A prospective study was initiated to monitor serum tocopherol levels in all infants admitted to Indiana University Medical Center with birth weights 1,500 g. These infants routinely receive 100 mg/kg/d of oral vitamin E (Aquasol E tocopherol acetate) every six hours. Levels are determined weekly or semiweekly using a modification of the fluorometric method of Hanson and Warwick. Vitamin E dosage is adjusted regularly to achieve levels ≥3.5 mg/dL. During the 6 months of this study, a total of 76 patients had 567 serum measurements. Of these, 220 levels (38%) were ≥3.5 mg/dL, 71 (13%) were ≥5.5 mg/dL, and 15 (2.7%) were 8 mg/dL. Serum tocopherol levels often (1) remained ≥3.5 mg/dL for several days after oral supplementation was discontinued or (2) again became ≥3.5 mg/dL on a reduced dosage of 25 to 50 mg/kg/d. These data indicate that infants weighing 1,500 g at birth who are receiving oral vitamin E supplementation at 100 mg/kg/d will have varied serum levels with a significant percentage exceeding 3.5 mg/dL.
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