@article{22b132cdcca94f009273a959b72276ca,
title = "Limited utility of repeated vital sign monitoring during initiation of oral propranolol for complicated infantile hemangioma",
abstract = "Background: Initial propranolol recommendations for infantile hemangioma published in 2013 were intended as provisional best practices to be updated as evidence-based data emerged. Methods: A retrospective multicenter study was performed to evaluate utility of prolonged monitoring after first propranolol dose and escalation(s). Inclusion criteria included diagnosis of hemangioma requiring propranolol of greater than or equal to 0.3 mg/kg per dose, younger than 2 years, and heart rate monitoring for greater than or equal to 1 hour. Data collected included demographics, dose, vital signs, and adverse events. Results: A total of 783 subjects met inclusion criteria; median age at initiation was 112 days. None of the 1148 episodes of prolonged monitoring warranted immediate intervention or drug discontinuation. No symptomatic bradycardia or hypotension occurred during monitoring. Mean heart rate change from baseline to 1 hour was –8.19/min (±15.54/min) and baseline to 2 hours was –9.24/min (±15.84/min). Three preterm subjects had dose adjustments because of prescriber concerns about asymptomatic vital sign changes. No significant difference existed in pretreatment heart rate or in heart rate change between individuals with later adverse events during treatment and those without. Conclusion: Prolonged monitoring for initiation and escalation of oral propranolol rarely changed management and did not predict future adverse events. Few serious adverse events occurred during therapy; none were cardiovascular.",
keywords = "heart rate, infantile hemangioma, monitoring, pediatric dermatology, propranolol",
author = "P{\"u}ttgen, {Katherine B.} and Hansen, {Leanna M.} and Christine Lauren and Nicole Stefanko and Erin Mathes and Olsen, {Gerilyn M.} and Tollefson, {Megha M.} and Denise Adams and Eulalia Baselga and Sarah Chamlin and Kristen Corey and Frascari, {Flora F.} and Frieden, {Ilona J.} and Galligan, {Eloise R.} and Deepti Gupta and Anita Haggstrom and Kimberly Horii and Hornik, {Christoph P.} and Justyna Klajn and Leonardo Liberman and Anthony Mancini and Diana Mannschreck and Anelah McGinness and Catherine McCuaig and Brandon Newell and Henry Nguyen and Amy Nopper and Tola Oyesanya and Julie Powell and Megan Reynolds and Monica Rios and Siegel, {Dawn H.} and Kendra Ward and Garzon, {Maria C.} and Peter Frommelt and Drolet, {Beth A.}",
note = "Funding Information: Conflicts of interest: Dr P{\"u}ttgen reports serving on the Pierre Fabre advisory board. Dr Mathes reports being a Pierre Fabre consultant. Dr Adams reports serving on the Venthera Medical Advisory Board. Dr Baselga reports serving on the Pierre Fabre advisory board and being a consultant for the company. Dr Frieden reports serving on the Pierre Fabre advisory board and the Venthera Medical Advisory Board. Dr Mancini reports being a Pierre Fabre consultant. Dr McCuaig reports serving on the Pierre Fabre advisory board. Dr Powell reports serving on the Pierre Fabre advisory board. Dr Drolet reports receiving funds for an investigator-initiated trial from Pierre Fabre, serving on the Venthera Medical Advisory Board, and cofounding Pediatric Derm Development LLC. Drs Lauren, Stefanko, Tollefson, Chamlin, Corey, Frascari, Galligan, Gupta, Haggstrom, Horii, Hornik, Liberman, Mannschreck, McGinness, Newell, Nguyen, Nopper, Oyesanya, Rios, Siegel, Ward, Garzon, and Frommelt and Ms Hansen, Ms Olsen, Dr Klajn, and Ms Reynolds have no conflicts of interest to declare. Funding sources: None. Publisher Copyright: {\textcopyright} 2021",
year = "2021",
month = aug,
doi = "10.1016/j.jaad.2020.04.013",
language = "English (US)",
volume = "85",
pages = "345--352",
journal = "Journal of the American Academy of Dermatology",
issn = "0190-9622",
publisher = "Mosby Inc.",
number = "2",
}