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 .
Plasma and tissue levels of lipids, fatty acids and plasma carnitine in neonates receiving a new fat emulsion
This study was undertaken to compare Intralipid ® with a new fat emulsion containing gamma‐linolenic acid and carnitine , named Pediatric Fat Emulsion 4501 , in neonates with regard to lipid and carnitine metabolism over a short period of total parenteral nutrition . There were 10 neonates in each group and they tolerated the total parenteral nutrition well . In spite of the gamma‐linolenic acid supplementation in the new emulsion , arachidonic acid decreased significantly in plasma lipid esters and adipose tissue in both groups after 5 d of treatment . Also , there was a decrease in plasma docosahexaenoic acid which was more pronounced in the treatment group . The relative percentage values of linoleic and linolenic acids in adipose tissue were increased , indicating that newborns have a rapid accretion of fatty acids . Plasma triglycerides were effectively cleared during the periods without fat infusion . In the group that received Pediatric Fat Emulsion 4501 the means of both free and total plasma carnitine concentrations increased significantly , whereas they tended to decrease in the Intralipid ® group
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 .