Haemodialysis in massive caffeine intoxication

Caffeine is the most widely consumed psychoactive substance worldwide. Intoxication causes central nervous system and haemodynamic complications, which have significant mortality rates. We report the case of a 39-year-old woman who ingested ~0.5 mol (100 g) of pure caffeine, leading to a peak serum concentration of 2.95 mmol/L (574 mg/L). Three consecutive haemodialysis sessions caused serum caffeine reduction rates of 66, 46 and 45%, indicating that the unbound caffeine fraction is not dose linear in this high serum caffeine concentration range. Aggressive and repeated haemodialysis sessions may be of benefit in cases of severe caffeine intoxication.