{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:15:49Z","timestamp":1767856549953,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The metabolic demands associated with critical illness place patients at risk for nutrition deficits. Carnitine is a small molecule essential for fatty acid oxidation and gluconeogenesis. Secondary carnitine deficiency can have clinically significant complications and has been observed anecdotally in patients receiving extracorporeal membrane oxygenation (ECMO) therapy at our institution. Guidelines for monitoring and supplementing carnitine are lacking. This retrospective study determined whether critically ill pediatric patients receiving ECMO have an increased risk of carnitine deficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Acylcarnitine analysis was performed on residual specimens from patients who received ECMO therapy. The control data were a convenience sample gathered by chart review of patients who had been tested for carnitine during a hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Acylcarnitines were measured in 217 non\u2010ECMO patients and 81 ECMO patients. Carnitine deficiency, based on age\u2010specific reference ranges, was observed in 41% of ECMO cases compared with 21% of non\u2010ECMO cases. Multivariable analysis of age\u2010matched patients identified that the odds of carnitine deficiency were significantly lower among patients on the floor compared with ECMO patients (odds ratio, 0.21; 95% CI, 0.10\u20130.44). Age\u2010specific frequency of qualitative carnitine deficiency ranged from 15% (patients &gt;5 years old) to 56% (patients 1 week to 1 month old) in ECMO patients and 15% (patients &gt;5 years old) to 34% (patients 1\u20135 years old) in non\u2010ECMO patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, ECMO patients were carnitine deficient more frequently compared with other inpatients, with the highest rates of deficiency among ECMO patients between 1 week and 1 month old.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2255","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T08:19:44Z","timestamp":1629447584000},"page":"1663-1672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Carnitine deficiency among hospitalized pediatric patients: A retrospective study of critically ill patients receiving extracorporeal membrane oxygenation therapy"],"prefix":"10.1002","volume":"45","author":[{"given":"Jenna","family":"Kelley","sequence":"first","affiliation":[{"name":"Department of Nutrition Services Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4280-6091","authenticated-orcid":false,"given":"Erin","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology, and Analytics for Research Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2856-775X","authenticated-orcid":false,"given":"Marie","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Nutrition and Integrative Physiology University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2694-2958","authenticated-orcid":false,"given":"Sarah","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Parietti","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4798-3537","authenticated-orcid":false,"given":"Kimberly","family":"Kellogg","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6975-8552","authenticated-orcid":false,"given":"Anna I.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Laboratories Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607117711387"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001713"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.104893"},{"issue":"125","key":"e_1_2_11_5_1","first-page":"1","article-title":"Nutritional status and clinical outcome of children on continuous renal replacement therapy: a prospective observational study","volume":"13","author":"Castillo A","year":"2012","journal-title":"BMC Nephrol"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(03)00170-9"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607109348065"},{"key":"e_1_2_11_8_1","first-page":"59","volume-title":"Micronutrient requirements in the critically ill child. 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