title: Propranolol for infantile haemangiomas: initiating treatment on an outpatient basis.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Hackensack University Medical Center, Hackensack, NJ 07601, USA. jdyme@hotmail.com
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Dyme
authors.forename: Ashis
authors.initials: A
authors.lastname: Thampan
authors.forename: Eugenia J
authors.initials: EJ
authors.lastname: Han
authors.forename: Themba L
authors.initials: TL
authors.lastname: Nyirenda
authors.forename: Mohy E
authors.initials: ME
authors.lastname: Kotb
authors.forename: Helen T
authors.initials: HT
authors.lastname: Shin
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D005260:Female; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D010045:Outpatients; D011433:Propranolol / Q000627:therapeutic use*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol