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Hemangioma Management

Pathway Background and Objectives

Infantile hemangiomas are common benign tumors that can cause significant complications such as permanent disfigurement, ulceration, bleeding, visual compromise, airway obstruction, and congestive heart failure. They affect up to 2-5% of all infants and up to 30% of premature babies. There are many variations in treatment protocols for infantile hemangiomas, including different medications and dosages. A new practice guideline released by the American Academy of Pediatrics in 2013 provided recommendations for the treatment of hemangiomas and monitoring any side effects. This guideline was updated in 2019.

The objectives of this pathway are to:

  • Ensure appropriate pre-admission work up
  • Ensure appropriate dosing of atenolol or propranolol
  • Safely increase doses of atenolol or propranolol as patient tolerates, with prevention of common side effects
  • Educate caregivers on administration and side effects
  • Collaborate with referring providers


Download Hemangioma Management Pathway Algorithm

Quality Metrics

  • Percentage of patients with order set usage
  • Percentage of patients without hypotension during hospital stay
  • Percentage of patients with medication dosage per pathway (propranolol or atenolol)
  • Percentage of patients receiving discharge instructions with correct medication instructions
  • Average length of stay

Educational Module

Download Hemangioma Management Educational Module

Key References

Pathway Contacts

  • Alex Golden, MD
  • Michael Isakoff, MD
  • Christine Longyear, APRN


The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.

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