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. 1999 May;80(3):F174–F177. doi: 10.1136/fn.80.3.f174

Randomised controlled trial of cisapride in preterm infants

R McClure, J Kristensen, A Grauaug
PMCID: PMC1720944  PMID: 10212076

Abstract

AIM—To determine the effect 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 (GET1/2) 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. GET1/2 was significantly longer during cisapride treatment than during placebo; the median of the differences (95% confidence interval) was 19.2 (11, 30minutes, p=0.008). WGTT was also longer during cisapride treatment, but the difference 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.



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Selected References

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  1. Barone J. A., Jessen L. M., Colaizzi J. L., Bierman R. H. Cisapride: a gastrointestinal prokinetic drug. Ann Pharmacother. 1994 Apr;28(4):488–500. doi: 10.1177/106002809402800413. [DOI] [PubMed] [Google Scholar]
  2. Bergmann J. F., Chassany O., Guillausseau P. J., Bayle M., Chagnon S., Caulin C., Sallenave J. R. Simultaneous noninvasive evaluation of gastric emptying and orocaecal transit times. Use in studying the actions of cisapride in diabetic patients. Eur J Clin Pharmacol. 1992;43(2):121–124. doi: 10.1007/BF01740656. [DOI] [PubMed] [Google Scholar]
  3. Berseth C. L. Gestational evolution of small intestine motility in preterm and term infants. J Pediatr. 1989 Oct;115(4):646–651. doi: 10.1016/s0022-3476(89)80302-6. [DOI] [PubMed] [Google Scholar]
  4. Bindl L., Buderus S., Ramirez M., Kirchhoff P., Lentze M. J. Cisapride reduces postoperative gastrocaecal transit time after cardiac surgery in children. Intensive Care Med. 1996 Sep;22(9):977–980. doi: 10.1007/BF02044127. [DOI] [PubMed] [Google Scholar]
  5. Bisset W. M., Watt J. B., Rivers R. P., Milla P. J. Ontogeny of fasting small intestinal motor activity in the human infant. Gut. 1988 Apr;29(4):483–488. doi: 10.1136/gut.29.4.483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Carroccio A., Iacono G., Li Voti G., Montalto G., Cavataio F., Tulone V., Lorello D., Kazmierska I., Acierno C., Notarbartolo A. Gastric emptying in infants with gastroesophageal reflux. Ultrasound evaluation before and after cisapride administration. Scand J Gastroenterol. 1992 Sep;27(9):799–804. doi: 10.3109/00365529209011187. [DOI] [PubMed] [Google Scholar]
  7. Cavell B. Reservoir and emptying function of the stomach of the premature infant. Acta Paediatr Scand Suppl. 1982;296:60–61. doi: 10.1111/j.1651-2227.1982.tb09598.x. [DOI] [PubMed] [Google Scholar]
  8. Chen H. T., Goh M. H., Pan S. The effect and mechanism of the prokinetic action of cisapride on gastrointestinal smooth muscle. Gastroenterol Jpn. 1993 Apr;28(2):218–223. doi: 10.1007/BF02779223. [DOI] [PubMed] [Google Scholar]
  9. Cucchiara S., Raia V., Minella R., Frezza T., De Vizia B., De Ritis G. Ultrasound measurement of gastric emptying time in patients with cystic fibrosis and effect of ranitidine on delayed gastric emptying. J Pediatr. 1996 Apr;128(4):485–488. doi: 10.1016/s0022-3476(96)70358-x. [DOI] [PubMed] [Google Scholar]
  10. Dieckmann K., Maurage C., Rolland J. C., Ramponi N., Jonville A. P. Torticollis as a side effect of cisapride treatment in an infant. J Pediatr Gastroenterol Nutr. 1996 Apr;22(3):336–336. doi: 10.1097/00005176-199604000-00022. [DOI] [PubMed] [Google Scholar]
  11. Enriquez A., Bolisetty S., Patole S., Garvey P. A., Campbell P. J. Randomised controlled trial of cisapride in feed intolerance in preterm infants. Arch Dis Child Fetal Neonatal Ed. 1998 Sep;79(2):F110–F113. doi: 10.1136/fn.79.2.f110. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Ernst J. A., Rickard K. A., Neal P. R., Yu P. L., Oei T. O., Lemons J. A. Lack of improved growth outcome related to nonnutritive sucking in very low birth weight premature infants fed a controlled nutrient intake: a randomized prospective study. Pediatrics. 1989 May;83(5):706–716. [PubMed] [Google Scholar]
  13. Greally P., Hampton F. J., MacFadyen U. M., Simpson H. Gaviscon and Carobel compared with cisapride in gastro-oesophageal reflux. Arch Dis Child. 1992 May;67(5):618–621. doi: 10.1136/adc.67.5.618. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gupta M., Brans Y. W. Gastric retention in neonates. Pediatrics. 1978 Jul;62(1):26–29. [PubMed] [Google Scholar]
  15. Lander A., Redkar R., Nicholls G., Lawson A., Choudhury S. R., Corkery J. J., Gornall P., Buick R. G., Booth I. W. Cisapride reduces neonatal postoperative ileus: randomised placebo controlled trial. Arch Dis Child Fetal Neonatal Ed. 1997 Sep;77(2):F119–F122. doi: 10.1136/fn.77.2.f119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lewin M. B., Bryant R. M., Fenrich A. L., Grifka R. G. Cisapride-induced long QT interval. J Pediatr. 1996 Feb;128(2):279–281. doi: 10.1016/s0022-3476(96)70409-2. [DOI] [PubMed] [Google Scholar]
  17. Lux G., Katschinski M., Ludwig S., Lederer P., Ellermann A., Domschke W. The effect of cisapride and metoclopramide on human digestive and interdigestive antroduodenal motility. Scand J Gastroenterol. 1994 Dec;29(12):1105–1110. doi: 10.3109/00365529409094895. [DOI] [PubMed] [Google Scholar]
  18. Madsen J. L. Effects of cisapride on gastrointestinal transit in healthy humans. Dig Dis Sci. 1990 Dec;35(12):1500–1504. doi: 10.1007/BF01540568. [DOI] [PubMed] [Google Scholar]
  19. McClure R. J., Newell S. J. Effect of fortifying breast milk on gastric emptying. Arch Dis Child Fetal Neonatal Ed. 1996 Jan;74(1):F60–F62. doi: 10.1136/fn.74.1.f60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Melis K., Janssens G. Long-term use of cisapride (Prepulsid) in premature neonates. Acta Gastroenterol Belg. 1990 Jul-Aug;53(4):372–375. [PubMed] [Google Scholar]
  21. Newell S. J., Chapman S., Booth I. W. Ultrasonic assessment of gastric emptying in the preterm infant. Arch Dis Child. 1993 Jul;69(1 Spec No):32–36. doi: 10.1136/adc.69.1_spec_no.32. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pan H., Galligan J. J. 5-HT1A and 5-HT4 receptors mediate inhibition and facilitation of fast synaptic transmission in enteric neurons. Am J Physiol. 1994 Feb;266(2 Pt 1):G230–G238. doi: 10.1152/ajpgi.1994.266.2.G230. [DOI] [PubMed] [Google Scholar]
  23. Rubaltelli F. F., Largajolli G. Effect of light exposure on gut transit time in jaundiced newborns. Acta Paediatr Scand. 1973 Mar;62(2):146–148. doi: 10.1111/j.1651-2227.1973.tb08082.x. [DOI] [PubMed] [Google Scholar]
  24. Vandenplas Y., Deneyer M., Verlinden M., Aerts T., Sacre L. Gastroesophageal reflux incidence and respiratory dysfunction during sleep in infants: treatment with cisapride. J Pediatr Gastroenterol Nutr. 1989 Jan;8(1):31–36. doi: 10.1097/00005176-198901000-00007. [DOI] [PubMed] [Google Scholar]
  25. al Tawil Y., Berseth C. L. Gestational and postnatal maturation of duodenal motor responses to intragastric feeding. J Pediatr. 1996 Sep;129(3):374–381. doi: 10.1016/s0022-3476(96)70069-0. [DOI] [PubMed] [Google Scholar]

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