L-Carnitine Effects on Clinical Status and Mortality Rate in Septic Patients: A Systematic Literature Review

Abstract

Introduction: Sepsis is one of the major causes of high morbidity and mortality in intensive care units (ICU) and severe sepsis leads to some metabolic disorder. The previous studies indicate that l-carnitine deficiency in septic patients and causing mitochondria dysfunction and worsening metabolic disorder. Reducing mortality in sepsis by nutritional supplements may help mitigate the risk of clinical outcomes in sepsis patients. Methods: Our systematic search to find relevant studies was performed up to March 2020, using ISI Web of Science, Google Scholar, EMBASE, PubMed/MEDLINE and SCOPUS databases. In this systematic review, the aim was to assess whether l-carnitine or levocarnitine may reduce the risk of mortality in patients with sepsis. Result: 10 articles were included in our systematic review. The results of the review showed that plasma carnitine levels were significantly associated with the Sequential Organ Failure Assessment score (SOFA) (p<0.001). On the other hand, other studies showed carnitine supplementation had no significant effect on SOFA score change in a short time, while carnitine deficiency was associated with significantly increased SOFA score in critically ill patients. L-carnitine supplementation indicated a significant decline in 28 days’ mortality as well. Conclusion: Evidencefrom limited data suggested that carnitine may helps to reduce mortality risk in sepsis patients, but further studies are required with different doses and durations.

Keywords

• l-carnitine
• acylcarnitine
• sepsis
• critically ill
• clinical status
• mortality rate