Cardioprotective role of the coenzyme Q10 and coconut oil in acute aluminum phosphide poisoning: a randomized controlled clinical trial.

Autor:	Elsharkawy RE; Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt., Ghonem MM; Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt., El-Sarnagawy GN; Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt., Nagy AA; Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt., Heshmat MM; Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.
Jazyk:	angličtina
Zdroj:	Toxicology research [Toxicol Res (Camb)] 2023 May 27; Vol. 12 (3), pp. 507-519. Date of Electronic Publication: 2023 May 27 (Print Publication: 2023).
DOI:	10.1093/toxres/tfad037
Abstrakt:	Aluminum phosphide (ALP)-induced cardiotoxicity is a major cause of high mortality rates. As there is no specific antidote, restoring cardiac hemodynamics is the cornerstone for saving patients. Based on oxidative stress theory in acute ALP poisoning, we examined the cardioprotective role of coconut oil and Coenzyme Q10 (COQ10) in ALP poisoning, focusing on their antioxidant capacity. This study was a randomized, controlled, single-blind, phase II clinical trial conducted at Tanta Poison Control Center over 1 year. Eighty-four ALP poisoned patients received supportive treatment and were randomly allocated to three equal groups. Gastric lavage was performed using sodium bicarbonate 8.4% with saline in group I. Alternatively, group II received 50 ml coconut oil, and group III initially received 600 mg CoQ10 dissolved in 50 ml coconut oil; and repeated 12 hours later. In addition to patient characteristics, clinical, laboratory, electrocardiography (ECG), and total antioxidant capacity (TAC) data were recorded and repeated 12 hours later. Patient outcomes were evaluated. There was no significant difference among groups considering patient characteristics, initial cardiotoxicity severity, vital, laboratory data, ECG changes, and TAC. However, 12 hours post-admissions, group III was significantly improved in all clinical, laboratory, and ECG parameters than comparable groups. Significant correlations were observed between elevated TAC in groups II and III with hemodynamic, serum troponin, and ECG variables. Accordingly, the need for intubation, mechanical ventilation, and the total vasopressor dose was significantly decreased in group III compared with other groups. Therefore, coconut oil and COQ10 are promising cardioprotective adjuvant therapy ameliorating the ALP-induced cardiotoxicity. (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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