Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Clin Nutr ESPEN. 2022 Jun;49:61-67. doi: 10.1016/j.clnesp.2022.04.001. Epub 2022 Apr 9.
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).
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.
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).
l-Carnitine supplementation showed beneficial effects on inflammatory and clinical outcomes of critically ill patients.
Trial registration: IRCT, Registered 30 May 2018, https://www.irct.ir/trial/30748.
危重症患者经历分解代谢应激，导致全身炎症反应。炎症反应与增加的并发症相关，包括感染、多器官功能障碍、ICU 住院时间延长和死亡率增加。左旋肉碱补充可能通过调节炎症细胞功能在这些患者中发挥重要作用。本研究旨在调查左旋肉碱补充对入住重症监护病房（ICU）的危重症患者临床状态、炎症标志物和死亡率的影响。
这是一项随机、双盲、安慰剂对照试验，对危重症患者进行了研究。受试者被随机分配到安慰剂（n=27）和左旋肉碱（n=27）组。左旋肉碱（3000mg/天）通过鼻胃管给予干预组 7 天，而另一组在相同时间内给予安慰剂。测量炎症标志物，包括 C 反应蛋白（CRP）和白细胞介素-6（IL-6）的血清水平。还记录了营养状况和急性生理学和慢性健康评估（APACHE）评分、序贯器官衰竭评估（SOFA）评分以及 28 天死亡率。
51 例危重症患者完成了研究。与基线相比，左旋肉碱补充显著降低了 CRP（平均变化±SE：-34.9±6.5）和 IL-6（平均变化±SE：-10.64±2.16）的水平，与对照组相比，这在统计学上均具有显著差异（p<0.05）。与安慰剂组相比，左旋肉碱组的 SOFA 和 APACHE 评分显著降低（p=0.02 和 p<0.001）。
左旋肉碱补充对危重症患者的炎症和临床结局有有益的影响。
试验注册：IRCT，注册于 2018 年 5 月 30 日，https://www.irct.ir/trial/30748。
