{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:34:30Z","timestamp":1780097670548,"version":"3.54.0"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>For infantile hemangiomas requiring treatment, existing recommendations advise initiation of propranolol followed by a 2\u2010hour period of blood pressure and heart rate monitoring, resulting in prolonged office visits for both families and clinicians.<\/jats:p><\/jats:sec>Objectives<\/jats:title>In order to reduce visit times, we evaluate our current practice of at\u2010home or in\u2010office propranolol administration followed by in\u2010office vital sign monitoring.<\/jats:p><\/jats:sec>Methods<\/jats:title>We retrospectively reviewed the medical records of 157 patients with infantile hemangiomas (IH) who initiated propranolol under this outpatient protocol. Blood pressure (BP<\/jats:styled-content>) and heart rate (HR<\/jats:styled-content>) were obtained at a baseline visit and 1\u20102\u00a0hours after initial dose administration. We identified potential risk factors for clinically significant decreases in systolic blood pressure (SBP) and HR<\/jats:styled-content> (defined as decrease of >\u00a020\u00a0mm Hg and > 15\u00a0bpm, respectively) using logistic regression analysis, and adverse events were recorded.<\/jats:p><\/jats:sec>Results<\/jats:title>Fifty\u2010five individuals (35.4%) showed a decrease in HR<\/jats:styled-content> of more than 15\u00a0bpm, and 23 individuals (14.7%) showed a decrease in SBP<\/jats:styled-content> of more than 20\u00a0mm Hg. Multivariable logistic regression suggested that younger age, history of preterm birth, and Caucasian race may slightly increase the odds of clinically significant changes in vital signs upon propranolol initiation. However, no clinically symptomatic adverse events occurred upon initiation of propranolol.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Vital sign monitoring may be important when starting propranolol treatment in younger or historically preterm patients. However, routine mandatory in\u2010office vital sign monitoring may not be necessary in healthy infants more than 45\u00a0weeks postconceptional age.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.13843","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T10:10:46Z","timestamp":1558606246000},"page":"471-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of a modified outpatient model for using propranolol to treat infantile hemangiomas"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3030-1483","authenticated-orcid":false,"given":"Elana","family":"Putterman","sequence":"first","affiliation":[{"name":"Section of Dermatology Department of Pediatrics The Children's Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"},{"name":"Drexel University College of Medicine Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Wan","sequence":"additional","affiliation":[{"name":"Section of Dermatology Department of Pediatrics The Children's Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna L.","family":"Streicher","sequence":"additional","affiliation":[{"name":"Section of Dermatology Department of Pediatrics The Children's Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert C.","family":"Yan","sequence":"additional","affiliation":[{"name":"Section of Dermatology Department of Pediatrics The Children's Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2011.01569.x"},{"key":"e_1_2_7_3_1","unstructured":"Pierre Fabre Pharmaceuticals Inc.Hemangeol\u2122product information2014."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1691"},{"issue":"6","key":"e_1_2_7_5_1","first-page":"5","article-title":"Treatment of infantile hemangiomas with beta\u2010blockers: a review","volume":"18","author":"Shah S","year":"2013","journal-title":"Skin Therapy Lett"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12435"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1404710"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-200202000-00001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.27.6.874"},{"issue":"2","key":"e_1_2_7_10_1","first-page":"35","article-title":"Comparison between mercury manometer, digital device and aneroid device in blood pressure measurements","volume":"4","author":"Chong JY","year":"2018","journal-title":"Public Health Prevent Med"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.13843","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.13843","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.13843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T21:24:46Z","timestamp":1694294686000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.13843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,23]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1111\/pde.13843"],"URL":"https:\/\/doi.org\/10.1111\/pde.13843","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,23]]},"assertion":[{"value":"2019-05-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}