Gastrointestinal dysmotility is prevalent in children with paediatric intestinal failure (PIF), causing delays in enteral nutrition progression (EN). There has been little research reported on the safety and efficacy of cisapride for improving enteral tolerance and weaning from parenteral feeding. Our goal was to present a single center’s experience with cisapride in patients with PIF. Patients’ charts were reviewed in retrospect. Data on demographics, intestinal anatomy, and outcomes were gathered. The percentage of EN before starting cisapride, advancement of EN at 3 and 6 months, and capacity to wean from parenteral nourishment after starting cisapride were all calculated. Prokinetics were utilised in 61 of 106 patients, with 29 of 60 patients starting on cisapride after failing to improve on other prokinetics. EN progressed for an average of 42.3 days prior to cisapride. The rate of feed advancement was 0.14 percent per day prior to cisapride administration and 0.69 percent per day following cisapride administration. The percentage of EN improved considerably from baseline to three months after treatment. An electrocardiogram was taken before starting cisapride and after each dosage adjustment. Medication was stopped in two of the 29 cases.
This study shows that cisapride may be helpful in PIF patients who do not progress EN on first-line prokinetics. The most substantial phase of improvement comes within three months of starting cisapride. Cardiac side effects were fewer in our group than previously described; nonetheless, cardiac monitoring is still advised.
Reference: https://journals.lww.com/jpgn/Abstract/2021/01000/Cisapride_Use_in_Pediatric_Patients_With.12.aspx
