Randomised controlled trial of cisapride in preterm infants

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 (GET 1/2 ) 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. GET 1/2 was significantly longer during cisapride treatment than during placebo; the median of the differences (95% confidence interval) was 19.2 (11, 30 minutes, 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.