Limited utility of repeated vital sign monitoring during initiation of oral propranolol for complicated infantile hemangioma.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Püttgen Katherine B, Hansen Leanna M, Lauren Christine, Stefanko Nicole, Mathes Erin, Olsen Gerilyn M, Tollefson Megha M, Adams Denise, Baselga Eulalia, Chamlin Sarah, Corey Kristen, Frascari Flora F, Frieden Ilona J, Galligan Eloise R, Gupta Deepti, Haggstrom Anita, Horii Kimberly, Hornik Christoph P, Klajn Justyna, Liberman Leonardo, Mancini Anthony, Mannschreck Diana, McGinness Anelah, McCuaig Catherine, Newell Brandon, Nguyen Henry, Nopper Amy, Oyesanya Tola, Powell Julie, Reynolds Megan, Rios Monica, Siegel Dawn H, Ward Kendra, Garzon Maria C, Frommelt Peter, Drolet Beth A
Аннотация
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.