title: Clinical relevance of L-carnitine-supplemented total parenteral nutrition in postoperative trauma. Metabolic effects of continuous or acute carnitine administration with special reference to fat oxidation and nitrogen utilization.
abstract: Carnitine-free total parenteral nutrition (TPN) is claimed to result in a carnitine deficiency with subsequent impairment of fat oxidation. The present study was designed to evaluate the possible benefit of carnitine supplementation on postoperative fat and nitrogen utilization. Sixteen patients undergoing total esophagectomy were evenly randomized and received TPN without or with L-carnitine supplementation (74 mumol.kg-1.d-1) during 11 postoperative days. On day 11, a 4-h infusion of L-carnitine (125 mumol/kg) was performed in both groups. The effect of supplementation was evaluated by indirect calorimetry, N balance, and repeated measurements of plasma lipids and ketone bodies. Irrespective of continuous or acute supplementation, respiratory quotient and fat oxidation were similarly maintained throughout the study in both groups whereas N balance appeared to be more favorable without carnitine. We conclude that carnitine-supplemented TPN does not improve fat oxidation or promote N utilization in the postoperative phase.
authors.affiliation: Institute of Physiology, University of Lausanne, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Pichard
authors.forename: M
authors.initials: M
authors.lastname: Roulet
authors.forename: Y
authors.initials: Y
authors.lastname: Schutz
authors.forename: C
authors.initials: C
authors.lastname: Rössle
authors.forename: R
authors.initials: R
authors.lastname: Chiolero
authors.forename: E
authors.initials: E
authors.lastname: Temler
authors.forename: C
authors.initials: C
authors.lastname: Schindler
authors.forename: F
authors.initials: F
authors.lastname: Zurlo
authors.forename: P
authors.initials: P
authors.lastname: Fürst
authors.forename: E
authors.initials: E
authors.lastname: Jéquier
mesh_terms: D000328:Adult; D002153:Calorimetry, Indirect; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002331:Carnitine / Q000008:administration & dosage* / Q000494:pharmacology; D004938:Esophageal Neoplasms / Q000601:surgery; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism*; D010084:Oxidation-Reduction; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications
chemical_list: D009584:Nitrogen; D002331:Carnitine