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

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.