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Propranolol for infantile haemangiomas: initiating treatment on an outpatient basis

Published online by Cambridge University Press:  14 December 2011

Joshua L. Dyme ,
Ashis Thampan ,
Eugenia J. Han ,
Themba L. Nyirenda ,
Mohy E. Kotb  and
Helen T. Shin
Joshua L. Dyme*
Affiliation:
Department of Pediatrics, Hackensack University Medical Center, Hackensack, United States
Ashis Thampan
Affiliation:
Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark, United States
Eugenia J. Han
Affiliation:
Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark, United States
Themba L. Nyirenda
Affiliation:
Research Department, Hackensack University Medical Center, Hackensack, New Jersey, United States
Mohy E. Kotb
Affiliation:
Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Newark, United States
Helen T. Shin
Affiliation:
Department of Pediatrics, Hackensack University Medical Center, Hackensack, United States
*
Correspondence to: Dr J. L. Dyme, MD, Division of Pediatric Cardiology, Department of Pediatrics, Hackensack University Medical Center, 155 Polifly Road, Suite 106, Hackensack, NJ 07601, New Jersey, United States. Tel: +1 201 487 7617; Fax: +1 201 342 5341; E-mail: jdyme@hotmail.com
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Abstract

Introduction

Propranolol was recently discovered to be an effective treatment for infantile haemangiomas, and varying doses and monitoring regimens have been proposed. Adverse events, although uncommon, have been reported.

Materials and methods

This was a retrospective chart review of infants with haemangiomas who were started on propranolol at a dose of 3 milligrams per kilogram per day on an outpatient basis. After a baseline cardiac evaluation including an electrocardiogram and an echocardiogram, treatment was initiated during 6 hours of observation.

Results

A total of 15 patients were identified; however, only 13 returned for at least one follow-up visit. This cohort was followed up for a median of 2.8 months with a range from 0.2 to 10.0. No hypotension, hypoglycaemia, bronchospasm, or clinically significant bradycardia occurred during treatment. All patients had clinical improvement of their haemangiomas.

Conclusions

This study suggests that initiating treatment during outpatient observation may be a reasonable alternative to inpatient admission. In addition, expensive testing may not be necessary during pre-treatment screening when the physical examination is normal.

Keywords

Beta blockerinfanthypoglycaemia
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 4 , August 2012 , pp. 424 - 429
Copyright
Copyright © Cambridge University Press 2012

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