parenteral nutrition in postoperative trauma. Metabolic effects of continuous or acute carnitine administration with special reference to fat oxidation and nitrogen utilization.13

Carnitine-free total parenteral nutrition (TPN) is claimed to result in a carni- tine deficiency with subsequent impairment of fat oxidation. The present study was designed to evaluate the possible benefit ofcarnitine supplementation on postoperative fat and nitrogen utilization. Sixteen patients undergoing total esophagectomy were evenly randomized and re- ceived TPN without or with L-carmtine supplementation (74 �imol. kg' . d') during 1 1 post- operative days. On day 1 1, a 4-h infusion ofL-carnitine (125 �imol/kg) was performed in both groups. The effect of supplementation was evaluated by indirect calorimetry, N balance, and repeated measurements ofplasma lipids and ketone bodies. Irrespective ofcontinuous 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.