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Energydrinks in der Notfallmedizin – verleihen nicht nur Flügel

Energy drinks in emergency medicine—give more than wings

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Zusammenfassung

Der Konsum von Energydrinks stieg in den vergangenen Jahren stark an. Demensprechend werden notfallmedizinische Strukturen wie der Rettungs- und Notarztdienst, aber auch Notaufnahmen immer häufiger mit Patienten konfrontiert, die Energydrinks zu sich genommen haben und an den meist sympathomimetisch induzierten unerwünschten Wirkungen des Koffeins leiden (z. B. Palpitationen, Tachykardien, Unruhe, Angstzustände, Agitationen, Elektrolytstörungen). Auf der anderen Seite wurden in den vergangenen Jahren auch zahlreiche Fallberichte zu Patienten veröffentlicht, die sich nach einem teilweise exzessiven Konsum von Energydrinks mit typischen notfallmedizinischen Krankheitsbildern präsentierten, bei deren Versorgung man aber primär meist nicht an Energydrinks als (mit‑)auslösendes Agens denken würde. Hierzu gehören u. a. Myokardinfarkte, Aortendissektionen, schwere Herzrhythmusstörungen, Herz-Kreislauf-Stillstände, Hirninfarkte und -blutungen, epileptische Anfälle und Hepatitis. Daher kann – bei entsprechender Konstellation – die Erhebung des aktuellen und chronischen Energydrinkkonsums in der Anamnese wichtige Informationen liefern. Ebenso sollten bei Patienten, die mit Beschwerden (z. B. thorakalen Schmerzen, neurologisches Defizit) nach exzessivem Konsum dieser Getränke rettungsdienstliche oder notärztliche Hilfe in Anspruch nehmen bzw. sich in einer Notaufnahme präsentieren, entsprechende Differenzialdiagnosen in Betracht gezogen werden. In der vorliegenden systematischen Übersichtarbeit werden daher Häufigkeit, Symptomkonstellationen und Aspekte der diagnostischen Abklärung bei Konsum von Energydrinks präsentiert und diskutiert.

Abstract

In recent years, the consumption of energy drinks has massively increased. For this reason, we see more and more patients in our emergency medical services and emergency departments who have consumed energy drinks and suffer from sympathomimetic side effects of the caffeine which is a main ingredient of energy drinks, e. g., palpitations, tachycardia, restlessness/anxiety/nervousness, electrolyte imbalances. On the other hand, numerous case reports have been published on the association of partly excessive energy drink consumption and severe typical emergency medical disease patterns, one would not associate with energy drinks as a triggering agent: myocardial infarction, aortic dissection, severe cardiac arrhythmias, cardiac arrest, cerebral infarction and hemorrhage, seizures, and hepatitis. Therefore, inquiry about the amount of the present and chronic consumption of energy drinks during the medical history taking may provide important information about a possible intoxications. In patients who seek medical help due to symptoms such as chest pain or neurological deficits after excessive consumption of energy drinks, appropriate differential diagnoses should be considered. In this systematic review, incidence, typical symptoms, and different diagnostic approaches for patients presenting with suspected intoxications with energy drinks are presented and discussed.

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Authors and Affiliations

  1. Universitätsklinik für Anästhesiologie und Schmerztherapie, Universitätsspital Bern, Freiburgstrasse, 3010, Bern, Schweiz

    J. Knapp DESA, EDIC, MHBA

  2. Klinik für Kardiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    M. Zylla

  3. GIZ-Nord (Giftinformationszentrum-Nord der Länder Bremen, Hamburg, Niedersachsen und Schleswig-Holstein), Zentrum Pharmakologie und Toxikologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    A. Schaper

  4. Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland

    D. Michalski

  5. Forensische Toxikologie, Institut für Rechtsmedizin, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    S. Hartwig

  6. Zentrale Notaufnahme, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland

    M. Bernhard

  7. Arbeitsgruppe „Trauma- und Schockraummanagement“, Arbeitskreis Notfallmedizin der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin, Roritzerstr. 27, 90419, Nürnberg, Deutschland

    M. Bernhard

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  1. J. Knapp DESA, EDIC, MHBA
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Correspondence to J. Knapp DESA, EDIC, MHBA.

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J. Knapp, M. Zylla, A. Schaper, D. Michalski, S. Hartwig und M. Bernhard geben an, dass kein Interessenkonflikt besteht.

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Knapp, J., Zylla, M., Schaper, A. et al. Energydrinks in der Notfallmedizin – verleihen nicht nur Flügel. Notfall Rettungsmed 21, 383–394 (2018). https://doi.org/10.1007/s10049-017-0386-3

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