Carnitine supplementation for preterm infants with recurrent apnoea

  • Review
  • Intervention

Authors


Abstract

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 apnoea.

Objectives

To determine whether treatment with carnitine will reduce the frequency of apnoea, the duration of ventilation and the duration of hospital stay in preterm infants with recurrent apnoea.

Search methods

Computerised searches were carried out independently by two reviewer authors. We searched MEDLINE (1966 to December 2010), EMBASE (1988 to December 2010), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2010), abstracts of annual meetings of the Society for Pediatric Research (1995 to 2010), and contacts were made with the subject experts.

Selection criteria

Only randomised or quasi-randomised treatment trials of preterm infants with a diagnosis of recurrent apnoea 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 reviewer authors evaluated the papers for inclusion criteria and quality. Corresponding authors were contacted for further information where needed.

Main results

No eligible trials were identified.

Authors' conclusions

Despite the plausible rationale for the treatment of apnoea 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.

摘要

背景

Carnitine治療早產兒反覆呼吸暫停

早產兒呼吸暫停是新生兒重症加護病房(NICU)常見的問題,經常會拖延其出院回家或轉到下一階病房單位的時間。早產兒常會增加Carnitine缺乏症的風險。Carnitine的補充已用於預防和治療呼吸暫停。

目標

確定Carnitine治療有反覆呼吸暫停的早產兒,其呼吸暫停的頻率,呼吸器使用時間,和住院時間方面,改善的成效。

搜尋策略

由兩名評論者獨立使用電腦進行搜索。搜查內容有MEDLINE(1966年至2007年5月),EMBASE(1988年至2007年5月),Cochrane中心註冊的對照試驗(CENTRAL, The Cochrane Library,第2期,2007年),每年召開的兒科研究學會會議摘要(1995  2007),並聯繫了這方面學科的專家。

選擇標準

只有隨機或半隨機確診早產兒反覆呼吸暫停的治療試驗被考慮納入。納入試驗的依據包括使用carnitine治療與安慰劑或不治療相比,並統計至少下列其中一個結果:緩解呼吸暫停失敗,使用呼吸器時間和住院時間。

資料收集與分析

兩名評論者評估論文納入標準和品質。也聯繫了通訊作者,以便在有需要時提供進一步資料。

主要結論

沒有任何符合資格的試驗被確認

作者結論

儘管表面上講得通,用carnitine治療早產兒呼吸暫停,但缺乏足夠的數據以支持其用於此適應症。在臨床應用中,還需要進一步的研究來確定這種治療的作用。

翻譯人

本摘要由臺中榮民總醫院薛榮華翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

在臨床應用中, 還需要進一步的研究來確定建議使用carnitine治療早產兒呼吸暫停。早產兒呼吸暫停是新生兒重症加護病房(NICU)常見的問題。在這個族群中,反覆性呼吸暫停是與神經發育不良有相關性的。carnitine缺乏症已被證明與嬰幼兒和成人呼吸暫停與呼吸衰竭有關。評論者試圖調查carnitine治療早產兒將有助於減少或緩解呼吸暫停發作,需要呼吸器的機會。但沒有任何符合資格的試驗被確認。

Plain language summary

Carnitine supplementation for preterm infants with recurrent apnoea

More research is needed before the use of carnitine for the treatment of apnoea of prematurity can be recommended in clinical practice.

Apnea of prematurity is a common problem in preterm infants in the neonatal intensive care setting (NICU). Recurrent apnoea episodes are correlated with adverse neurological development in this population. Carnitine deficiency has been shown to be associated with apnoea and respiratory failure in infants and in adults. The review authors investigated whether treatment of premature babies with carnitine will help in the reduction or resolution of apnoea episodes, and the need for ventilation. No treatment trials were identified.