The efficacy of Coenzyme Q10 and liquid paraffin oil in the management of acute aluminum phosphide poisoning

Abstract

<jats:title>Abstract</jats:title> <jats:p>Aluminum phosphide (AlP) poisoning had high morbidities and mortalities with absence of a standardized approach for the treatment. The present study investigated the efficiency of GIT decontamination methods and Coenzyme Q10(Co Q10) (Ubiquinone) in improving the outcome of acute AlP poisoning. A total of 90 patients were included and all patients received immediately supportive measures, then they distributed into three equal groups: In group I, gastric lavage was done using KMNO4 solution (1:10 000); group II received 250–500 ml liquid paraffin oil orally; group III received 300 mg of Co Q10 dissolved in liquid paraffin. Co Q10 was continued in a dose of 200 mg/day every 12 h. Follow-up blood pressure, arterial blood gases, serum troponin level and need for intubation revealed that the best improvement was in group III followed by group II. The percentage of survivors was 76.67% in group III and 70% of the patients had no residual effects. In group II, the survivors were 63.33%, and 36.67% of the cases discharged without sequelae. The survivors in group I constituted 26.67% and only 16.67% of the patients had no residual effects. GIT decontamination with aqueous solutions in acute AlP poisoning should be avoided. Rapid oral intake of any available oil as a prehospital treatment or immediately on hospital admission could critically improve the outcome of acute AlP poisoning. Besides, the addition of Co Q10 to the oil further improve patients’ prognosis. HighlightsAcute aluminum phosphide (AlP) poisoning is associated with high mortalities.The appropriate method of GIT decontamination in acute AlP poisoning is controversy.Conventional gastric lavage was associated with poor prognosis in acute AlP poisoning.GIT decontamination using liquid paraffin oil improved outcome of acute AlP poisoning.Coenzyme Q10 ameliorated AlP toxicity with improvement of cardiac functions.</jats:p>

Comparison between Gastric Lavage with Paraffin Oil versus Coconut Oil in Acute Aluminum Phosphide Poisoning: A Randomized Controlled Clinical Trial

“…In terms of sociodemographic data, toxicological data, clinical characteristics, laboratory investigation results, and ECG findings, there were no significant changes between the saline and both the paraffin and coconut groups. These were comparable to previous research ( Farahani et al, 2016;Elgazzar et al, 2019;Darwish et al, 2020;Emam et al, 2020;Helal et al, 2022). These findings suggest that the sequentially numbered opaque sealed envelopes (SNOSE) approach was used to achieve optimal randomization in this research.…”

“…After 12-hour from lavage, ABG showed nonsignificant values between the three studied groups. That disagreed with Darwish et al, (Darwish et al, 2020) who found that patients receiving paraffin oil lavage had non-significantly higher pH and PaCO2 values than the patients receiving potassium permanganate lavage solution (1:10000) at three-time intervals. Bicarbonate levels were significantly higher after 16 and 24 hours after admission.…”

Efficacy of intravenous lipid emulsion (ILE) in the treatment of acute aluminum phosphide toxicity at Alexandria Main University Hospital, Egypt

“…There was a significant decrease in mortality in the case group (61.3%) compared with the control group (94.3%), which demonstrated that ILE infusion helped improve the outcomes of the cases. This mortality rate was lower than in many previous studies [15,20,21].…”

“…These measures consecutively restore mitochondrial functions and ATP production and improve the contractility of the heart. Furthermore, CoQ10 can aid in improving the multiorgan dysfunction caused by acute AlP poisoning [14][15][16].…”

Oxidative Stress Parameters, Can They Predict Mortality in Acute Aluminum Phosphide Poisoning?

“…With absence of specific antidote for aluminum phosphide poisoning the treatment of the AlP poisoning only is supportive and symptomatic (6) .…”