What is the appropriate intravenous dose of vitamin E for very-low-birth-weight infants?
The Committee on Fetus and Newborn of the American Academy of Pediatrics (AAP) has endorsed 1 to 2 mg/dl as the normal range of serum tocopherol level. Our Cochrane review has shown that vitamin E supplementation resulting in levels >3.5 mg/dl, but not < or =3.5 mg/dl, significantly reduces the risk for severe retinopathy among very-low-birth-weight (VLBW) infants examined but increases the risks of sepsis and of necrotizing enterocolitis among infants treated for >1 week. As a fixed daily intravenous dose of vitamin E results in an inverse relationship between serum level and birth weight and is a risk for both low and high serum tocopherol levels, a dose adjusted for current weight appears more judicious than a fixed dose per day. Based on currently available data the AAP and the American Society for Clinical Nutrition currently recommend a routine intake of 2 ml/kg/day of MVI Pediatric (2.8 IU/kg/day) in VLBW infants (maximum of 5 ml/day or 7 IU/day).
Brion
Luc P
LP
Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY 10461-2373, USA.
Bell
Edward F
EF
Raghuveer
Talkad S
TS
Soghier
Lamia
L
D001835:Body Weight; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007275:Injections, Intravenous; D010288:Parenteral Nutrition; D012306:Risk; D014810:Vitamin E / Q000008:administration & dosage*; D024502:alpha-Tocopherol / Q000097:blood
D014810:Vitamin E; D024502:alpha-Tocopherol