Randomised controlled trial of cisapride in preterm infants

Aim-To determine the effect of cisapride on gastrointestinal motility in pr eterm infants. Methods-Cisapride (0.2 mg/kg, 8 hourly) or placebo was given first for seve n 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 fee d. The whole gastrointestinal transit time (WGTT) was assessed by timing th e transit of carmine red through the gut. Treatments were compared using th e Wilcoxon matched pairs signed ranks test. Results-Median (range) birthweight was 1200 (620, 1450) g and postconceptio nal age 33 (29, 34) weeks at recruitment. GET1/2 was significantly longer d uring cisapride treatment than during placebo; the median of the difference s (95% confidence interval) was 19.2 (11, 30 minutes, p=0.008). WGTT was al so longer during cisapride treatment, but the difference was not significan t; 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.