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Cisapride reduces postoperative gastrocaecal transit time after cardiac surgery in children
Insights
Cisapride significantly speeds up gastrocaecal transit time (GCTT) in children recovering from open heart surgery. This prokinetic drug may enable earlier enteral feeding for critically ill pediatric patients.
Area of Science:
- Pediatric intensive care
- Gastroenterology
- Pharmacology
Background:
- Gastrointestinal motility is often impaired in children post-open heart surgery.
- Delayed gastrocaecal transit time (GCTT) can hinder the reintroduction of enteral nutrition.
Purpose of the Study:
- To evaluate the effect of cisapride on GCTT in pediatric patients after open heart surgery.
- To determine if cisapride can improve gastrointestinal function in this vulnerable population.
Main Methods:
- A prospective, randomized, controlled study was conducted in a pediatric intensive care unit.
- Twenty-one children post-open heart surgery received either cisapride or placebo.
- Gastrocaecal transit time (GCTT) was measured using hydrogen breath testing with lactulose and mannitol.
Main Results:
- GCTT was significantly delayed in post-surgery patients compared to healthy controls.
- Children receiving cisapride showed accelerated gastrocaecal transit, with 8/10 achieving transit within 8 hours versus 4/11 in the non-cisapride group.
- No adverse side effects were reported with cisapride administration.
Conclusions:
- Cisapride effectively accelerates gastrocaecal transit in children following open heart surgery.
- The prokinetic agent cisapride may facilitate earlier enteral feeding in pediatric intensive care patients, particularly those on inotropic support or opioid medication.
Objective:
To investigate the influence of the prokinetic drug cisapride on gastrocaecal transit time (GCTT) in children after open heart surgery.
Design:
Prospective, randomized and controlled study.
Setting:
Interdisciplinary paediatric intensive care unit in a tertiary-care children's hospital.
Patient:
Twenty-one children with a median age of 6.2 years on day 1 after uncomplicated open heart surgery for isolated septal defects, acquired mitral or aortic valve disease or tetralogy of Fallot. Control group consisting of 10 healthy children with a median age of 8.1 years.
Interventions:
Ten children were randomized to receive cisapride 0.2 mg/kg body weight, 30 min prior to measurement of GCTT.
Measurements And Results:
GCTT was measured using hydrogen breath testing with a test solution containing lactulose and mannitol (0.4 g/kg and 0.1 g/kg body weight respectively). GCTT was markedly delayed in all patients compared to the control group. Within 8 h 8/10 patients in the treatment group versus 4/11 patients in the non-cisapride group achieved gastrocaecal transit. No adverse side-effects were observed.
Conclusions:
Cisapride accelerates gastrocaecal transit after open heart surgery in children. In intensive care patients on inotropic support or opioid medication, it may facilitate the earlier reintroduction of enteral feeding.