Carnitine supplementation for preterm infants with recurrent apnea.
BACKGROUND
Apnea of prematurity is a common problem in preterm infants in the neonatal intensive care setting (NICU), often delaying their discharge home or transfer to a step down unit. Premature infants are at increased risk of carnitine deficiency. Carnitine supplementation has been used for both prevention and treatment of apnea.


OBJECTIVE
To determine whether treatment with carnitine will reduce the frequency of apnea, the duration of ventilation and the duration of hospital stay in preterm infants with recurrent apnea.


METHODS
Computerised searches were carried out by two reviewers independently. Searches were made of MEDLINE (1966 to May 2004), EMBASE (1980 to May 2004), CINAHL (1982-2004 June 2004,1st week), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2004), abstracts of annual meetings of the Society for Pediatric Research (1995-2004), and contacts were made with the subject experts.


METHODS
Only randomized or quasi-randomized treatment trials of preterm infants with a diagnosis of recurrent apnea of prematurity were considered. Trials were included if they involved treatment with carnitine compared to placebo or no treatment, and measured at least one of the following outcomes: failure of resolution of apneas, the duration of ventilation and the duration of hospital stay.


METHODS
Two reviewers evaluated the papers for inclusion criteria and quality. Corresponding authors were contacted for further information where needed.


RESULTS
No eligible trials were identified.


CONCLUSIONS
Despite the plausible rationale for the treatment of apnea of prematurity with carnitine, there are insufficient data to support its use for this indication. Further studies are needed to determine the role of this treatment in clinical practice.
Kumar
M
M
Department of Pediatrics, McMaster Children's Hospital, 1200 Main Street West, Hamilton, L8S 3Z5, Ontario, Canada. manojk2@hotmail.com
Kabra
N S
NS
Paes
B
B
D001049:Apnea / Q000517:prevention & control*; D002331:Carnitine / Q000008:administration & dosage*; D019587:Dietary Supplements; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D007902:Length of Stay; D012121:Respiration, Artificial
D002331:Carnitine