Long term gastric pH monitoring for determining optimal dose of ranitidine for critically ill preterm and term neonates
Department of
Paediatrics, University of Tampere Medical School, POB 607, FIN-33101
Tampere, Finland
Correspondence to: Dr Anna-Leena Kuusela.
Accepted 20 October 1997
AIM
To determine the optimal doses of ranitidine
for both preterm and term infants.
METHODThe effect of ranitidine treatment
was measured from the long term intraluminal gastric pH in 16 preterm
(gestational age under 37 weeks) and term infants treated in neonatal
intensive care. The infants received three different bolus doses of
ranitidine: 0.5 mg, 1.0 mg, and 1.5 mg per kilogram of body weight to
keep the intraluminal gastric pH above 4 on a 24 hour basis.
RESULTSCritically ill neonates, including very
low birth weight infants, were capable of gastric acid formation, and
ranitidine treatment increased the intraluminal gastric pH. The effect
of a single dose lasted longer in preterm than in term infants. The
time needed for reaching the maximum gastric pH was significantly
longer in preterm than in term infants. The ranitidine given correlated with the duration of increased gastric pH in a dose dependent manner
both in preterm and term infants.
CONCLUSIONPreterm infants need significantly
smaller doses of ranitidine than term neonates to keep their
intraluminal gastric pH over 4. The required optimal dose of ranitidine
for preterm infants is 0.5 mg/kg/body weight twice a day and that for
term infants 1.5 mg/kg body weight three times a day.
© 1998 by Archives of Disease in Childhood
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