Carnitine deficiency in surgical neonates receiving total parenteral nutrition.
Carnitine plays a key role in the oxidation of fatty acids. Most solutions for parenteral nutrition do not contain carnitine. Because endogenous carnitine synthesis is insufficient in newborns, they are prone to developing a carnitine deficiency when they are dependent on total parenteral nutrition (TPN). Stimulated by the clinical observation of manifest clinical symptoms of carnitine deficiency in one patient, a study of 13 consecutive neonates who received TPN for over 2 weeks was begun. Their plasma carnitine levels before and during carnitine supplementation were determined. All patients had a carnitine intake far below the recommended minimal need of 11 mumol/kg per day. Although only three of them clearly showed clinical symptoms described as carnitine deficiency, carnitine supplementation for all neonates receiving TPN for over 2 weeks is recommended.
Tibboel
D
D
Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical School, Rotterdam, The Netherlands.
Delemarre
F M
FM
Przyrembel
H
H
Bos
A P
AP
Affourtit
M J
MJ
Molenaar
J C
JC
D002331:Carnitine / Q000097:blood / Q000172:deficiency*; D004040:Dietary Carbohydrates / Q000032:analysis; D004041:Dietary Fats / Q000032:analysis; D002149:Energy Intake; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D002331:Carnitine