Strawberry haemangioma /
AAP report: Working group Propanolol Strawberry Haemangioma
01 What Others Say
AAP Working group
Initiation and use of Propanolol in Infantile Haemangioma: Report of a Consensus Conference
For Propranolol in Infantile Hemangioma, Only 'Provisional' Guidelines Available
Dec 24, 2012
Among the "Consensus Meeting Key Learnings":
- There is significant uncertainty and divergence of opinion regarding safety monitoring and dose escalation for propranolol use in IH.
- ECG should be part of the pretreatment evaluation in any child when the heart rate is below normal, arrhythmia is detected on cardiac exam, or there is a family history of arrhythmias or maternal history of connective tissue disease.
- Cardiac and aortic arch anomalies are common in PHACE syndrome and require echocardiography to assess intracardiac anatomy and function in at-risk children.
- It is recommended that the 20mg/5mL preparation of propranolol be used.
- The consensus group advocates that the daily dose of propranolol be divided into three times daily.
- Regardless of the setting in which propranolol is initiated, it is recommended that the propranolol dose be titrated up to a target dose, starting at 1 mg/kg/day divided three times daily.
- Dose response is usually most dramatic after the first dose of propranolol.
- Bradycardia may be the most reliable measurement of toxicity because obtaining accurate BPs in infants may be challenging, and normative data for bradycardia are better established.
- If a major escalation in dosage (>0.5 mg/kg/day) is indicated, the patient's heart rate should be assessed before, one and two hours after the increased dose is administered.
- Hypoglycemia may be the most common serious complication in children treated with propranolol for IH.
- Propranolol should be discontinued during intercurrent illness, especially in the setting of restricted oral intake to prevent hypoglycemia.
The information is not intended to take the place of medical advice.
Please seek advice from a qualified healthcare professional.
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Last updated: 29/12/2012