THE EFFECT OF INTRAVENOUS RANITIDINE ON THE INTRAGASTRIC PH OF PRETERM INFANTS RECEIVING DEXAMETHASONE

Gastric perforation is a catastrophic, albeit uncommon, side effect of steroid treatment for premature infants with bronchopulmonary dysplas ia (BPD). A reduction of intragastric acidity may protect against pept ic ulceration. The effect of different doses of ranitidine, given as i ntravenous infusions, on intragastric acidity in premature neonates wa s therefore examined. Ten consecutive, enterally starved, infants rece iving dexamethasone (0.6 mg/kg) for BPD were enrolled. Intragastric pH was continuously monitored on the day before steroid treatment and on the four following days, initially without H-2 blockade and then usin g a continuous intravenous infusion of ranitidine at 0.031, 0.0625, an d 0.125 mg/kg/hour. An infusion of 0.0625 mg/kg/hour of ranitidine was sufficient to increase and maintain gastric pH above 4; the authors t herefore use this infusion during dexamethasone administration as poss ible prevention of gastric perforation.