ABSTRACT
Aim : Critical ill patients experience catabolic stress which
results in systemic inflammatory response. Inflammatory response is
associated with increased complications including infection, multi-organ
dysfunction, increased length of ICU stays and mortality. L-Carnitine
supplementation may play an important role in these patients by
regulating inflammatory cell function. The purpose of the present study
was to investigate the effect of L-Carnitine supplementation on clinical
status, inflammatory markers, and mortality rate in critically ill
patients admitted in the intensive care unit(ICU)
Methods : This randomized, double-blind, placebo-controlled
trial was performed on critically ill patients. Subjects were randomly
assigned into placebo (n=27) and L-Carnitine (n=27) groups. L-Carnitine
(3000mg/day) was administered via nasogastric tube for the intervention
group for 7 days while the other group received placebo for the same
duration. Serum levels of inflammatory markers including C-reactive
protein (CRP) and interlukin-6 (IL-6) were measured. Nutritional status
and the acute physiology and chronic health evaluation (APACHE) score,
sequential organ failure assessment (SOFA) score, and 28-day mortality
were also recorded.Results : Fifty-one critically ill patients completed the study.
L-Carnitine supplementation significantly reduced the levels of CRP
(mean change± SE: -34.9 ± 6.5) and IL-6 (mean change ±SE: -10.64 ± 2.16)
compared to the baseline, which are both statistically significant
compared with the control group (p<0.05). The SOFA and APACHE
scores significantly reduced in the L-Carnitine group compared with the
placebo group (p=0.02 and p<0.001, respectively).Conclusions : L-Carnitine supplementation has a substantial
beneficial effects on inflammatory and clinical outcomes of critically
ill patients.
Keywords : L-Carnitine, Inflammation, Supplement, Critically ill
patient, Intensive care unit