The effects of adjunctive treatment with l-carnitine on monitoring laboratory variables in ICU patients: a double-blinded randomized controlled clinical trial

Abstract

Background Critically ill patients must be monitored constantly in intensive care units (ICUs). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of l-carnitine adjunctive therapy on monitoring variables in critical illness. Method A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 g l-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status. Result Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P-value: 0.001), total protein (P-value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate (<0.001), creatinine (Cr) (0.005), and international normalized ratio (INR) (0.049) decreased meaningfully in the intervention vs. control group. Conclusion l-Carnitine supplementation in critically ill patients can improve several parameters including INR, Cr, ALT, lactate, Ca, Alb, and total protein. Trial registration Iranian Registry of Clinical Trials IRCT 20151108024938N2. This trial was approved by the Research Ethics Committee of Mashhad University of Medical Sciences (registration code: IR.MUMS.fm.REC.1396.671) (available at https://en.irct.ir/trial/30748, May 2018).

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial

“…A randomized ICU-based clinical trial by Yahyapoor, et al which was published recently, revealed that 3 g LC per day for 7 days in the liquid form via enteral tube feeding in 54 critically ill patients, improved serum Alb and decreased CRP and IL-6 biomarkers in the LC group in comparison to the placebo group which is in line with our results. The major limitation of the mentioned trial was the broadly heterogeneous patients that were included but we focus on septic patients [20,28]. Thirteen clinical trials on the topic of LC supplementation effects on inflammatory biomarkers [21].…”

Unveiling Pathophysiological Insights: Serum Metabolic Dysregulation in Acute Respiratory Distress Syndrome Patients with Acute Kidney Injury

“…41 Creatine, stored in skeletal muscles, undergoes breakdown to fulfill energy requirements in such a population in the condition of deprived energy, and hence, an increased level of both creatine and creatinine 44 is found in AKI patients. Yahyapoor et al, 45 in a double-blinded randomized controlled trial on 54 ICU patients with multiple conditions, observed that providing 3 g L-carnitine supplementation to patients along with feed improved their creatinine levels along with albumin, calcium, alanine transaminase (ALT), and lactate. In our study, the ARDS patients with AKI had elevated creatine levels, indicating higher energy requirements resulting in increased severity, with the results of correlation analysis pointing in the same direction.…”

A Comprehensive Review on L-carnitine: A Promising Nutraceutical

“…(Yahyapoor et al, 2023) [137] Randomized controlled trials During major depressive episodes (MDEs), there's a notable decline in the metabolic activity of mitochondria converting l-carnitine to ALC.…”