Dyme Joshua L, Thampan Ashis, Han Eugenia J, Nyirenda Themba L, Kotb Mohy E, Shin Helen T
Department of Pediatrics, Hackensack University Medical Center, Hackensack, NJ 07601, USA.
Cardiol Young. 2012 Aug;22(4):424-9. doi: 10.1017/S1047951111001946. Epub 2011 Dec 14.
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.
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.
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.
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.
最近发现普萘洛尔是治疗婴儿血管瘤的有效药物，并且已经提出了不同的剂量和监测方案。不良事件虽不常见，但已有报道。
这是一项对血管瘤婴儿的回顾性病历审查，这些婴儿在门诊开始使用普萘洛尔，剂量为每日每千克3毫克。在进行包括心电图和超声心动图在内的基线心脏评估后，在6小时观察期内开始治疗。
共确定了15例患者；然而，只有13例返回进行了至少一次随访。该队列的中位随访时间为2.8个月，范围为0.2至10.0个月。治疗期间未发生低血压、低血糖、支气管痉挛或具有临床意义的心动过缓。所有患者的血管瘤均有临床改善。
本研究表明，在门诊观察期间开始治疗可能是住院治疗的合理替代方案。此外，当体格检查正常时，治疗前筛查可能无需进行昂贵的检查。
