Randomised controlled trial of cisapride in feed intolerance in preterm infants

Aim-To assess the efficacy of cisapride in reducing the time required to establish enteral feeds in preterm infants. Methods-A randomised, double blind, placebo controlled trial was conducted of 34 infants of less than or equal to 32 weeks of gestation, assigned to receive either cisapride 0.2 mg/kg/dose four times daily (n=18) or placebo (n=16). Results-The time taken by the babies to tolerate full enteral feeds was not significantly different between the groups (median 9.5 days vs 10 days). There was a significantly lower incidence of large gastric residuals and regurgitation in the treated group compared with the placebo group. The number of episodes of large gastric residuals per infant was also significantly less. No adverse effects were noted. Conclusion-The routine use of cisapride in preterm infants cannot be recommended to decrease the time to establish enteral feeds. Its use may be justified for clinically significant gastric stasis or regurgitation.