Adams Lucinda, Ryan Emma
Division of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Dermatology Department, Women's and Children's Hospital, Adelaide, South Australia, Australia.
Australas J Dermatol. 2022 Nov;63(4):473-478. doi: 10.1111/ajd.13906. Epub 2022 Aug 8.
BACKGROUND/OBJECTIVES: Infantile haemangiomas (IH) are common benign tumours of childhood. The current guideline recommended treatment is oral propranolol, the use of which for IH is relatively recent and there are no safety audits in Australian children published. As a result, it is a primarily inpatient initiated treatment. The aim of this study was to examine the short-term complication rates in infants treated with oral propranolol for IH.
Retrospective case note review of IH patients initiated on oral propranolol admitted to the day-unit of tertiary metropolitan hospital in an Australia capital city, from January 2016 to December 2019.
Overall, 72 children were included in the study. Mean age at time of admission was 3.8 ± 2 months. Eight patients (11.1%) experienced complications during their initiation admission. Pulmonary complications (oxygen desaturation, wheeze, increased respiratory rate) was the most common type. No children required high-dependency or intensive care unit admission. The children who experienced complications had a mean age of 2.4 ± 1.2 months; t-test of equality of means found a relationship between propranolol-associated complication rate and age (p = 0.007). All other patient or admission characteristics were not associated with complication events (all p > 0.05).
Propranolol is a safe, effective and well-tolerated treatment in Australian children with IH. This study demonstrates younger infants will most likely benefit from inpatient initiation. More research needs to be done to characterise the risk profile of propranolol initiation for IH.
背景/目的:婴儿血管瘤(IH)是儿童期常见的良性肿瘤。目前指南推荐的治疗方法是口服普萘洛尔,该药物用于IH相对较新,且澳大利亚尚未发表关于儿童使用安全性的审核报告。因此,这主要是一种需住院开始的治疗方法。本研究的目的是检查口服普萘洛尔治疗IH的婴儿的短期并发症发生率。
对2016年1月至2019年12月在澳大利亚首都城市一家三级城市医院日间病房开始口服普萘洛尔治疗的IH患者进行回顾性病例记录审查。
总体而言,72名儿童纳入了研究。入院时的平均年龄为3.8±2个月。8名患者(11.1%)在初次入院期间出现并发症。肺部并发症(氧饱和度下降、喘息、呼吸频率增加)是最常见的类型。没有儿童需要入住高依赖或重症监护病房。出现并发症的儿童平均年龄为2.4±1.2个月;均值相等性t检验发现普萘洛尔相关并发症发生率与年龄之间存在关联(p = 0.007)。所有其他患者或入院特征与并发症事件均无关联(所有p>0.05)。
普萘洛尔在澳大利亚患IH的儿童中是一种安全、有效且耐受性良好的治疗方法。本研究表明,年龄较小的婴儿很可能从住院开始治疗中获益。需要开展更多研究以明确IH患者开始使用普萘洛尔的风险特征。