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.