Huang Cho-Yi, Huang Hsin-Chung, Chen Mei-Huei, Lai Tso-Ting, Chou Hung-Chieh, Chen Chien-Yi, Yen Ting-An, Cardoso Wellington V, Tsao Po-Nien
Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Chest. 2022 Dec;162(6):1328-1337. doi: 10.1016/j.chest.2022.06.017. Epub 2022 Jun 23.
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.
玻璃体内注射贝伐单抗（IVB）是一种抗血管内皮生长因子（VEGF）抗体，是治疗早产儿视网膜病变（ROP）广泛采用的方法。虽然动物研究表明IVB可抑制新生大鼠肺的肺泡形成，但IVB对呼吸结局的临床影响尚未得到研究。
IVB是否会影响患有支气管肺发育不良的早产儿的呼吸结局？
我们回顾性评估了2016年1月至2021年6月期间入住我院新生儿重症监护病房的极低出生体重（VLBW）早产儿。此外，我们评估了在孕龄36周（PMA）时需要通气支持的VLBW早产儿接受IVB治疗后的短期呼吸结局。
招募了174例患有支气管肺发育不良的VLBW早产儿。88例婴儿在脱离呼吸机之前出现ROP发作，78例婴儿在脱离呼吸机之前被诊断为最严重的ROP。其中，32例被诊断为1型ROP并接受了IVB治疗。在调整了胎龄、出生体重和基线呼吸状态后，我们发现IVB与通气支持时间延长和脱离呼吸机的可能性降低显著相关（风险比，0.53；P = 0.03）。
IVB可能对在孕龄36周时需要通气支持的患者有短期呼吸不良影响。因此，对于接受IVB治疗的VLBW婴儿，可能需要考虑对呼吸结局进行长期随访。
