The Effect of L-Carnitine Supplementation on Some Inflammatory Biomarkers in Critically Ill Children in the Pediatric Intensive Care Unit (PICU): A Triple-Blind, Randomized Controlled Clinical Trial
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Protocol summary
Effect of L-carnitine supplementation on mean serum MDA concentration in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean serum TAC concentration in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean serum CRP and ESR concentrations in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean NLR, MLR, and PLR in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean serum MDA, TAC and SOD concentration in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean serum CRP, ESR and IL_6 concentrations in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean NLR, MLR, and PLR in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean serum MDA concentration in critically ill children in the PICU. Effect of L-carnitine supplementation on mean serum, TAC and SOD concentration in critically ill children in the PICU. Effect of L-carnitine supplementation on mean serum CRP, ESR and ESRIL_6 concentrations in critically ill children in the PICU. Effect of L-carnitine supplementation on mean NLR, MLR, and PLR in critically ill children in the PICU.
-تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی MDA در کودکان بد حال بستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی TAC در کودکان بدحال بستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی CRP و ESR در کودکان بدحال بستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین نسبت نوتروفیل به لنفوسیت (NLR)، نسبت مونوسیت به لنفوسیت (MLR) و نسبت پلاکت به لنفوسیت (PLR) در کودکان بدحال ستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی MDA ، TAC و SOD در کودکان بدحال بستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی CRP ، ESR و IL-6 در کودکان بدحال بستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین نسبت نوتروفیل به لنفوسیت (NLR)، نسبت مونوسیت به لنفوسیت (MLR) و نسبت پلاکت به لنفوسیت (PLR) در کودکان بدحال ستری در بخش مراقبت های ویژه
-تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی MDA در کودکان بد حال بستری در بخش مراقبت های ویژه -تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی، TAC و SOD در کودکان بدحال بستری در بخش مراقبت های ویژه -تعیین اثر مکمل ال-کارنیتین بر میانگین غلظت سرمی CRP ، ESR و ESRIL-6 در کودکان بدحال بستری در بخش مراقبت های ویژه -تعیین اثر مکمل ال-کارنیتین بر میانگین نسبت نوتروفیل به لنفوسیت (NLR)، نسبت مونوسیت به لنفوسیت (MLR) و نسبت پلاکت به لنفوسیت (PLR) در کودکان بدحال ستری در بخش مراقبت های ویژه
This study will be conducted for one week on 36 critically ill children admitted to the PICU of the Zahra Mardani Azari Pediatric Research and Educational Center in Tabriz. Before the intervention, the Prism questionnaire will be completed for the children. Blood samples will be collected before and after the intervention to assess serum MDA, CRP, TAC, ESR, MLR, and NLR levels. All patients, the intervention staff, and the investigator analyzing the results will remain blinded to the intervention type in each group.
This study will be conducted for one week on 38 critically ill children admitted to the PICU of the Zahra Mardani Azari Pediatric Research and Educational Center in Tabriz. Before the intervention, the Prism questionnaire will be completed for the children. Blood samples will be collected before and after the intervention to assess serum MDA, CRP, TAC, ESR, MLR, and NLR levels. All patients, the intervention staff, and the investigator analyzing the results will remain blinded to the intervention type in each group.
This study will be conducted for one week on 3638 critically ill children admitted to the PICU of the Zahra Mardani Azari Pediatric Research and Educational Center in Tabriz. Before the intervention, the Prism questionnaire will be completed for the children. Blood samples will be collected before and after the intervention to assess serum MDA, CRP, TAC, ESR, MLR, and NLR levels. All patients, the intervention staff, and the investigator analyzing the results will remain blinded to the intervention type in each group.
این مطالعه به مدت یک هفته بر روی 36 کودک بدحال بستری در بخش PICU مرکز آموزشی پژوهشی کودکان زهرا مردانی آذری تبریز انجام خواهد گرفت. قبل از مداخله پرسشنامه Prism برای کودکان تکمیل خواهد شد.قبل و بعد از مداخله نمونه های خون جهت بررسی غلظت سرمی MDA، CRP، TAC، ESR ،MLR، NLR جمع آوری خواهد شد. تمامی بیماران، کادر اجرایی مداخله و محققی که نتایج را تحلیل می کند از نوع مداخله در هر گروه بی اطلاع هستند.
این مطالعه به مدت یک هفته بر روی 38 کودک بدحال بستری در بخش PICU مرکز آموزشی پژوهشی کودکان زهرا مردانی آذری تبریز انجام خواهد گرفت. قبل از مداخله پرسشنامه Prism برای کودکان تکمیل خواهد شد.قبل و بعد از مداخله نمونه های خون جهت بررسی غلظت سرمی MDA، CRP، TAC، ESR ،MLR، NLR جمع آوری خواهد شد. تمامی بیماران، کادر اجرایی مداخله و محققی که نتایج را تحلیل می کند از نوع مداخله در هر گروه بی اطلاع هستند.
این مطالعه به مدت یک هفته بر روی 3638 کودک بدحال بستری در بخش PICU مرکز آموزشی پژوهشی کودکان زهرا مردانی آذری تبریز انجام خواهد گرفت. قبل از مداخله پرسشنامه Prism برای کودکان تکمیل خواهد شد.قبل و بعد از مداخله نمونه های خون جهت بررسی غلظت سرمی MDA، CRP، TAC، ESR ،MLR، NLR جمع آوری خواهد شد. تمامی بیماران، کادر اجرایی مداخله و محققی که نتایج را تحلیل می کند از نوع مداخله در هر گروه بی اطلاع هستند.
With parental consent, critically ill children (1 month to 12 years old) expected to stay in the PICU for more than 2 to 3 days will be included in the study. Patients with liver or kidney diseases, those undergoing hemodialysis or chemotherapy, and NPO patients will be excluded from the study.
With parental consent, critically ill children (1 month to 12 years old) expected to stay in the PICU for more than 7 days will be included in the study. Patients with liver or kidney diseases, those undergoing hemodialysis or chemotherapy, and NPO patients will be excluded from the study.
With parental consent, critically ill children (1 month to 12 years old) expected to stay in the PICU for more than 2 to 37 days will be included in the study. Patients with liver or kidney diseases, those undergoing hemodialysis or chemotherapy, and NPO patients will be excluded from the study.
در صورت رضایت والدین، کودکان بدحال (1 ماه تا 12 سال) که بیش از 2 تا 3 روز در ICU خواهند ماند، در مطالعه شرکت خواهند کرد. بیماران مبتلا به بیماری های کبدی یا کلیوی، بیماران تحت همودیالیز و شیمی درمانی و بیماران NPO از مطالعه حذف خواهند شد.
در صورت رضایت والدین، کودکان بدحال (1 ماه تا 12 سال) که بیش از 7 روز در ICU خواهند ماند، در مطالعه شرکت خواهند کرد. بیماران مبتلا به بیماری های کبدی یا کلیوی، بیماران تحت همودیالیز و شیمی درمانی و بیماران NPO از مطالعه حذف خواهند شد.
در صورت رضایت والدین، کودکان بدحال (1 ماه تا 12 سال) که بیش از 2 تا 37 روز در ICU خواهند ماند، در مطالعه شرکت خواهند کرد. بیماران مبتلا به بیماری های کبدی یا کلیوی، بیماران تحت همودیالیز و شیمی درمانی و بیماران NPO از مطالعه حذف خواهند شد.
General information
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The minimum length of ICU stay was revised from 3 days to 7 days to ensure that participants receive the full planned intervention duration (7 days). Since the intervention is administered daily for 7 consecutive days, inclusion of patients with shorter ICU stays could lead to incomplete exposure to the intervention and introduce bias in outcome assessment. Therefore, this modification was made to maintain methodological consistency and internal validity of the trial.
The sample size was adjusted by increasing the anticipated attrition rate to account for potential dropouts and incomplete data, in order to improve the precision and reliability of the study results. This led to a slight increase (from 36 to 38) in the final recruitment target.
The minimum length of ICU stay was revised from 3 days to 7 days to ensure that participants receive the full planned intervention duration (7 days). Since the intervention is administered daily for 7 consecutive days, inclusion of patients with shorter ICU stays could lead to incomplete exposure to the intervention and introduce bias in outcome assessment. Therefore, this modification was made to maintain methodological consistency and internal validity of the trial. The sample size was adjusted by increasing the anticipated attrition rate to account for potential dropouts and incomplete data, in order to improve the precision and reliability of the study results. This led to a slight increase (from 36 to 38) in the final recruitment target.
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حداقل مدت بستری در ICU از 3 روز به 7 روز اصلاح شد تا اطمینان حاصل شود که تمامی شرکتکنندگان دوره کامل مداخله (7 روز) را دریافت میکنند. از آنجا که مداخله بهصورت روزانه و به مدت 7 روز متوالی انجام میشود، ورود بیمارانی با مدت بستری کوتاهتر میتوانست منجر به ناقص ماندن دریافت مداخله و ایجاد سوگیری در ارزیابی نتایج شود. بنابراین این اصلاح در جهت افزایش یکنواختی روش اجرا و ارتقای اعتبار داخلی مطالعه انجام شده است.
حجم نمونه با در نظر گرفتن افزایش نرخ ریزش احتمالی (attrition rate) در مرحله طراحی مطالعه اصلاح شد تا امکان جبران دادههای ناقص یا خروج احتمالی بیماران فراهم گردد و دقت و قابلیت اطمینان نتایج مطالعه افزایش یابد. این موضوع منجر به افزایش جزئی (از 36 به 38) در تعداد نهایی نمونههای مورد نیاز شد.
حداقل مدت بستری در ICU از 3 روز به 7 روز اصلاح شد تا اطمینان حاصل شود که تمامی شرکتکنندگان دوره کامل مداخله (7 روز) را دریافت میکنند. از آنجا که مداخله بهصورت روزانه و به مدت 7 روز متوالی انجام میشود، ورود بیمارانی با مدت بستری کوتاهتر میتوانست منجر به ناقص ماندن دریافت مداخله و ایجاد سوگیری در ارزیابی نتایج شود. بنابراین این اصلاح در جهت افزایش یکنواختی روش اجرا و ارتقای اعتبار داخلی مطالعه انجام شده است. حجم نمونه با در نظر گرفتن افزایش نرخ ریزش احتمالی (attrition rate) در مرحله طراحی مطالعه اصلاح شد تا امکان جبران دادههای ناقص یا خروج احتمالی بیماران فراهم گردد و دقت و قابلیت اطمینان نتایج مطالعه افزایش یابد. این موضوع منجر به افزایش جزئی (از 36 به 38) در تعداد نهایی نمونههای مورد نیاز شد.
The age range of one month to 12 years.
Critically Ill children expected to stay in the PICU for more than 2 to 3 days
Legal guardian's consent.
The age range of one month to 12 years.
Critically Ill children expected to stay in the PICU for more than 7 days
Legal guardian's consent.
The age range of one month to 12 years. Critically Ill children expected to stay in the PICU for more than 2 to 37 days Legal guardian's consent.
محدوده سنی یک ماه تا 12 سال
کودکان بدحال که تخمین زده شود بیش از 2 تا 3 روز در ICU بماند
رضایت سرپرست قانونی بیمار
محدوده سنی یک ماه تا 12 سال
کودکان بدحال که تخمین زده شود بیش از 7 روز در ICU بماند
رضایت سرپرست قانونی بیمار
محدوده سنی یک ماه تا 12 سال کودکان بدحال که تخمین زده شود بیش از 2 تا 37 روز در ICU بماند رضایت سرپرست قانونی بیمار
Primary outcomes
#1
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Superoxide Dismutase
Superoxide Dismutase
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سوپر اکسید دسموتاز
سوپر اکسید دسموتاز
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Before the start of the intervention and 7 days after the start of the intervention
Before the start of the intervention and 7 days after the start of the intervention
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قبل از شروع مداخله و 7 روز پس از شروع مداخله
قبل از شروع مداخله و 7 روز پس از شروع مداخله
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Blood test
Blood test
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آزمایش خون
آزمایش خون
#2
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Interleukin-6
Interleukin-6
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اینترلوکین- 6
اینترلوکین- 6
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Before the start of the intervention and 7 days after the start of the intervention
Before the start of the intervention and 7 days after the start of the intervention
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قبل از شروع مداخله و 7 روز پس از شروع مداخله
قبل از شروع مداخله و 7 روز پس از شروع مداخله
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Blood test
Blood test
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آزمایش خون
آزمایش خون
Secondary outcomes
#1
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Total protein
Total protein
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پروتئین تام
پروتئین تام
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Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
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قبل از شروع مداخله و 7 روز پس از مداخله
قبل از شروع مداخله و 7 روز پس از مداخله
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Blood test
Blood test
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آزمایش خون
آزمایش خون
#2
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Serum Albumin
Serum Albumin
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آلبومین سرم
آلبومین سرم
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Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
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قبل از شروع مداخله و 7 روز پس از مداخله
قبل از شروع مداخله و 7 روز پس از مداخله
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Blood test
Blood test
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آزمایش خون
آزمایش خون
#3
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Prognostic Nutritional Index (PNI)
Prognostic Nutritional Index (PNI)
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شاخص پیش آگهی تغذیهای
شاخص پیش آگهی تغذیهای
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Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
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قبل از شروع مداخله و 7 روز پس از مداخله
قبل از شروع مداخله و 7 روز پس از مداخله
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serum albumin (g/L) + 0.005 × total lymphocyte count per micro liter of blood
serum albumin (g/L) + 0.005 × total lymphocyte count per micro liter of blood
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البومین سرم (گرم/لیتر) + 0.005 * میزان لنفوسیت تام در هر میکرولیتر خون
البومین سرم (گرم/لیتر) + 0.005 * میزان لنفوسیت تام در هر میکرولیتر خون
#4
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Systemic Immune-Inflammation Index (SII)
Systemic Immune-Inflammation Index (SII)
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شاخص سیستمیک ایمنی-التهابی
شاخص سیستمیک ایمنی-التهابی
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Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
(تعداد پلاکت* تعداد نوتروفیل) تقسیم بر تعداد لنفوسیت خون
(تعداد پلاکت* تعداد نوتروفیل) تقسیم بر تعداد لنفوسیت خون
#5
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Prognostic Index (PI)
Prognostic Index (PI)
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شاخص پیش آگهی
شاخص پیش آگهی
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Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
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قبل از شروع مداخله و 7 روز پس از مداخله
قبل از شروع مداخله و 7 روز پس از مداخله
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based on C-reactive protein (CRP) and white blood cell (WBC) count as follows: PI = 2 when both CRP > 1 mg/dL and WBC > 11×10⁹/L; PI = 1 when only one of these parameters is elevated; and PI = 0 when both parameters are within normal ranges
based on C-reactive protein (CRP) and white blood cell (WBC) count as follows: PI = 2 when both CRP > 1 mg/dL and WBC > 11×10⁹/L; PI = 1 when only one of these parameters is elevated; and PI = 0 when both parameters are within normal ranges
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بر اساس پروتئین واکنشی سی (CRP) و شمارش گلبولهای سفید خون (WBC) به شرح زیر: شاخص پیشآگهی (PI) برابر 2 در نظر گرفته میشود زمانی که هر دو معیار CRP > 1 mg/dL و WBC > 11×10⁹/L باشند؛ PI برابر 1 زمانی که فقط یکی از این دو پارامتر افزایش یافته باشد؛ و PI برابر 0 زمانی که هر دو پارامتر در محدوده طبیعی قرار داشته باشند.
بر اساس پروتئین واکنشی سی (CRP) و شمارش گلبولهای سفید خون (WBC) به شرح زیر: شاخص پیشآگهی (PI) برابر 2 در نظر گرفته میشود زمانی که هر دو معیار CRP > 1 mg/dL و WBC > 11×10⁹/L باشند؛ PI برابر 1 زمانی که فقط یکی از این دو پارامتر افزایش یافته باشد؛ و PI برابر 0 زمانی که هر دو پارامتر در محدوده طبیعی قرار داشته باشند.
#6
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Glasgow Prognostic Score (GPS)
Glasgow Prognostic Score (GPS)
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امتیاز پیش آگهی گلاسکو
امتیاز پیش آگهی گلاسکو
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Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
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قبل از شروع مداخله و 7 روز پس از مداخله
قبل از شروع مداخله و 7 روز پس از مداخله
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based on serum C-reactive protein (CRP) (g/L) and serum albumin (g/L). The score ranges from 0 to 2. A GPS of 0 will be assigned when CRP < 10 g/L and albumin > 35 g/L. A GPS of 1 will be assigned when either CRP > 10 g/L or albumin < 35 g/L is present. A GPS of 2 will be assigned when both CRP > 10 g/L and albumin < 35 g/L are present
based on serum C-reactive protein (CRP) (g/L) and serum albumin (g/L). The score ranges from 0 to 2. A GPS of 0 will be assigned when CRP < 10 g/L and albumin > 35 g/L. A GPS of 1 will be assigned when either CRP > 10 g/L or albumin < 35 g/L is present. A GPS of 2 will be assigned when both CRP > 10 g/L and albumin < 35 g/L are present
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بر اساس سطح پروتئین واکنشی C (CRP) سرم (g/L) و آلبومین سرم (g/L) محاسبه میشود و دامنه آن بین 0 تا 2 است. GPS برابر 0 زمانی در نظر گرفته میشود که CRP < 10 g/L و آلبومین > 35 g/L باشد. GPS برابر 1 زمانی اختصاص مییابد که تنها یکی از این دو شرط (CRP > 10 g/L یا آلبومین < 35 g/L) وجود داشته باشد. GPS برابر 2 زمانی در نظر گرفته میشود که هر دو شرط بهطور همزمان (CRP > 10 g/L و آلبومین < 35 g/L) برقرار باشند.
بر اساس سطح پروتئین واکنشی C (CRP) سرم (g/L) و آلبومین سرم (g/L) محاسبه میشود و دامنه آن بین 0 تا 2 است. GPS برابر 0 زمانی در نظر گرفته میشود که CRP < 10 g/L و آلبومین > 35 g/L باشد. GPS برابر 1 زمانی اختصاص مییابد که تنها یکی از این دو شرط (CRP > 10 g/L یا آلبومین < 35 g/L) وجود داشته باشد. GPS برابر 2 زمانی در نظر گرفته میشود که هر دو شرط بهطور همزمان (CRP > 10 g/L و آلبومین < 35 g/L) برقرار باشند.
Intervention groups
#1
Intervention group: 18 critically ill children admitted to the PICU will receive 50 to 100 mg/kg of liquid oral L-carnitine, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
Intervention group: 19 critically ill children admitted to the PICU will receive 50 to 100 mg/kg of liquid oral L-carnitine, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
Intervention group: 1819 critically ill children admitted to the PICU will receive 50 to 100 mg/kg of liquid oral L-carnitine, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
گروه مداخله: 18 کودک بدحال بستری در ICU روزانه 50 تا 100 میلی گرم بر کیلوگرم ال کارنیتین مایع روده ای تهیه شده توسط شرکت پارس بهروزان جم همراه با تغذیه با لوله روده به مدت 7 روز دریافت می کنند.
گروه مداخله:19 کودک بدحال بستری در ICU روزانه 50 تا 100 میلی گرم بر کیلوگرم ال کارنیتین مایع روده ای تهیه شده توسط شرکت پارس بهروزان جم همراه با تغذیه با لوله روده به مدت 7 روز دریافت می کنند.
گروه مداخله: 1819 کودک بدحال بستری در ICU روزانه 50 تا 100 میلی گرم بر کیلوگرم ال کارنیتین مایع روده ای تهیه شده توسط شرکت پارس بهروزان جم همراه با تغذیه با لوله روده به مدت 7 روز دریافت می کنند.
#2
Control group: 18 critically ill children admitted to the ICU will receive 50 to 100 mg/kg of distilled water, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
Control group: 19 critically ill children admitted to the ICU will receive 50 to 100 mg/kg of distilled water, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
Control group: 1819 critically ill children admitted to the ICU will receive 50 to 100 mg/kg of distilled water, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
گروه کنترل: 18 کودک بدحال بستری در ICU روزانه 50 تا 100 میلی گرم بر کیلوگرم آب مقطر تهیه شده توسط شرکت پارس بهروزان جم همراه با تغذیه با لوله روده به مدت 7 روز دریافت می کنند.
گروه کنترل: 19 کودک بدحال بستری در ICU روزانه 50 تا 100 میلی گرم بر کیلوگرم آب مقطر تهیه شده توسط شرکت پارس بهروزان جم همراه با تغذیه با لوله روده به مدت 7 روز دریافت می کنند.
گروه کنترل: 1819 کودک بدحال بستری در ICU روزانه 50 تا 100 میلی گرم بر کیلوگرم آب مقطر تهیه شده توسط شرکت پارس بهروزان جم همراه با تغذیه با لوله روده به مدت 7 روز دریافت می کنند.
Recruitment centers
#1
Name of recruitment center - English: Zahra Mardani Azari Children's Educational and Research Center
Name of recruitment center - Persian: مرکز آموزشی پژوهشی کودکان زهرا مردانی آذری
Full name of responsible person - English: Maryam Behrooz
Full name of responsible person - Persian: مریم بهروز
Street address - English: Khavaran town, Mardani Azari street, Zahra Mardani Azari Children Training, Research & Treatment Center
Street address - Persian: تبريز، شهرک خاوران ، خیابان مردانی آذری، مرکز آموزش، پژوهشی و درمانی کودکان زهرا مردانی آذری
City - English: Tabriz
City - Persian: تبریز
Province: East Azarbaijan
Country: Iran (Islamic Republic of)
Postal code: 5367153121
Phone: +98 914 996 9060
Fax:
Email: mm.behrooz@gmail.com
Web page address:
Name of recruitment center - English: Zahra Mardani Azari Children's Educational and Research Center
Name of recruitment center - Persian: مرکز آموزشی پژوهشی کودکان زهرا مردانی آذری
Full name of responsible person - English: Maryam Behrooz
Full name of responsible person - Persian: مریم بهروز
Street address - English: Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
Street address - Persian: مرکز آموزشی و پژوهشی کودکان زهرا مردانی آذری، شهرک خاوران، خیابان مردانی آذری.
City - English: Tabriz
City - Persian: تبریز
Province: East Azarbaijan
Country: Iran (Islamic Republic of)
Postal code: 5367153121
Phone: +98 914 996 9060
Fax:
Email: mm.behrooz@gmail.com
Web page address:
Name of recruitment center - English: Zahra Mardani Azari Children's Educational and Research Center Name of recruitment center - Persian: مرکز آموزشی پژوهشی کودکان زهرا مردانی آذری Full name of responsible person - English: Maryam Behrooz Full name of responsible person - Persian: مریم بهروز Street address - English: Khavaran townZahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari streetStreet, Zahra Mardani Azari Children Training, Research & Treatment CenterKheavaran Town. Street address - Persian: تبريز، شهرک خاوران ، خیابان مردانی آذری، مرکز آموزش، پژوهشیآموزشی و درمانیپژوهشی کودکان زهرا مردانی آذری، شهرک خاوران، خیابان مردانی آذری. City - English: Tabriz City - Persian: تبریز Province: East Azarbaijan Country: Iran (Islamic Republic of) Postal code: 5367153121 Phone: +98 914 996 9060 Fax: Email: mm.behrooz@gmail.com Web page address:
Sponsors / Funding sources
#1
Name of organization / entity - English:
Name of organization / entity - Persian:
Full name of responsible person - English: Maryam Behrooz
Full name of responsible person - Persian: مریم بهروز
Street address - English: Khavaran town, Mardani Azari street, Zahra Mardani Azari Children Training, Research & Treatment Center
Street address - Persian: شهرک خاوران ، خیابان مردانی آذری، مرکز آموزش، پژوهشی و درمانی کودکان زهرا مردانی آذری
City - English: Tabriz
City - Persian: تبریز
Province: East Azarbaijan
Country: Iran (Islamic Republic of)
Postal code: 5367153121
Phone: +98 41 3159 5050
Fax:
Email: mm.behrooz@gmail.com
Web page address:
Name of organization / entity - English:
Name of organization / entity - Persian:
Full name of responsible person - English: Maryam Behrooz
Full name of responsible person - Persian: مریم بهروز
Street address - English: Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
Street address - Persian: مرکز آموزشی و پژوهشی کودکان زهرا مردانی آذری، شهرک خاوران ، خیابان مردانی آذری
City - English: Tabriz
City - Persian: تبریز
Province: East Azarbaijan
Country: Iran (Islamic Republic of)
Postal code: 5367153121
Phone: +98 41 3159 5050
Fax:
Email: mm.behrooz@gmail.com
Web page address:
Name of organization / entity - English: Name of organization / entity - Persian: Full name of responsible person - English: Maryam Behrooz Full name of responsible person - Persian: مریم بهروز Street address - English: Khavaran townZahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari streetStreet, Zahra Mardani Azari Children Training, Research & Treatment CenterKheavaran Town. Street address - Persian: مرکز آموزشی و پژوهشی کودکان زهرا مردانی آذری، شهرک خاوران ، خیابان مردانی آذری، مرکز آموزش، پژوهشی و درمانی کودکان زهرا مردانی آذری City - English: Tabriz City - Persian: تبریز Province: East Azarbaijan Country: Iran (Islamic Republic of) Postal code: 5367153121 Phone: +98 41 3159 5050 Fax: Email: mm.behrooz@gmail.com Web page address:
Protocol summary
Study aim
Effect of L-carnitine supplementation on mean serum MDA, TAC and SOD concentration in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean serum CRP, ESR and IL_6 concentrations in critically ill children in the PICU.
Effect of L-carnitine supplementation on mean NLR, MLR, and PLR in critically ill children in the PICU.
Design
A phase 3, randomized, parallel-group, triple-blind, controlled clinical trial on 36 patients. Randomization will be performed using a random number table.
Settings and conduct
This study will be conducted for one week on 38 critically ill children admitted to the PICU of the Zahra Mardani Azari Pediatric Research and Educational Center in Tabriz. Before the intervention, the Prism questionnaire will be completed for the children. Blood samples will be collected before and after the intervention to assess serum MDA, CRP, TAC, ESR, MLR, and NLR levels. All patients, the intervention staff, and the investigator analyzing the results will remain blinded to the intervention type in each group.
Participants/Inclusion and exclusion criteria
With parental consent, critically ill children (1 month to 12 years old) expected to stay in the PICU for more than 7 days will be included in the study. Patients with liver or kidney diseases, those undergoing hemodialysis or chemotherapy, and NPO patients will be excluded from the study.
Intervention groups
The intervention group will receive 50-100 mg/kg body weight of liquid L-carnitine daily (50 mg/kg body weight for infants under six months and 100 mg/kg body weight for older children, up to a maximum of 2 grams), while the placebo group will receive the same dose of distilled water daily for 7 days.
Main outcome variables
Reduction of oxidative stress, inflammation, and improvement of clinical status.
General information
Reason for update
The minimum length of ICU stay was revised from 3 days to 7 days to ensure that participants receive the full planned intervention duration (7 days). Since the intervention is administered daily for 7 consecutive days, inclusion of patients with shorter ICU stays could lead to incomplete exposure to the intervention and introduce bias in outcome assessment. Therefore, this modification was made to maintain methodological consistency and internal validity of the trial.
The sample size was adjusted by increasing the anticipated attrition rate to account for potential dropouts and incomplete data, in order to improve the precision and reliability of the study results. This led to a slight increase (from 36 to 38) in the final recruitment target.
Acronym
IRCT registration information
IRCT registration number:IRCT20221206056734N2
Registration date:2025-03-07, 1403/12/17
Registration timing:registered_while_recruiting
Last update:2026-06-20, 1405/03/30
Update count:1
Registration date
2025-03-07, 1403/12/17
Registrant information
Name
Samaneh Hajjarzadeh
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 61 3553 9049
Email address
hajarzadeh70@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2025-02-03, 1403/11/15
Expected recruitment end date
2026-02-04, 1404/11/15
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
The Effect of L-Carnitine Supplementation on Some Inflammatory Biomarkers in Critically Ill Children in the Pediatric Intensive Care Unit (PICU): A Triple-Blind, Randomized Controlled Clinical Trial
Public title
The effect of L-carnitine in critically ill children admitted to PICU
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
The age range of one month to 12 years.
Critically Ill children expected to stay in the PICU for more than 7 days
Legal guardian's consent.
Exclusion criteria:
Having liver or kidney diseases that contraindicate L-carnitine use.
Children undergoing hemodialysis
Children undergoing chemotherapy
NPO patients who cannot start enteral nutrition
Age
From 1 month old to 12 years old
Gender
Both
Phase
3
Groups that have been masked
Participant
Care provider
Investigator
Outcome assessor
Data analyser
Sample size
Target sample size:
38
Randomization (investigator's opinion)
Randomized
Randomization description
Block randomization is used to allocate participants to each study group randomly. For this study, six blocks of six participants each have been considered, with an equal number of participants assigned to the intervention and control groups within each block. The unit of randomization in this study is individual-based, and a random number table will be used for the allocation process.
Blinding (investigator's opinion)
Triple blinded
Blinding description
The supplements and placebos were provided by Pars Behrouzan Jam Pharmaceutical Company and labeled with two-letter codes. All patients, researchers, data analysts, and outcome assessors will remain blinded to the contents of each label until the end of the study.
Placebo
Used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics Committee of Tabriz University of Medical Sciences
Street address
Mardani Azari Street, Khavaran Town, Zahra Mardani Azari Children's Educational and Research Center
City
Tabriz
Province
East Azarbaijan
Postal code
5367153121
Approval date
2024-12-02, 1403/09/12
Ethics committee reference number
IR.TBZMED.1403.753
Health conditions studied
1
Description of health condition studied
Critically ill children admitted to the PICU
ICD-10 code
ICD-10 code description
Primary outcomes
1
Description
Serum C-Reactive Protein (CRP)
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
2
Description
Serum ESR
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
3
Description
Serum Total Antioxidant Capacity (TAC)
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
4
Description
Serum Malondialdehyde (MDA)
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
5
Description
Serum neutrophil to lymphocyte ratio (NLR)
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
6
Description
Serum monocyte to lymphocyte ratio (MLR)
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
7
Description
Serum platelet-to-lymphocyte ratio (PLR)
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
8
Description
Superoxide Dismutase
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
9
Description
Interleukin-6
Timepoint
Before the start of the intervention and 7 days after the start of the intervention
Method of measurement
Blood test
Secondary outcomes
1
Description
Total protein
Timepoint
Before the intervention and 7 days after the intervention
Method of measurement
Blood test
2
Description
Serum Albumin
Timepoint
Before the intervention and 7 days after the intervention
Method of measurement
Blood test
3
Description
Prognostic Nutritional Index (PNI)
Timepoint
Before the intervention and 7 days after the intervention
Method of measurement
serum albumin (g/L) + 0.005 × total lymphocyte count per micro liter of blood
4
Description
Systemic Immune-Inflammation Index (SII)
Timepoint
Before the intervention and 7 days after the intervention
Before the intervention and 7 days after the intervention
Method of measurement
based on C-reactive protein (CRP) and white blood cell (WBC) count as follows: PI = 2 when both CRP > 1 mg/dL and WBC > 11×10⁹/L; PI = 1 when only one of these parameters is elevated; and PI = 0 when both parameters are within normal ranges
6
Description
Glasgow Prognostic Score (GPS)
Timepoint
Before the intervention and 7 days after the intervention
Method of measurement
based on serum C-reactive protein (CRP) (g/L) and serum albumin (g/L). The score ranges from 0 to 2. A GPS of 0 will be assigned when CRP < 10 g/L and albumin > 35 g/L. A GPS of 1 will be assigned when either CRP > 10 g/L or albumin < 35 g/L is present. A GPS of 2 will be assigned when both CRP > 10 g/L and albumin < 35 g/L are present
Intervention groups
1
Description
Intervention group: 19 critically ill children admitted to the PICU will receive 50 to 100 mg/kg of liquid oral L-carnitine, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
Category
Treatment - Drugs
2
Description
Control group: 19 critically ill children admitted to the ICU will receive 50 to 100 mg/kg of distilled water, produced by Pars Behrouzan Jam Company, along with tube feeding for 7 days.
Category
Placebo
Recruitment centers
1
Recruitment center
Name of recruitment center
Zahra Mardani Azari Children's Educational and Research Center
Full name of responsible person
Maryam Behrooz
Street address
Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
City
Tabriz
Province
East Azarbaijan
Postal code
5367153121
Phone
+98 914 996 9060
Fax
Email
mm.behrooz@gmail.com
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Maryam Behrooz
Street address
Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
City
Tabriz
Province
East Azarbaijan
Postal code
5367153121
Phone
+98 41 3159 5050
Email
mm.behrooz@gmail.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Tabriz University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Maryam Behrooz
Position
Nutrition specialist
Latest degree
Ph.D.
Other areas of specialty/work
Nutrition
Street address
Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
City
Tabriz
Province
East Azarbaijan
Postal code
5367153121
Phone
+98 41 3159 5050
Email
mm.behrooz@gmail.com
Person responsible for scientific inquiries
Contact
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Maryam behrooz
Position
Nutrition specialist
Latest degree
Ph.D.
Other areas of specialty/work
Nutrition
Street address
Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
City
Tabriz
Province
East Azarbaijan
Postal code
5367153121
Phone
+98 41 3159 5050
Email
mm.behrooz@gmail.com
Person responsible for updating data
Contact
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Maryam Behrooz
Position
Nutrition specialist
Latest degree
Ph.D.
Other areas of specialty/work
Nutrition
Street address
Zahra Mardani Azari Pediatric Research and Educational Center, Mardani Azari Street, Kheavaran Town.
City
Tabriz
Province
East Azarbaijan
Postal code
5367153121
Phone
+98 41 3159 5050
Email
mm.behrooz@gmail.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Not applicable
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Not applicable
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available