Related Experiment Video
Updated: May 2, 2026
In Vivo Real-Time Study of Drug Effects on Carotid Blood Flow in the Ovine Fetus
Published on: April 28, 2023
Propranolol in infantile haemangioma: simplifying pretreatment monitoring
Oumama El Ezzi1, Judith Hohlfeld, Anthony de Buys Roessingh
1Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland.
Insights
Propranolol is a safe and effective treatment for infantile haemangiomas (IHs). A 48-hour hospital monitoring period may be unnecessary, simplifying treatment initiation for IH patients.
Area of Science:
- Pediatric Dermatology
- Vascular Biology
- Pharmacology
Background:
- Infantile haemangiomas (IHs) are common vascular tumors in infants.
- Propranolol is the established first-line therapy for problematic IH.
- Current Swiss protocols mandate 48-hour inpatient monitoring for propranolol initiation.
Purpose of the Study:
- To evaluate the safety and efficacy of propranolol for infantile haemangiomas.
- To assess the necessity of a 48-hour hospital monitoring period for propranolol treatment.
- To advocate for a simplified pretreatment monitoring process.
Main Methods:
- Retrospective analysis of 29 infants with problematic IH treated with propranolol (Sept 2009-Sept 2012).
- Patients received 1 mg/kg/day propranolol on day 1, then 2 mg/kg/day.
- Inclusion criteria involved 48-hour hospitalisation with continuous monitoring and measurements.
Main Results:
- 86.2% of infants showed immediate response to propranolol.
- No severe adverse reactions were reported.
- Transient side effects (bradycardia, hypotension, hypoglycemia) occurred after the first dose in 6 patients; none after the second dose. Treatment was not interrupted.
Conclusions:
- Propranolol is a safe treatment for problematic infantile haemangiomas.
- Side effects are typically transient and occur after the initial dose.
- Strict 48-hour inpatient monitoring may be unnecessary if contraindications are respected, potentially reducing healthcare costs.
Background:
Infantile haemangiomas (IHs) are very common vascular tumours. Propranolol is at present the first-line treatment for problematic and complicated haemangioma. In accordance with a Swiss protocol, children are monitored for 2 days at the start of the treatment to detect possible side effects of this drug. Our study advocates a simplification of the pretreatment monitoring process.
Methods:
All children with a problematic and complicated haemangioma treated with propranolol between September 2009 and September 2012 were included in the study. All patients were hospitalised under constant nurse supervision for 48 hours at the start of the treatment and subjected to cardiac and blood measurements. The dosage of propranolol was 1 mg/kg/day on the first day and 2 mg/kg/day from the second day. Demographic data, clinical features, treatment outcome and complications were analysed.
Results:
Twenty-nine infants were included in our study. Of these, 86.2% responded immediately to the treatment. There were no severe adverse reactions. Six patients presented transient side effects such as bradycardia, hypotension after the first dose and hypoglycaemia later. No side effects occurred after the second dose. Treatment was never interrupted.
Conclusion:
Propranolol (a β-blocker) is a safe treatment for problematic IH. Side effects may occur after the first dose. A strict 48 hour monitoring in hospital is expensive and may be unnecessary as long as the contraindications for the drug are respected.
Related Concept Videos
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
01:29Drug Dosing: Infants and Children
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
01:26Mitral Stenosis III: Medical Management
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:28Antihypertensive Drugs: Types of β-Blockers