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Puttgen, KB; Summerer, B; Schneider, J; Cohen, BA; Boss, EF; Bauman, NM.
Cardiovascular and blood glucose parameters in infants during propranolol initiation for treatment of symptomatic infantile hemangiomas.
Ann Otol Rhinol Laryngol. 2013; 122(9): 550-554.
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Autor/innen der Med Uni Graz:
Rainer Barbara
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Abstract:
We sought to determine the effect of propranolol on cardiovascular and blood glucose parameters in infants with symptomatic infantile hemangiomas who were hospitalized for initiation of treatment, and to analyze adverse effects of propranolol throughout the course of inpatient and outpatient treatment. A retrospective cohort analysis was performed on 50 infants (age less than 12 months) with symptomatic infantile hemangiomas who were hospitalized for propranolol initiation between 2008 and 2012. Demographic data and disease characteristics were recorded. Systolic and diastolic blood pressures, heart rate, blood glucose values, and adverse events recorded during hospitalization were analyzed. An additional cohort of 200 consecutively treated children was also assessed for adverse events associated with outpatient propranolol use. The median age among the inpatient cohort was 3.4 months (range, 0.8 to 12.0 months). Infants older than 6 months were more likely to exhibit bradycardia than were younger infants (p < 0.001). Hypotensive and/or bradycardic periods were infrequent and were not associated with observable clinical symptoms. The mean systolic and diastolic blood pressures and the mean heart rate decreased significantly from day 1 of hospitalization to day 2 (p = 0.004; p = 0.008; p < 0.001), but not from day 2 to day 3, when the propranolol dose was increased to target. Hypoglycemia was rare (0.3% incidence.) Among the 250 outpatients, 2 infants developed lethargy and hypoglycemia during a viral illness and recovered without sequelae. One infant experienced recurrent bronchospasm with viral illnesses and required concomitant bronchodilator therapy. Frequent deviations from normal ranges of blood pressure and heart rate occur upon initiation of propranolol, but are clinically asymptomatic. These findings support that outpatient initiation of propranolol in healthy, normotensive infants appears to be a relatively safe alternative to inpatient initiation. Hypoglycemia is rare, but can occur throughout the treatment period; parent counseling is of paramount importance.
Find related publications in this database (using NLM MeSH Indexing)
Adrenergic beta-Antagonists - administration & dosage
Adrenergic beta-Antagonists - therapeutic use
Blood Glucose - metabolism
Blood Pressure -
Cardiovascular System - physiopathology
Dose-Response Relationship, Drug -
Female -
Follow-Up Studies -
Hemangioma - blood
Hemangioma - complications
Hemangioma - drug therapy
Humans -
Hypoglycemia - blood
Hypoglycemia - complications
Hypoglycemia - epidemiology
Incidence -
Infant -
Male -
Outpatients -
Propranolol - administration & dosage
Propranolol - therapeutic use
Retrospective Studies -
Skin Neoplasms - blood
Skin Neoplasms - drug therapy
Skin Neoplasms - physiopathology
Treatment Outcome -
Treatment Outcome - epidemiology

Find related publications in this database (Keywords)
blood pressure
cardiovascular system
heart rate
infantile hemangioma
propranolol
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