ABSTRACT
Background: Respiratory distress syndrome [RDS] is among the most common diseases of preterm infants. RDS is caused by a decreased production or secretion of pulmonary surfactant. Numerous causes of RDS have been identified, and the factors suspected to be involved in the pathogenesis of RDS are numerous, Carnitine is essential for the fetus and is provided via placental transport. As the gestational age increases, fetal tissues store increasing amounts of carnitine, therefore, preterm infants require exogenous carnitine supplementation for carnitine homeostasis. Treatment with carnitine has shown benefit in the respiratory status of ventilator- dependent adults, as well as stabilization of respiratory parameters and increased physical performance in adult patients with chronic respiratory insufficiency
Objective: The present study was designed to measure the level of free carnitine in preterm neonates with RDS and to evaluate the efficacy of L-carnitine therapy on those neonates
Patients and Methods: Forty preterm infants, including 14 females and 26 males. Study group were divided in to 2 groups, group A: received L-carnitin in a dose of 30 mg/kg/ day for 7 days and group B: did not receive supplementation
Results: our results show non statistically significant difference between group A [with Carnitine supplementation] and group B [no supplementation] at day 1. There was statistically significant higher serum carnitine level in group A compared to group B at day 7 [after supplementation]. Seven neonates [35%] in group A, and 13 [65%] in group B, needed surfactant administration and MV after 24 hours from admission and this difference was statistically significant. Dose of surfactant was statistically significant lower in group A compared to group B [P=0.001] and duration of mechanical ventilation was statistically significant lower in group A compared to group B [p=0.03]
Conclusion: L-carnitine is more deficient in preterm with RDS than preterm without RDS and its supplementation can reduce the need and duration of MV and/ or need and dose of surfactant