Randomised controlled trial of cisapride in preterm infants
Department of
Newborn Services, King Edward Memorial
Hospital, Perth,
Western Australia
Correspondence to: Dr RJ McClure, Neonatal Unit, Rosie Hospital, Addenbrooke's NHS Hospital Trust Cambridge CB2 2SW.
Accepted 26 October
1998
AIM
To determine the
effect of cisapride on gastrointestinal motility in preterm infants.
METHODSCisapride (0.2 mg/kg, 8 hourly ) or placebo was given first for seven days in a double
blind randomised crossover study of 10 preterm infants.
Gastrointestinal motility was assessed on day 3 of each treatment. The
half gastric emptying time (GET1/2) was
determined by using ultrasonography to measure the decrease in the
gastric antral cross sectional area after a feed. The whole gastrointestinal transit time (WGTT) was assessed by timing the transit
of carmine red through the gut. Treatments were compared using the
Wilcoxon matched pairs signed ranks test.
RESULTSMedian
(range) birthweight was 1200 (620, 1450) g and postconceptional age 33 (29, 34) weeks at recruitment. GET1/2 was
significantly longer during cisapride treatment than during placebo;
the median of the differences (95% confidence interval) was 19.2 (11, 30 minutes, p=0.008). WGTT was also longer during cisapride treatment, but the difference was not significant; the median of the differences was 11(
18, 52 hours, p=0.1).
CONCLUSIONSCisapride
delays gastric emptying and may delay WGTT in preterm infants. Its use
to promote gastrointestinal motility in this group cannot be recommended.
Keywords: cisapride; gastric emptying; gastrointestinal transit; gastrointestinal motility
© 1999 by Archives of Disease in Childhood
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