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[The use of vitamin E in childhood]
1Klinikum Berlin-Buch, Kinderklinik.
Insights
Vitamin E (tocopherol) primarily acts as an antioxidant. Its therapeutic use in infants is limited to specific malabsorption conditions, with unproven benefits and potential risks for premature infants.
Area of Science:
- Biochemistry
- Pediatrics
- Nutritional Science
Context:
- Tocopherol (Vitamin E) is a key antioxidant with established roles in cellular protection.
- Infant nutrition and therapeutic interventions require careful consideration of efficacy and safety.
- Premature infants, especially those with severe underweight, present unique physiological challenges.
Purpose:
- To review the established and potential therapeutic applications of Vitamin E in infancy.
- To evaluate the evidence supporting Vitamin E's prophylactic and therapeutic use in premature infants.
- To assess the risks versus benefits of high-dose Vitamin E therapy in vulnerable infant populations.
Summary:
- The primary function of tocopherol (Vitamin E) is its antioxidative capacity, contributing to overall organismal health.
- Established indications for Vitamin E therapy in infants include malabsorption syndromes like chronic cholestasis, pancreatic insufficiency (cystic fibrosis), and short bowel syndrome.
- High-dose Vitamin E is suggested for emergency treatment of conditions such as shock lung and haemolytic-uraemic syndrome.
- Evidence for the positive effects of daily Vitamin E for preventing retinopathy of prematurity, bronchopulmonary dysplasia, and intraventricular encephalorrhagia in premature infants is not established.
- The potential benefits of Vitamin E in these prophylactic scenarios are questionable and may be outweighed by risks of severe complications like necrotizing enterocolitis and neonatal sepsis in severely underweight premature infants.
Impact:
- Highlights the limited, yet critical, established roles of Vitamin E in infant care.
- Underscores the lack of evidence and potential risks associated with widespread Vitamin E use in premature infants.
- Informs clinical decision-making regarding Vitamin E supplementation and therapy in neonatal intensive care settings.
Abstract:
The essential effects of Tocopherol are based on its antioxidative capacity. Tocopherol, however, is just one in a group of antioxidants, which are important for the organism. Established indication for therapeutical application of vitamin E in infancy is only vitamin-E-malabsorption in connection with chronic cholestasis, pancreatic insufficiency (cystic fibrosis) and short bowel syndrome. In emergency therapy vitamin E is suggested with high dosage in case of shock lung and haemolytic-uraemic syndrome. Positive effects of daily vitamin E application in connection with prophylaxis of retinopathy prematurity, bronchopulmonary dysplasia and intraventricular encephalorrhagia of premature infants of severe underweight are not established. Very questionable therapeutic or prophylactic efficiency is opposed to the risk of higher incidence of severe complications in caring for premature infants of severe underweight, such as enterocolitis necroticans and neonatal septicaemia.