A survey on clinical use of propranolol for infantile hemangiomas in mainland China.
OBJECTIVE
To provide a guideline for Chinese clinicians regarding oral propranolol treatment on infantile hemangioma (IH).


METHODS
A survey for management of propranolol therapy (clinical consultation, dosage initiation, dosage changing, monitoring of complications and effectiveness evaluation) was performed and was delivered to the Division of Vascular Anomalies (DVA), Chinese Stomatological Association (CSA), and to the Division of Hemangioma and Vascular Malformations (DHVM), Chinese Society of Plastic and Reconstructive Surgery.


RESULTS
Data from 31 hospitals were collected and analyzed. In all hospitals, IH patients were treated with oral propranolol as a routine. Twenty-two (71%) of the 31 hospitals treated patients with IH as part of a multidisciplinary strategy. Cardiology consultation was routinely sought in 21 (95%) of these 22 hospitals before initiation of propranolol therapy. Sixteen hospitals (52%) recommend an initial propranolol dose of 1 to 1.5 mg/kg/day, in most cases 1.0 mg/kg/day. The dosage frequency of once a day was recommended in 18 (58%) of the surveyed hospitals. The maximum dose of 1.5 mg/kg/day or 2.0 mg/kg/day was suggested in 10 (32%) and 13 (42%) hospitals, respectively. Similarly, the optimal dose of 1.5 mg/kg/day or 2.0 mg/kg/day was recommended in 11 (37%) and 9 (30%) hospitals, respectively. The duration of therapy varied from 1 to 24 months. Tapering was advised by 10 (40%) hospitals and immediate discontinuation was applied in 13 (52%) hospitals. Complications were emphasized by all hospitals. The most common complications were gastrointestinal symptoms (17 of 31 hospitals), whereas the complication most commonly monitored for was changes in heart rate. No rebound effects were reported.


CONCLUSIONS
Propranolol has become the first-line agent for IH in mainland China. This is a practical survey which is helpful to standardize and develop a guideline for propranolol therapy.
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology Shanghai 200011, China ; Department of Oral and Maxillofacial Surgery, Qingdao Municipal Hospital Shandong 266071, China.
Zheng-Gang
ZG
Chen
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology Shanghai 200011, China.
Jia-Wei
JW
Zheng
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology Shanghai 200011, China.
Ling
L
Zhang
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology Shanghai 200011, China.
Ling
L
Zhu
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology Shanghai 200011, China.
Yan-An
YA
Wang
Propranolol; infantile hemangioma; medication; side effects