ICU sedation, delirium & recovery
Abnormal carnitine concentrations in critical illness associated with compromised outcome
Authors' conclusion
On ICU-day-6, both low and high free carnitine concentrations associated with delayed ICU-recovery, and excess morbidity and mortality, suggesting a U-shaped relationship.
Study context
- Population
- Patients with prolonged critical illness in the EPaNIC RCTICU-day-6 carnitine measured
- Participants
- 1,600 patients
- Comparison
- Low or high vs intermediate plasma free carnitine on ICU-day-6
- Lown = 374
- Intermediaten = 831reference
- Highn = 395
- Primary endpoint
- Likelihood of an earlier alive ICU discharge
Methodological detailsadjusted multivariable Cox and logistic regression
- Adjusted multivariable Cox and logistic regression
Primary result
As reported in the abstract
Earlier alive ICU discharge
- Lower likelihood of earlier alive ICU discharge for lowest (< 24 µmol/L) and highest (> 50 µmol/L) vs intermediate quartiles (24-50 µmol/L) on partial residuals plot
Further findings
Plasma free carnitine concentration on ICU-day-6
- Median concentration (IQR 24.4-49.8 µmol/L)
- 34.8
ICU and hospital dependency, need for life-supporting therapies, 90-day mortality (low and high carnitine)
- Both low and high carnitine associated with prolonged ICU and hospital dependency, prolonged need for life-supporting therapies and increased mortality at 90-days
Muscle weakness and two- and five-year mortality (carnitine > 50 µmol/L)
- Concentrations above 50 µmol/L associated with muscle weakness and increased two- and five-year mortality
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Abnormal carnitine concentrations in critical illness associated with compromised outcome. Crit Care. Published 22 January 2026. doi:10.
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