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Acquired carnitine abnormalities in critically ill children

F Proulx1, J Lacroix, I A Qureshi

  • 1Department of Paediatrics, Sainte-Justine Hospital, Montreal, Quebec, Canada.

European Journal of Pediatrics
|December 10, 1997
PubMed
Summary

Critically ill children often show abnormal carnitine levels in plasma and urine. The clinical significance of these carnitine changes is currently unknown.

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Area of Science:

  • Biochemistry
  • Pediatric Critical Care
  • Metabolic Disorders

Background:

  • Carnitine plays a vital role in fatty acid metabolism.
  • Metabolic stress in critically ill patients can impact nutrient utilization.
  • Secondary carnitine deficiency can arise from various conditions.

Purpose of the Study:

  • To investigate carnitine profiles in critically ill children without pre-existing metabolic disorders.
  • To determine the frequency and patterns of abnormal carnitine levels during critical illness.

Main Methods:

  • Prospective study of 28 critically ill children.
  • Measurement of plasma and urine carnitine levels at multiple time points (admission, days 2, 5, 10, 15).
  • Analysis of free carnitine (FC) and esterified carnitine.

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Main Results:

  • Over 25% of plasma and 50% of urine carnitine measurements were abnormal.
  • 96% of patients exhibited at least one abnormal plasma carnitine value.
  • Three children had extremely low plasma free carnitine levels.
  • Admission carnitine levels did not correlate with mortality risk, muscle lysis, or caloric intake.

Conclusions:

  • Abnormal plasma and urine carnitine levels are common in critically ill children.
  • The clinical significance of these carnitine perturbations requires further investigation.
  • Abnormal carnitine values in this population should be interpreted cautiously, avoiding premature assumptions of hereditary metabolic disorders.