title: The effect of an osmotic contrast agent on complete meconium evacuation in preterm infants.
abstract: OBJECTIVE
  To determine whether enteral application of the osmotic contrast agent Gastrografin accelerates complete meconium excretion and improves feeding tolerance in very low birth weight infants.
  
  
  METHODS
  This study was a stratified, randomized, placebo-controlled trial in premature infants with a birth weight <1500 g and a gestational age <32 weeks who received 3 mL/kg Gastrografin diluted 1:3 with water within their first 24 hours of life, or placebo.
  
  
  RESULTS
  Passage of last meconium occurred after a median of 7 days (95% confidence interval: 6-9 days, n = 39) in the intervention group and after 8 days (95% confidence interval: 7-10 days, n = 39) in the control group (P = .61); however, Gastrografin application was associated with a 7.5-day shorter time to full enteral feedings, a 24-day shorter stay in the NICU, and a 17-day reduction in the overall hospital stay in the intervention group compared with the control group. A numerically higher incidence of necrotizing enterocolitis (21%) was observed in the intervention group, however.
  
  
  CONCLUSIONS
  Gastrografin application did not accelerate meconium evacuation, but the higher stool frequency during the first week of life had a beneficial effect on the time to full enteral feedings and later hospital stay; however, it may increase the necrotizing enterocolitis risk. Further investigations are needed with modified protocols, and the prophylactic use of Gastrografin cannot currently be recommended without further clinical trials.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Medical University of Vienna, Vienna, Austria. nadja.haiden@meduniwien.ac.at
authors.forename: Nadja
authors.initials: N
authors.lastname: Haiden
authors.forename: Florentine
authors.initials: F
authors.lastname: Norooz
authors.forename: Kathrin
authors.initials: K
authors.lastname: Klebermass-Schrehof
authors.forename: Anna Sophie
authors.initials: AS
authors.lastname: Horak
authors.forename: Bernd
authors.initials: B
authors.lastname: Jilma
authors.forename: Angelika
authors.initials: A
authors.lastname: Berger
authors.forename: Andreas
authors.initials: A
authors.lastname: Repa
mesh_terms: D000284:Administration, Oral; D001317:Austria; D015331:Cohort Studies; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003672:Defecation / Q000187:drug effects; D003974:Diatrizoate Meglumine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing / Q000139:chemically induced; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D007441:Intubation, Gastrointestinal; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008470:Meconium / Q000187:drug effects*
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine