Frieden Ilona J, Püttgen Katherine B, Drolet Beth A, Garzon Maria C, Chamlin Sarah L, Pope Elena, Mancini Anthony J, Lauren Christine T, Mathes Erin F, Siegel Dawn H, Gupta Deepti, Haggstrom Anita N, Tollefson Megha M, Baselga Eulalia, Morel Kimberly D, Shah Sonal D, Holland Kristen E, Adams Denise M, Horii Kimberly A, Newell Brandon D, Powell Julie, McCuaig Catherine C, Nopper Amy J, Metry Denise W, Maguiness Sheilagh
University of California San Francisco, San Francisco, California, USA.
Intermountain Healthcare, Salt Lake City, Utah, USA.
Pediatr Dermatol. 2020 May;37(3):412-418. doi: 10.1111/pde.14196. Epub 2020 May 16.
The COVID-19 pandemic has caused significant shifts in patient care including a steep decline in ambulatory visits and a marked increase in the use of telemedicine. Infantile hemangiomas (IH) can require urgent evaluation and risk stratification to determine which infants need treatment and which can be managed with continued observation. For those requiring treatment, prompt initiation decreases morbidity and improves long-term outcomes. The Hemangioma Investigator Group has created consensus recommendations for management of IH via telemedicine. FDA/EMA-approved monitoring guidelines, clinical practice guidelines, and relevant, up-to-date publications regarding initiation and monitoring of beta-blocker therapy were used to inform the recommendations. Clinical decision-making guidelines about when telehealth is an appropriate alternative to in-office visits, including medication initiation, dosage changes, and ongoing evaluation, are included. The importance of communication with caregivers in the context of telemedicine is discussed, and online resources for both hemangioma education and propranolol therapy are provided.
新冠疫情导致了患者护理方面的重大转变，包括门诊就诊量急剧下降以及远程医疗的使用显著增加。婴儿血管瘤（IH）可能需要紧急评估和风险分层，以确定哪些婴儿需要治疗，哪些可以通过持续观察来管理。对于那些需要治疗的婴儿，及时开始治疗可降低发病率并改善长期预后。血管瘤研究小组制定了通过远程医疗管理婴儿血管瘤的共识建议。美国食品药品监督管理局/欧洲药品管理局批准的监测指南、临床实践指南以及有关β受体阻滞剂治疗的启动和监测的相关最新出版物为这些建议提供了依据。其中包括关于远程医疗何时是门诊就诊合适替代方式的临床决策指南，涵盖药物起始、剂量调整和持续评估等方面。讨论了在远程医疗背景下与护理人员沟通的重要性，并提供了有关血管瘤教育和普萘洛尔治疗的在线资源。
