title: Treatment of severe infantile hemangiomas with propranolol: an evaluation of the efficacy and effects of cardiovascular parameters in 25 consecutive patients.
abstract: OBJECTIVE
  The aim of this study was to investigate the therapeutic results and effects of propranolol on cardiovascular parameters in infants receiving systemic propranolol for complicated infantile hemangiomas (IHs), as well as to evaluate the adverse effects of propranolol throughout the course of treatment.
  
  
  METHODS
  Twenty-five consecutive patients who presented with complicated IHs were prospectively recruited into this study between April 2012 and June 2013. All patients were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg, and the drug was taken once per day. The length of treatment was 8.2 months on average and ranged from 6 to 12 months. The follow-up visits were scheduled monthly after discharge. Changes were recorded during the 3-day hospitalization, including systolic and diastolic blood pressures, heart rate, and blood glucose level. The treatment responses were scored according to a 4-point scale system as very good, good, mild, or no response. The adverse effects after medication administration were evaluated and managed accordingly.
  
  
  RESULTS
  Of the 25 patients, 8 (32%) had a very good response, 11 (44%) had a good response, and 6 (24%) had a mild response. When pretreatment and post-treatment values were compared, there was no significant decrease in mean systolic and diastolic blood pressures and mean heart rate (all P > .05). The decreases in the cardiovascular parameters were not commonly associated with observable clinical symptoms. No major collateral effects were observed, and no infants were withdrawn from treatment because of side effects.
  
  
  CONCLUSIONS
  Fluctuations from the normal ranges of cardiovascular parameters occurred frequently with the initiation of propranolol, but were clinically asymptomatic. Therefore oral propranolol was an effective and safe treatment for IHs, particularly for early intervention suitable for severe IHs.
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
authors.forename: Da-Peng
authors.initials: DP
authors.lastname: Xu
authors.affiliation: Resident, Department of Endodontics, School of Stomatology, Shandong University, Jinan, China.
authors.forename: Rong-Yu
authors.initials: RY
authors.lastname: Cao
authors.affiliation: Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xue
authors.affiliation: Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
authors.forename: Ning-Ning
authors.initials: NN
authors.lastname: Sun
authors.affiliation: Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Tong
authors.affiliation: Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China. Electronic address: wangxukai757892@sina.com.
authors.forename: Xu-Kai
authors.initials: XK
authors.lastname: Wang
mesh_terms: D000284:Administration, Oral; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005153:Facial Neoplasms / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D009062:Mouth Neoplasms / Q000188:drug therapy*; D011433:Propranolol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D014665:Vasodilator Agents; D011433:Propranolol