Clinical Use

Carnitine supplementation may be administered as intravenous or oral doses. This review will only focus on oral supplementation as this is the form generally used by the public and available over the counter. TREATMENT OF DEFICIENCY

l-Carnitine supplementation is traditionally used to treat or prevent deficiency. It is indicated in primary l-carnitine deficiency and secondary deficiency due to inborn

errors of metabolism or haemodyalisis. l-Carnitine 50-200 mg/kg/day has been shown to normalise plasma carnitine levels within 10 days (Campos et al 1993). Apnoea of prematurity Preterm neonates develop carnitine deficiency due to impaired proximal renal tubule carnitine re-absorption and immature carnitine biosynthesis (Evangeliou & Vlassopoulos 2003) and are at risk of developing apnoea of prematurity. Despite a promising preliminary study, a blinded, randomised, placebo-controlled study found that infants who received supplemental carnitine did not demonstrate any reduction in apnoea of prematurity, days requiring ventilator or nasal continuous positive airway pressure, or the need for supplemental oxygen therapy (O'Donnell et al 2002). A recent Cochrane review was unable to locate studies of significant quality to confirm any effects (Kumar et al 2004a). Further studies are needed to determine the role of this treatment in clinical practice as present evidence does not support its use (Kumar et al 2004b).

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