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Randomised controlled trial of cisapride in feed intolerance in preterm infants
A Enriquez1, S Bolisetty, S Patole
1Department of Newborn Care, Royal Hospital for Women, Randwick New South Wales, Australia.
Insights
Cisapride did not significantly reduce the time to establish enteral feeds in preterm infants. However, it did decrease gastric residuals and regurgitation, suggesting potential benefits for specific clinical issues.
Area of Science:
- Neonatal Medicine
- Clinical Pharmacology
- Gastroenterology
Background:
- Establishing enteral nutrition is crucial for preterm infant growth and development.
- Gastric stasis and regurgitation are common complications in preterm infants, potentially delaying feeding progression.
Purpose of the Study:
- To evaluate the effectiveness of cisapride in accelerating the establishment of enteral feeds in preterm infants.
- To assess cisapride's impact on gastrointestinal motility and feeding tolerance.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 34 preterm infants (gestational age ≤ 32 weeks).
- Infants received either cisapride (0.2 mg/kg/dose, four times daily) or a placebo.
- Primary outcome was the time to tolerate full enteral feeds; secondary outcomes included incidence of gastric residuals and regurgitation.
Main Results:
- No significant difference in the time to establish full enteral feeds between the cisapride and placebo groups (median 9.5 vs. 10 days).
- Significantly lower incidence and fewer episodes of large gastric residuals and regurgitation in infants treated with cisapride.
- No adverse effects were reported during the study period.
Conclusions:
- Routine use of cisapride is not recommended for expediting enteral feeding establishment in preterm infants.
- Cisapride may be beneficial for managing preterm infants with clinically significant gastric stasis or regurgitation.
- Further research could explore optimal dosing or specific indications for cisapride in neonatal care.
Aim:
To assess the efficacy of cisapride in reducing the time required to establish enteral feeds in preterm infants.
Methods:
A randomised, double blind, placebo controlled trial was conducted of 34 infants of < or = 32 weeks of gestation, assigned to receive either cisapride 0.2 mg/kg/dose four times daily (n = 18) or placebo (n = 16).
Results:
The time taken by the babies to tolerate full enteral feeds was not significantly different between the groups (median 9.5 days vs 10 days). There was a significantly lower incidence of large gastric residuals and regurgitation in the treated group compared with the placebo group. The number of episodes of large gastric residuals per infant was also significantly less. No adverse effects were noted.
Conclusion:
The routine use of cisapride in preterm infants cannot be recommended to decrease the time to establish enteral feeds. Its use may be justified for clinically significant gastric stasis or regurgitation.