Assessment of blood purification in acute caffeine intoxication

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  • Takeda Saki
    Department of Forensic Medicine, Fukushima Medical University, School of Medicine
  • Ueno Satoshi
    Department of Regional Emergency Medicine, Fukushima Medical University
  • Suzuki Tsuyoshi
    Department of Emergency and Critical Care Medicine, Fukushima Medical University, School of Medicine
  • Onodera Makoto
    Department of Regional Emergency Medicine, Fukushima Medical University
  • Kato Naho
    Department of Forensic Medicine, Fukushima Medical University, School of Medicine
  • Nishikata Rie
    Department of Forensic Medicine, Fukushima Medical University, School of Medicine
  • Iseki Ken
    Department of Regional Emergency Medicine, Fukushima Medical University Department of Emergency and Critical Care Medicine, Fukushima Medical University, School of Medicine

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Other Title
  • 急性カフェイン中毒患者に実施した血液浄化法の評価
  • キュウセイ カフェイン チュウドク カンジャ ニ ジッシ シタ ケツエキ ジョウカホウ ノ ヒョウカ

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Abstract

<p>We performed continuous hemodiafiltration (CHDF) and hemodialysis (HD) in two patients suspected of severe acute caffeine intoxication and could save their lives. Caffeine clearance (CL) and elimination half-life (t1/2) were calculated and assessed for performing effective blood purification.</p><p>Blood caffeine concentration was quantified using gas chromatography/mass spectrometry, and CL and t1/2 were calculated. The blood caffeine concentrations in Case 1 and Case 2 on arrival were 86 μg/mL and 135 μg/mL, respectively, reaching the lethal level. Caffeine CL values for CHDF and HD were 3-29 mL/min and 132-149 mL/min, respectively, and t1/2 values were 12 h and 3.5 h, respectively.</p><p>For cases suspected of severe acute caffeine intoxication, it is desirable to select (1) HD, (2) direct hemoperfusion (DHP), or (3) their combination. It was considered desirable to perform multiple HDs for cases wherein a high blood caffeine concentration was expected. For cases wherein performing HD or DHP is difficult, it is desirable to first choose CHDF and then switch to HD or DHP.</p>

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