Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth
Edward F Bell, Nellie I Hansen, Luc P Brion, Richard A Ehrenkranz, Kathleen A Kennedy, Michele C Walsh, Seetha Shankaran, Michael J Acarregui, Karen J Johnson, Ellen C Hale, Lynn A Messina, Margaret M Crawford, Abbot R Laptook, Ronald N Goldberg, Krisa P Van Meurs, Waldemar A Carlo, Brenda B Poindexter, Roger G Faix, David P Carlton, Kristi L Watterberg, Dan L Ellsbury, Abhik Das, Rosemary D Higgins, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Edward F Bell, Nellie I Hansen, Luc P Brion, Richard A Ehrenkranz, Kathleen A Kennedy, Michele C Walsh, Seetha Shankaran, Michael J Acarregui, Karen J Johnson, Ellen C Hale, Lynn A Messina, Margaret M Crawford, Abbot R Laptook, Ronald N Goldberg, Krisa P Van Meurs, Waldemar A Carlo, Brenda B Poindexter, Roger G Faix, David P Carlton, Kristi L Watterberg, Dan L Ellsbury, Abhik Das, Rosemary D Higgins, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Abstract
Objective: Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage.
Methods: Ninety-three infants <27 weeks' gestation and <1000 g were randomly assigned to receive a single dose of vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing.
Results: Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs. 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels <0.5 mg/dL.
Conclusions: A 50-IU/kg dose of vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.
Trial registration: ClinicalTrials.gov NCT01193270.
Keywords: preterm infants; vitamin E.
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Source: PubMed