Carnitine deficiency in surgical neonates receiving total parenteral nutrition |
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Authors: | D Tibboel F M Delemarre H Przyrembel A P Bos M J Affourtit J C Molenaar |
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Affiliation: | Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical School, Rotterdam, The Netherlands. |
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Abstract: | 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. |
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