Effects of carnitine administration to multiple injury patients receiving total parenteral nutrition

Blood, urine and tissue concentrations of carnitine have been found to be below the normal values in patients receiving total parenteral nutrition (TPN). It might be postulated that the carnitine deficiency is responsible for the metabolic disturbances observed during TPN. To 20 patients (10 male and 10 female) in a state of coma following multiple injuries or brain injury and submitted to a TPN regimen (hypertonic polycarbohydrate, 7% aminoacid solutions on 10% lipid suspensions), we have administered 3-8 g/day of carnitine i.v. as a single bolus each morning. We have found no increase in cholesterol and triglycerides serum levels and a normalization of pyruvate and lactate serum levels. Our results seem to confirm the importance of carnitine in improving metabolism of the energy-giving substrate in patients receiving TPN.