Coenzyme Q10 combined with mild hypothermia after cardiac arrest: a preliminary study.
BACKGROUND
Therapeutic hypothermia can improve survival after cardiopulmonary resuscitation (CPR). Coenzyme Q10 (CoQ10) has shown a protective effect in neurodegenerative disorders. We investigated whether combining mild hypothermia with CoQ10 after out-of-hospital cardiac arrest provides additional benefit.


RESULTS
Forty-nine patients were randomly assigned to either hypothermia plus CoQ10 or hypothermia plus placebo after CPR. Hypothermia with a core temperature of 35 degrees C was instituted for 24 hours. Liquid CoQ10 250 mg followed by 150 mg TID for 5 days or placebo was administered through nasogastric tube. Age, sex, premorbidity, cause of arrest, conditions of CPR, and degree of hypoxia were similar in both groups; no side effects of CoQ10 were identified. Three-month survival in the CoQ10 group was 68% (17 of 25) and 29% (7 of 24) in the placebo group (P=0.0413). Nine CoQ10 patients versus 5 placebo patients survived with a Glasgow Outcome Scale of 4 or 5. Mean serum S100 protein 24 hours after CPR was significantly lower in the CoQ10 group (0.47 versus 3.5 ng/mL).


CONCLUSIONS
Combining CoQ10 with mild hypothermia immediately after CPR appears to improve survival and may improve neurological outcome in survivors.
Damian
Maxwell Simon
MS
Department of Neurology, University Hospitals of Leicester, Leicester, United Kingdom. msd13@le.ac.uk
Ellenberg
Diana
D
Gildemeister
Ramona
R
Lauermann
Jörg
J
Simonis
Gregor
G
Sauter
Wolfgang
W
Georgi
Christian
C
D000328:Adult; D000368:Aged; D015415:Biomarkers; D001925:Brain Damage, Chronic / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D003131:Combined Modality Therapy; D004569:Electroencephalography; D005073:Evoked Potentials, Somatosensory; D005260:Female; D023261:Glasgow Outcome Scale; D006323:Heart Arrest / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009418:S100 Proteins / Q000097:blood; D016037:Single-Blind Method; D016019:Survival Analysis; D016896:Treatment Outcome; D014451:Ubiquinone / Q000008:administration & dosage / Q000627:therapeutic use*
D015415:Biomarkers; D009418:S100 Proteins; D014451:Ubiquinone