title: Carnitine supplementation in premature neonates: effect on plasma and red blood cell total carnitine concentrations, nutrition parameters and morbidity.
abstract: OBJECTIVE
  Carnitine may be considered conditionally essential in the neonatal population. The purpose of this study was to evaluate the effects of long-term carnitine supplementation on total carnitine status and morbidity in premature neonates.
  
  
  METHODS
  In this prospective, randomized, placebo-controlled, double-blinded study, premature neonates received carnitine supplementation (20mg/kg/day) or placebo. Plasma (nmol/ml) and red blood cell (RBC) (nmol/mg hemoglobin) total carnitine concentrations, 24-h nitrogen excretion, intake and weight, and respiratory, gastroesophageal, and infectious morbidity were assessed.
  
  
  RESULTS
  Twenty-nine neonates (13 placebo, 16 carnitine; 27+/-2 weeks gestation; 976+/-259g birthweight) were studied for up to 8 weeks. Plasma total carnitine concentrations exceeded the reference range in the carnitine group (weeks 1-8); however, concentrations did not reach reference range until week 4 in the placebo group. RBC total carnitine concentrations increased, but remained below reference range in both the carnitine (weeks 1-6) and placebo (weeks 1-8) groups. Carnitine group neonates regained their birthweight more rapidly than placebo group neonates (day of life 11.8+/-6 vs. 16.9+/-6.3, P=0.034). In addition, percent periodic breathing calculated from cardiopulmonary trend monitor data (weeks 1-8) was lower in the carnitine group (0.4+/-0.9 vs. 1.4+/-1.9, P=0.014). There was no difference with respect to other markers of respiratory, gastroesophageal and infectious morbidity or nitrogen balance.
  
  
  CONCLUSIONS
  Carnitine supplementation at 20mg/kg/day results in increased plasma and RBC total carnitine concentrations, has a positive effect on catch-up growth, and may improve periodic breathing in premature neonates.
authors.affiliation: Department of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN 38163, USA. ccrill@utmem.edu
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crill
authors.forename: Michael C
authors.initials: MC
authors.lastname: Storm
authors.forename: Michael L
authors.initials: ML
authors.lastname: Christensen
authors.forename: Charles T
authors.initials: CT
authors.lastname: Hankins
authors.forename: M
authors.initials: M
authors.lastname: Bruce Jenkins
authors.forename: Richard A
authors.initials: RA
authors.lastname: Helms
mesh_terms: D002331:Carnitine / Q000008:administration & dosage / Q000097:blood*; D019587:Dietary Supplements; D004311:Double-Blind Method; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D009584:Nitrogen / Q000652:urine; D011446:Prospective Studies; D012016:Reference Values; D012119:Respiration / Q000187:drug effects; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000097:blood*
chemical_list: D014803:Vitamin B Complex; D009584:Nitrogen; D002331:Carnitine