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Gastric emptying in infants: response to metoclopramide depends on the underlying condition
P E Hyman1, C E Abrams, A Dubois
1Department of Pediatrics, UCLA Harbor-UCLA Medical Center, Torrance 90502.
Insights
Metoclopramide significantly accelerated gastric emptying in infants with regurgitation or post-surgical gastroparesis. However, it did not improve gastric emptying in premature infants, with no observed side effects.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Clinical Trials
Background:
- Gastric emptying is crucial for infant nutrition and development.
- Delayed gastric emptying (gastroparesis) can cause significant morbidity in infants.
- Metoclopramide is a prokinetic agent with potential to improve gastric motility.
Purpose of the Study:
- To evaluate the efficacy of metoclopramide in accelerating gastric emptying in infants.
- To assess metoclopramide's effect on different causes of delayed gastric emptying in infants.
Main Methods:
- A double-blind, placebo-controlled, randomized study design.
- Utilized a phenol red dye dilution technique to measure gastric emptying.
- Administered 1 mg/kg intravenous metoclopramide or placebo to infants with specific gastrointestinal conditions.
Main Results:
- Metoclopramide doubled gastric emptying rates in infants with regurgitation (p<0.02).
- Metoclopramide more than doubled gastric emptying in infants with post-surgical gastroparesis (p<0.05).
- No significant effect on gastric emptying was observed in premature infants with gastroparesis.
Conclusions:
- Metoclopramide is effective in accelerating gastric emptying for specific infant populations.
- The prokinetic effect of metoclopramide varies depending on the underlying cause of gastroparesis.
- Metoclopramide demonstrated a favorable safety profile in this infant cohort.
Abstract:
In a double-blind, placebo-controlled, randomized study we measured the effect of 1 mg/kg intravenous metoclopramide on the gastric emptying of a 15 ml/kg 5% glucose meal, using a phenol red dye dilution technique. In a group of nine infants referred for multiple daily episodes of regurgitation, metoclopramide doubled the rate of gastric emptying (p less than 0.02). In six infants with prolonged gastroparesis following abdominal surgery, metoclopramide more than doubled the rate of gastric emptying (p less than 0.05). In contrast, in seven infants with gastroparesis related to prematurity, metoclopramide did not significantly change gastric emptying. No extrapyramidal side effects of metoclopramide occurred during the study.