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Arch Dis Child Fetal Neonatal Ed 1999;80:F174-F177 ( May )

Randomised controlled trial of cisapride in preterm infants

R J McClure, J H Kristensen, A Grauaug

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.
METHODS---Cisapride (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.
RESULTS---Median (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).
CONCLUSIONS---Cisapride 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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