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Effect of cisapride on gastric emptying in premature infants with feed intolerance

C P Barnett1, T Omari, G P Davidson

  • 1Neonatal Medicine Unit, Women's and Children's Hospital, North Adelaide, Australia. barnettc@wch.sa.gov.au

Journal of Paediatrics and Child Health
|March 21, 2002
PubMed

Insights

Cisapride did not improve gastric emptying or reflux symptoms in preterm infants with feeding intolerance. The drug was associated with slower infant growth, and its use is not recommended.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Pharmacology

Background:

  • Feed intolerance is a common issue in preterm infants.
  • Gastro-oesophageal reflux (GOR) and delayed gastric emptying contribute to feeding intolerance.
  • Cisapride is a prokinetic agent that may improve gastrointestinal motility.

Purpose of the Study:

  • To evaluate the efficacy of cisapride in preterm infants with feed intolerance.
  • To assess the impact of cisapride on gastric emptying and GOR symptoms.

Main Methods:

  • A randomized, placebo-controlled crossover study involving 16 preterm infants (24-35 weeks gestational age).
  • Infants received cisapride (0.2 mg/kg four times daily) or placebo for 7 days, followed by a crossover period.
  • Gastric emptying was measured using the [13C]-octanoic acid breath test; GOR symptoms were monitored via a standardized chart.

Main Results:

  • No significant difference in gastric emptying (t1/2: 31.9 ± 4.7 min vs. 34.2 ± 3.9 min, P = 0.65) between cisapride and placebo.
  • Infants receiving cisapride exhibited slower growth rates.
  • No improvement in gastro-oesophageal reflux symptoms was observed with cisapride treatment.

Conclusions:

  • Cisapride does not improve gastric emptying or reduce GOR symptoms in preterm infants with feed intolerance.
  • The potential for adverse effects on growth suggests cisapride should not be recommended for this patient population.
  • Further research may be needed to explore alternative treatments for feed intolerance in preterm neonates.
Abstract

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