Assessment of domperidone and eritromisin efficiency in premature infants with nutrition intolerance

Assessment Of Domperidone And Eritromisin Efficiency In Premature Infants With Nutrition Intolerance Aim: To assess the effect of eritromisin and domperidone on the rate of transition to full enteral nutrition for premature infants with nutrition intolerance within in neonatal intensive care unit. Material and Method: The study group consists of preterm infants with nutrition intolerance under ?1999 gram who were ?34 gestational weeks and 6 days and treated in neonatal intense care between January 2011 - March 2013. Patients were divided into three groups retrospectively; patients in 1st, 2nd and 3rd groups were treated with eritromisin, domperidone and non-prokinetic agents, respectively. In all these three groups, no other treatment method was used for nutrition intolerance. Each of these groups was divided into three sub groups (?999 gram and ?1000 gram; ?1499 gram and ?1500 gram; 31 gestational weeks and 6 days and ?32 gestational weeks). All patients, apart from innutrition and gastric residue, had at least one of the findings of abdominal distension, vomit, apnea, bradycardia and saturation decrease within first 5 days. 1st group took eritromisin 4 x10mg/kg 2 days and 4 x 4mg/kg 5 days (max.7days), 2nd group took domperidone 3 x 0.3mg/kg (max. 7days). Findings: This study assessed 73 newborns with nutrition intolerance retrospectively. Eritromisin group consisted of 30, domperidone group consisted of 21 and control group consisted of 22 patients. No statistically significant difference was found related to transition success and period (P>0,05) . When subgroups of each group was compared for transition success to full enteral nutrition, no statistically significant difference was found between three groups (P>0,05). In comparison of three groups for success of transition to full nutrition, no statistically significant difference was found in any of subgroups (P>0,05). When cases that achieved transition to full nutrition and those who failed were compared for the residence time of umbilical venous catheter, no statistically significant difference was found between two groups (P>0,05). When cases that achieved transition to full nutrition and those who failed were compared for the residence time of umbilical arterial catheter, no statistically significant difference was found between two groups (P>0,05). At the end of 1st and 2nd hours following the nutrition in a total of 38 cases, stomach content volume was calculated and rates of stomach discharge were assessed. No statistically difference was found between three groups (P>0,05). Conclusion: Eritromisin and domperidone are generally investigated for their prokinetic efficiency in treatment of nutrition intolerance of premature infants. In this study, these two drugs were compared with each other and with control group. No statistically significant difference was found between three groups in the comparison of rate and success of transition to full enteral nutrition. No side effect of either of drugs was observed. In light of these results, it is asserted that it is safe to use eritromisin and domperidone in premature infants; however, there is need for more randomized controlled studies to suggest their routine use for the treatment of nutrition intolerance of premature infants with very low birth weight. Patients' stomach content volumes calculated 1st and 2nd hour following the nutrition were similar to those calculated with USG. It is thought that there is need for more randomized controlled studies to assess the routine usability of this method in determination of the rate of stomach discharge. Keywords: Enteral nutrition, Feeding intolerance, Gastrointestinal motility, Premature, Prokinetic drugs