CISAPRIDE REDUCES POSTOPERATIVE GASTROCAECAL TRANSIT-TIME AFTER CARDIAC-SURGERY IN CHILDREN

Objective: To investigate the influence of the prokinetic drug cisapri de on gastrocaecal transit time (GCTT) in children after open heart su rgery. Design: Prospective, randomized and controlled study. Setting: Interdisciplinary paediatric intensive care unit in a tertiary-care ch ildren'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 o f Fallot. Control group consisting of 10 healthy children with a media n age of 8.1 years. Interventions: Ten children were randomized to rec eive cisapride 0.2 mg/kg body weight, 30 min prior to measurement of G CTT. 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 patient s in the treatment group versus 4/11 patients in the non-cisapride gro up achieved gastrocaecal transit. No adverse side-effects were observe d. Conclusions: Cisapride accelerates gastrocaecal transit after open heart surgery in children. In intensive care patients on inotropic sup port or opioid medication, it may facilitate the earlier reintroductio n of enteral feeding.