Cisapride reduces postoperative gastrocaecal transit time after cardiac surgery in children.

OBJECTIVE

To investigate the influence of the prokinetic drug cisapride on gastrocaecal transit time (GCTT) in children after open heart surgery.

DESIGN

Prospective, randomized and controlled study.

SETTING

Interdisciplinary paediatric intensive care unit in a tertiary-care children'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 of Fallot. Control group consisting of 10 healthy children with a median age of 8.1 years.

INTERVENTIONS

Ten children were randomized to receive cisapride 0.2 mg/kg body weight, 30 min prior to measurement of GCTT.

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 patients in the treatment group versus 4/11 patients in the non-cisapride group achieved gastrocaecal transit. No adverse side-effects were observed.

CONCLUSIONS

Cisapride accelerates gastrocaecal transit after open heart surgery in children. In intensive care patients on inotropic support or opioid medication, it may facilitate the earlier reintroduction of enteral feeding.