Abstract
In healthy preterm infants, gastric acid is a barrier against bacterial colonization of the upper small bowel, and thus may decrease the risk of infection and neonatal necrotizing enterocolitis. We examined the effect of anticholinergic eyedrops on basal acid output (BAO) and pentagastrin-stimulated (6 μg/kg, s.c.) maximal acid output (MAO). Twenty infants ( age 6 ± 4 wk, weight 1.7 ± 0.2 kg, mean ± SD) were each studied by continuous aspiration of gastric contents for 2 hr on 2 consecutive days during a clinically indicated eye exam. On day 1 BAO was measured before and after eyedrops; on day 2 pentagastrin was given on 2 consecutive hr; eyedrops were administered with the second injection. Eyedrops were saline placebo (n=6), cyclopentolate (CPL) 0.25% (n=6), or CPL 0.5% (n=8). Results are the mean ± SEM. Overall BAO = 12 ± 2 μmole/kg/hr; MAO = 38 ± 5 μmole/kg/hr. There were not significant differences among the subgroups. BAO was not altered by placebo or CPL 0.25%, but decreased from 15 ± 3 to 4 ± 1 μmole/kg/hr following CPL 0.5% (p<0.01). MAO was unaffected by CPL, but acid and volume output were each decreased by 50% following the 2nd pentagastrin injection (p<0.01). Thus, in preterm infants 1) cholinergic mechanisms influence BAO, 2) anticholinergic eyedrops do not alter MAO, and 3) repeated injections of pentagastrin result in tachyphalaxis. Anticholinergic eyedrops may reduce the acid barrier against microorganisms. To avoid undesirable gastrointestinal effects in infants, CPL eyedrops must be limited to 0.25%.
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Hyman, P., Abrams, C. & Leake, R. 674 CHOLINERGIC INFLUENCE ON GASTRIC ACID SECRETION IN PRETERM INFANTS. Pediatr Res 19, 223 (1985). https://doi.org/10.1203/00006450-198504000-00704
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DOI: https://doi.org/10.1203/00006450-198504000-00704