Among infants supplemented with carnitine , there was no evidence of effect on weight gain , lipid utilization or ketogenesis .
REVIEW ER 'S CONCLUSIONS We found no evidence to support the routine supplementation of parenterally fed neonates with carnitine
BACKGROUND Carnitine , a quaternary amino acid , plays an important role in the oxidation of long chain fatty acids .
Both breast milk and infant formulas contain carnitine .
However , it is not routinely provided in parenteral nutrition solutions .
Non supplemented parenterally fed infants have very low tissue carnitine levels .
The clinical significance of this is uncertain .
Carnitine deficiency may be an etiological factor in the limited ability of premature babies to utilize parenteral lipid .
In vitro studies have suggested that fatty acid oxidation is impaired when the tissue carnitine levels fall below 10 % of normal .
Therefore relative carnitine deficiency may impair fatty acid oxidation , thus reducing the available energy and impairing growth .
OBJECTIVES The primary aim of this review is to determine whether carnitine supplementation of parenterally fed neonates will improve weight gain .
The secondary aims are to determine the effect on lipid tolerance and ketogenesis .
Randomised controlled trial of L-carnitine as a nutritional supplement in preterm infants
AIMS To evaluate the effect of L-carnitine supplementation ( 25 mg/kg/d ) on the growth and incidence of hypoglycaemia in preterm infants . METHODS A double blind , placebo controlled r and omised trial , stratified for gestational age , was conducted of 86 preterm infants between 28 and 34 gestational weeks . The median gestational ages in the carnitine group and placebo groups were 30.7 weeks ( range 28.0 to 33.6 ) and 31.4 weeks ( range 28.0 to 33.9 ) , respectively . The median birthweights were 1.557 kg ( range 0.944 to 2.275 ) and 1.645 kg ( range 0.885 to 2.545 ) , respectively . RESULTS Mean plasma free carnitine concentrations were below values for normal term infants in both groups on day 1 ( carnitine group 44.8 μmol/l , placebo group 25.5 μmol/l ) in the placebo group on day 7 ( 50.7 μmol/l ) , but in neither group on days 14 and 28 . Total , free , and acylcarnitine concentrations were significantly increased in both urine and blood in the L-carnitine group . There was no significant difference between the placebo and carnitine supplemented groups in growth rate , as assessed by weight , length , skinfold thickness and head circumference measurements , or in the incidence of episodes of hypoglycaemia . CONCLUSION The addition of carnitine as a nutritional supplement at a dose of 25mg/kg/day did not improve growth in our group of preterm infants nor protect them from episodes of hypoglycaemia
Among infants supplemented with carnitine , there was no evidence of effect on weight gain , lipid utilization or ketogenesis .
REVIEW ER 'S CONCLUSIONS We found no evidence to support the routine supplementation of parenterally fed neonates with carnitine
BACKGROUND Carnitine , a quaternary amino acid , plays an important role in the oxidation of long chain fatty acids .
Both breast milk and infant formulas contain carnitine .
However , it is not routinely provided in parenteral nutrition solutions .
Non supplemented parenterally fed infants have very low tissue carnitine levels .
The clinical significance of this is uncertain .
Carnitine deficiency may be an etiological factor in the limited ability of premature babies to utilize parenteral lipid .
In vitro studies have suggested that fatty acid oxidation is impaired when the tissue carnitine levels fall below 10 % of normal .
Therefore relative carnitine deficiency may impair fatty acid oxidation , thus reducing the available energy and impairing growth .
OBJECTIVES The primary aim of this review is to determine whether carnitine supplementation of parenterally fed neonates will improve weight gain .
The secondary aims are to determine the effect on lipid tolerance and ketogenesis .