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A systematic review about prophylactic L-carnitine administration in parenteral nutrition of extremely preterm

Alba Salguero Olid1, Germán Blanco Sánchez2, Almudena Alonso Ojembarrena3

  • 1Unidad de Farmacia Hospitalaria, Hospital Universitario Puerta del Mar, Cádiz. alba9691@hotmail.com.

Farmacia Hospitalaria : Organo Oficial De Expresion Cientifica De La Sociedad Espanola De Farmacia Hospitalaria
|July 1, 2018
PubMed

Insights

Prophylactic L-carnitine in preterm infants receiving total parenteral nutrition may increase carnitine levels. However, it did not demonstrate significant improvements in lipid profiles, weight gain, or clinical outcomes.

Area of Science:

  • Neonatology
  • Nutritional Science
  • Biochemistry

Background:

  • Preterm infants on total parenteral nutrition (TPN) face risks of carnitine deficiency.
  • Carnitine deficiency impairs the tolerance of parenteral lipids in these infants.

Purpose of the Study:

  • To systematically review the scientific literature on the potential benefits of prophylactic L-carnitine administration in TPN for preterm newborns.
  • To assess the impact of L-carnitine supplementation on metabolic and clinical outcomes in this vulnerable population.

Main Methods:

  • A systematic review of scientific articles from major databases (MEDLINE/PubMed, Scopus, Cochrane Library, etc.).
  • Inclusion of studies using "Total Parenteral Nutrition" and "Carnitine" as descriptors.
  • Quality assessment of selected studies using the Jadad scale.

Main Results:

  • 18 out of 93 retrieved references were selected after applying inclusion/exclusion criteria; 4 were discarded due to low quality.
  • Studies consistently measured analytical variables like free carnitine, acylcarnitine, triglycerides, and ketone bodies.
  • Clinical variables such as weight gain, apnea, and hospital length of stay were also considered.

Conclusions:

  • Routine L-carnitine supplementation in TPN for preterm infants can increase carnitine levels.
  • No significant improvements were demonstrated in lipid profiles, weight gain, morbimortality, or hospital stay duration.
  • Further research is needed to determine the long-term clinical benefits of L-carnitine supplementation in neonates requiring prolonged TPN.
Abstract

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