Hemangiol® initiation protocol
The conventional Hemangiol® initiation protocol was the most commonly
used (N=76; 80.9%). The rapid Hemangiol® initiation protocol concerned
children with ulcerated IH (N=11), life-threatening IH (N=4), as well as
the neonate with non-sustained ventricular tachycardia associated with
IH of the cheek, the case of coarctation of aorta associated with IH of
the arm and PHACES syndrome and a two month old child with parotid IH
with a risk of compression. In children with ulcerated IH, the rapid
Hemangiol® protocol included the prescription of strong analgesics and
local treatment during hospitalisation.
Hospital monitoring at the initiation of the treatment showed a
significant decrease in heart rate one hour after treatment initiation,
especially in stage 1 (from mean 140.3±18.1 bpm to mean 127.1±16.1 bpm,
P<0.01). Then the heart rate remained stable during the
monitoring. In stage 2, one hour after treatment increase, a less marked
than in stage 1 but significant heart rate decrease was observed (from
mean 128.1±19.0 bpm to mean 121.7±17.0 bpm, P=0.02). No significant
decrease in heart rate was observed in stage 3. Overall, no significant
bradycardia was observed. We found a significant but non-symptomatic
decrease in diastolic blood pressure at stage 2 and stage 3, without
requiring any drug discontinuation. No change was observed in the
systolic blood pressure (Table 2).
We found no significant difference in terms of heart rate and blood
pressure change, between the two conventional and rapid initiation
protocols.