The effects of l-Carnitine supplementation on inflammatory markers, clinical status, and 28 days mortality in critically ill patients: A double-blind, randomized, placebo-controlled trial.
- 2022-06
- Clinical nutrition ESPEN 49
- Farveh Yahyapoor
- Alireza Sedaghat
- Awat Feizi
- Mohammad Bagherniya
- Naseh Pahlavani
- Majid Khadem-Rezaiyan
- Mohammad Safarian
- Mohammad Shariul Islam
- Sudiyeh Hejri Zarifi
- Seyyed Mostafa Arabi
- Abdolreza Norouzy
- PubMed: 35623869
- DOI: 10.1016/j.clnesp.2022.04.001
Study Design
- Type
- Randomized Controlled Trial (RCT)
- Sample size
- n = 27
- Population
- 51 critically ill patients
- Methods
- Randomized, double-blind, placebo-controlled trial, 3000 mg/day l-Carnitine via nasogastric tube for 7 days vs placebo
- Blinding
- Double-blind
- Duration
- 7 days
- Funding
- Unclear
Aim
Critical ill patients experience catabolic stress, which results in a systemic inflammatory response. The 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 to 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 (3000 mg/day) was administered via nasogastric tube for the intervention group for 7 days, while the other group received a placebo for the same duration. Serum levels of inflammatory markers, including C-reactive protein (CRP) and interleukin-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 is both statistically significant compared with the control group (p < 0.05). The SOFA and APACHE scores were significantly reduced in the l-Carnitine group compared with the placebo group (p = 0.02 and p < 0.001, respectively).Conclusions
l-Carnitine supplementation showed beneficial effects on inflammatory and clinical outcomes of critically ill patients.Trial registration details
Trial registration: IRCT, Registered 30 May 2018, https://www.irct.ir/trial/30748.Research Insights
The ... APACHE scores were significantly reduced in the l-Carnitine group compared with the placebo group (p < 0.001, respectively).
- Effect
- Beneficial
- Effect size
- Small
- Dose
- 3000 mg/day
l-Carnitine supplementation significantly reduced the levels of CRP (mean change ± SE: -34.9 ± 6.5) compared to the baseline, which is both statistically significant compared with the control group (p < 0.05).
- Effect
- Beneficial
- Effect size
- Large
- Dose
- 3000 mg/day
l-Carnitine supplementation significantly reduced the levels of ... IL-6 (mean change ± SE: -10.64 ± 2.16) compared to the baseline, which is both statistically significant compared with the control group (p < 0.05).
- Effect
- Beneficial
- Effect size
- Moderate
- Dose
- 3000 mg/day
The ... 28-day mortality were also recorded.
- Effect
- Neutral
- Effect size
- Small
- Dose
- 3000 mg/day
The SOFA ... scores were significantly reduced in the l-Carnitine group compared with the placebo group (p = 0.02 ...).
- Effect
- Beneficial
- Effect size
- Small
- Dose
- 3000 mg/day