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Updated: Aug 6, 2026
A Swine Model of Neonatal Asphyxia
Published on: October 11, 2011
Carnitine supplementation for preterm infants with recurrent apnea
1Department of Pediatrics, McMaster Children's Hospital, 1200 Main Street West, Hamilton, L8S 3Z5, Ontario, Canada. manojk2@hotmail.com
Insights
Carnitine supplementation for apnea of prematurity is not supported by current evidence. No eligible trials were found, indicating a need for further research into its effectiveness in preterm infants.
Area of Science:
- Neonatal Intensive Care Medicine
- Pediatric Pulmonology
- Nutritional Science
Background:
- Apnea of prematurity is a common complication in preterm infants, frequently prolonging NICU stays.
- Preterm infants have an elevated risk of carnitine deficiency.
- Carnitine supplementation is explored for preventing and treating apnea in neonates.
Purpose of the Study:
- To assess if carnitine treatment reduces apnea frequency, ventilation duration, and hospital stay in preterm infants with recurrent apnea.
Main Methods:
- Comprehensive literature searches were conducted across multiple databases (MEDLINE, EMBASE, CINAHL, CENTRAL) and conference abstracts.
- Only randomized or quasi-randomized trials involving carnitine versus placebo/no treatment for apnea of prematurity were included.
- Outcomes assessed included apnea resolution, ventilation duration, and hospital stay duration.
Main Results:
- No eligible randomized or quasi-randomized trials were identified in the systematic search.
Conclusions:
- Current evidence is insufficient to support the use of carnitine for treating apnea of prematurity.
- Further rigorous studies are required to establish the clinical efficacy of carnitine supplementation in this population.
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.
Objectives:
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.
Search Strategy:
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.
Selection Criteria:
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.
Data Collection And Analysis:
Two reviewers evaluated the papers for inclusion criteria and quality. Corresponding authors were contacted for further information where needed.
Main Results:
No eligible trials were identified.
Reviewers' 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.
