Randomised controlled trial of cisapride in preterm infants

Abstract

Aim-To determine the eVect 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 (GET 1 ⁄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. GET 1 ⁄2 was significantly longer during cisapride treatment than during placebo; the median of the diVerences (95% confidence interval) was 19.2 (11, 30 minutes, p=0.008). WGTT was also longer during cisapride treatment, but the diVerence 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. (Arch Dis Child Fetal Neonatal Ed 1999;80:F174-F177)

Cisapride May Improve Feeding Tolerance of Preterm Infants: A Randomized Placebo-Controlled Trial

“…The same dose of cisapride was chosen as in our study. Gastric emptying was delayed with cisapride [8] . These results were surprising, but the small study population consisted mainly of older infants with established feeding intolerance who may have had other medical problems.…”

“…0.1 mg/kg/day) to 20 preterm infants and demonstrated improved gastric emptying. McClure et al [8] included 10 enterally fed patients with a median postnatal age of 22 days. The same dose of cisapride was chosen as in our study.…”

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

“…There are few agents possessing prokinetic properties. Cisapride has been used for this purpose with mixed success using different dosage [3,4], but following concerns regarding its cardiac complications, most probably due to accumulation of the drug [5,6] it is no longer recommended.…”

Randomised controlled trial of the effect of cisapride on the pyloric muscle in preterm infants

“…Cisapride is a benzamide, prokinetic agent that stimulates gastrointestinal motility by enhancing acetylcholine release, an eect mediated through stimulation of 5-hydroxytryptamine-4 receptors [20,25]. It is chemically related to metoclopramide but does not exhibit central antidopaminergic properties [19].…”