Tibboel D, Delemarre F M, Przyrembel H, Bos A P, Affourtit M J, Molenaar J C
Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical School, Rotterdam, The Netherlands.
J Pediatr Surg. 1990 Apr;25(4):418-21. doi: 10.1016/0022-3468(90)90384-l.
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.
