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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 Publisher Pubmed



Keshani M1 ; Alikiaii B2 ; Babaei Z3 ; Askari G1, 2 ; Heidari Z4 ; Sharma M5 ; Bagherniya M1, 2
Authors
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Authors Affiliations
  1. 1. Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Nursing and Midwifery, Islamic Azad University Isfahan (Khorasgan) Branch, Isfahan, Iran
  4. 4. Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Social & amp
  6. 6. Behavioral Health, School of Public Health, & amp
  7. 7. Department of Internal Medicine, University of Nevada, Las Vegas, United States

Source: Nutrition Journal Published:2024


Abstract

Background: Sepsis, a life-threatening organ dysfunction caused by a host’s dysregulated response to infection with an inflammatory process, becomes a real challenge for the healthcare systems. L-carnitine (LC) has antioxidant and anti-inflammatory properties as in previous studies. Thus, we aimed to determine the effects of LC on inflammation, oxidative stress, and clinical parameters in critically ill septic patients. Methods: A randomized double-blinded controlled trial was conducted. A total of 60 patients were randomized to receive LC (3 g/day, n = 30) or placebo (n = 30) for 7 days. Inflammatory and oxidative stress parameters (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (TAC), 28-day mortality rate, and some monitoring variables were evaluated. Results: There was no statistically significant difference between study arms in baseline characteristics and disease severity scores. CRP (p < 0.001) and ESR (p: 0.004) significantly reduced, and SOD (p < 0.001) and TAC (p < 0.001) significantly improved in the LC group after 7 days. Between-group analysis revealed a significant reduction in CRP (p: 0.001) and serum chloride (p: 0.032), an increase in serum albumin (p: 0.036) and platelet (p: 0.004) significantly, and an increase in SOD marginally (p: 0.073). The 28-day mortality rate was also lower in the LC group compared with placebo (7 persons vs. 15 persons) significantly (odds ratio: 0.233, p: 0.010). Conclusions: L-carnitine ameliorated inflammation, enhanced antioxidant defense, reduced mortality, and improved some clinical outcomes in critically ill patients with sepsis. Trial registration: IRCT20201129049534N1; May 2021. © The Author(s) 2024.
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