Intravitreal Bevacizumab Is Associated With Prolonged Ventilatory Support in Preterm Infants With Bronchopulmonary Dysplasia.


Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 20 03 2022
revised: 31 05 2022
accepted: 15 06 2022
pubmed: 27 6 2022
medline: 15 12 2022
entrez: 26 6 2022
Statut: ppublish

Résumé

Intravitreal bevacizumab (IVB), an anti-vascular endothelial growth factor (VEGF) antibody, is a widely adopted treatment for retinopathy of prematurity (ROP). Although animal studies have demonstrated that IVB inhibits alveologenesis in neonatal rat lung, the clinical influence of IVB on respiratory outcomes has not been studied. Does IVB affect the respiratory outcome in preterm infants with bronchopulmonary dysplasia? We retrospectively assessed very low birth weight (VLBW) preterm infants admitted to our neonatal ICU between January 2016 and June 2021. Furthermore, we evaluated the short-term respiratory outcomes after IVB therapy in VLBW preterm infants requiring ventilatory support at 36 weeks' postmenstrual age (PMA). One hundred seventy-four VLBW preterm infants with bronchopulmonary dysplasia were recruited. Eighty-eight infants showed ROP onset before being ventilator free, and 78 infants received a diagnosis of the most severe ROP before being ventilator free. Among them, 32 received a diagnosis with type 1 ROP and received IVB treatment. After adjusting for gestational age, birth body weight, and baseline respiratory status, we discovered that IVB is associated significantly with prolonged ventilatory support and a lower likelihood of becoming ventilator free (hazard ratio, 0.53; P = .03). IVB may have a short-term respiratory adverse effect in patients requiring ventilatory support at 36 weeks' PMA. Therefore, long-term follow-up for respiratory outcomes may be considered in VLBW infants who receive IVB treatment.

Sections du résumé

BACKGROUND BACKGROUND
Intravitreal bevacizumab (IVB), an anti-vascular endothelial growth factor (VEGF) antibody, is a widely adopted treatment for retinopathy of prematurity (ROP). Although animal studies have demonstrated that IVB inhibits alveologenesis in neonatal rat lung, the clinical influence of IVB on respiratory outcomes has not been studied.
RESEARCH QUESTION OBJECTIVE
Does IVB affect the respiratory outcome in preterm infants with bronchopulmonary dysplasia?
STUDY DESIGN AND METHODS METHODS
We retrospectively assessed very low birth weight (VLBW) preterm infants admitted to our neonatal ICU between January 2016 and June 2021. Furthermore, we evaluated the short-term respiratory outcomes after IVB therapy in VLBW preterm infants requiring ventilatory support at 36 weeks' postmenstrual age (PMA).
RESULTS RESULTS
One hundred seventy-four VLBW preterm infants with bronchopulmonary dysplasia were recruited. Eighty-eight infants showed ROP onset before being ventilator free, and 78 infants received a diagnosis of the most severe ROP before being ventilator free. Among them, 32 received a diagnosis with type 1 ROP and received IVB treatment. After adjusting for gestational age, birth body weight, and baseline respiratory status, we discovered that IVB is associated significantly with prolonged ventilatory support and a lower likelihood of becoming ventilator free (hazard ratio, 0.53; P = .03).
INTERPRETATION CONCLUSIONS
IVB may have a short-term respiratory adverse effect in patients requiring ventilatory support at 36 weeks' PMA. Therefore, long-term follow-up for respiratory outcomes may be considered in VLBW infants who receive IVB treatment.

Identifiants

pubmed: 35753385
pii: S0012-3692(22)01183-7
doi: 10.1016/j.chest.2022.06.017
pii:
doi:

Substances chimiques

Bevacizumab 2S9ZZM9Q9V
Angiogenesis Inhibitors 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1328-1337

Informations de copyright

Copyright © 2022 American College of Chest Physicians. All rights reserved.

Auteurs

Cho-Yi Huang (CY)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Hsin-Chung Huang (HC)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Mei-Huei Chen (MH)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.

Tso-Ting Lai (TT)

Department of Ophthalmology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Hung-Chieh Chou (HC)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Chien-Yi Chen (CY)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Ting-An Yen (TA)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Wellington V Cardoso (WV)

Columbia Center for Human Development, Department of Medicine, Columbia University Medical Center, New York, NY.

Po-Nien Tsao (PN)

Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: tsaopn@ntu.edu.tw.

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