ArticleAnnals of medicine and surgery (2012)2025
Effect of oral l-carnitine on hepatic function in pediatric patients under repair of congenital cardiac defect.
Article in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: l-carnitine, with anti-inflammatory and antioxidant properties, may help prevent liver damage caused by factors including hypoxia, hemodynamic instability, heparin-protamine reactions, and transfusion-related complications. This study evaluates the effect of preoperative oral l-carnitine on liver function in pediatric patients undergoing congenital heart disease repair. Methods: This randomized, double-blind clinical trial assessed l-carnitine's impact on liver function in children aged 6-60 months after cardiac surgery for congenital heart defects. All patients underwent on-pump cardiac surgery following a standardized institutional protocol, including systemic heparinization (300 IU/kg) prior to cardiopulmonary bypass and reversal with protamine sulfate post-bypass (1 mg per 100 IU of heparin). Blood transfusion was guided by intraoperative hemoglobin levels (<8 g/dL threshold). Re-exploration criteria included ongoing hemodynamic instability, chest drainage >5 mL/kg/h for >3 hours, or evidence of tamponade on echocardiography. Results: A total of 60 patients participated in the study, the l-carnitine group showed a faster recovery in liver function, with significantly lower aspartate aminotransferase (AST) levels by day 7 compared to the control group. Alanine aminotransferase and lactate dehydrogenase levels were higher in the l-carnitine group at baseline but evened out over time. Alkaline phosphatase levels were significantly higher in the l-carnitine group by day 7. The l-carnitine group also had lower indirect bilirubin levels by day 7, suggesting improved liver recovery. Conclusion: The findings suggest that l-carnitine may aid liver recovery and affect specific biochemical markers in pediatric patients following surgery. This points to its potential therapeutic role in enhancing recovery outcomes in this group.
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