Effects of cisapride on QTc interval in term neonates
D S Semama, S Bernardini, S Louf, B Laurent-Atthalin, J-B Gouyon
Service
de Pédiatrie 2, Centre Hospitalier Universitaire, 10 Bd Maréchal de
Lattre de Tassigny, 21034 Dijon Cedex, France
Correspondence to: Dr Semama, Service de Pédiatrie 2, Hôpital d'Enfants, Centre Hospitalier Universitaire, 10 Bd Maréchal de Lattre de Tassigny, 21034 Dijon Cedex, France denis.semama{at}libertysurf.fr
Accepted 29 August
2000
BACKGROUND
Cisapride
administration for 48 hours has been shown to increase heart rate
corrected QT (QTc) interval in preterm neonates. Accumulation of the
drug because of liver enzyme immaturity has been suggested to be the
reason. If this is correct, a longer survey of QTc interval should
disclose an increase even in term neonates.
OBJECTIVEA
prospective survey of the effects of cisapride on QTc interval in term
neonates administered cisapride.
SETTINGNeonatal Unit
of the University Hospital of Dijon, France.
DESIGNQTc interval
was determined just before and 48 hours, seven days, and 15 days after
the start of treatment.
SUBJECTSTwenty one
term newborn infants (mean gestational age 39.3 weeks) given the
recommended dose of cisapride (0.2 mg/kg, four times a day).
RESULTSAdministration
of cisapride caused a significant increase in QTc interval
(p < 0.01). The mean value increased from 0.397 before treatment to
0.418 after 48 hours, 0.431 by day 7, and 0.447 by day 15. A QTc
interval exceeding 0.450 was found in six neonates: three at 48 hours,
one at day 7, and two at day 15. In two infants, withdrawal of the drug
was associated with normalisation of the QTc interval.
CONCLUSIONSThese
results support the hypothesis of cisapride accumulation in newborns
due to enzymatic immaturity and indicate that QTc interval should be
monitored in neonates receiving this drug.
Keywords: heart; cisapride; QT interval; QTc interval; neonate; term
© 2001 by Archives of Disease in Childhood
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