","year":"2018","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-234256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:26:58Z","timestamp":1756376818000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-234256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":17,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5,14]]},"published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1136\/bcr-2020-234256"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-234256","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}