Pioneering brain haemorrhage treatment reduces long-term disability in premature babies

Date:
July 6, 2020
Source:
University of Bristol
Summary:
Premature babies with serious brain haemorrhage treated with a
'brain washing' technique were twice as likely to survive without
severe learning disability when compared with infants given
standard treatment.



FULL STORY ========================================================================== Premature babies with serious brain haemorrhage treated with a 'brain
washing' technique pioneered by Bristol researchers have shown in
a 10-year follow-up study, were twice as likely to survive without
severe learning disability when compared with infants given standard
treatment. The findings are published today [5 July] in the journal
Archives of Diseases in Childhood.


==========================================================================
The surgical technique called 'Drainage, Irrigation and Fibrinolytic
Therapy' (DRIFT), is the first and only treatment to objectively benefit infants with serious brain haemorrhage, known as intraventricular
haemorrhage (IVH) which can lead to severe learning impairment and
cerebral palsy.

Pioneered in 1998 and trialled from 2003 by Andrew Whitelaw, Professor of Neonatal Medicine at the University of Bristol and Ian People, Consultant Neurosurgeon from University Hospitals Bristol NHS Foundation Trust,
the therapy aimed to reduce disability in premature babies with serious
brain haemorrhage by washing out the ventricles in the brain to remove
toxic fluid and reduce pressure.

In this NIHR-funded (DRIFT10) ten-year follow-up study, researchers
assessed 52 of the 65 survivors from the original (DRIFT) cohort of 77 premature babies with severe brain haemorrhage who had been recruited
for the randomised controlled trial. Of these, 39 babies received the
DRIFT intervention, and 38 received standard treatment which uses lumbar punctures to control expansion of the ventricles and reduce pressure.

A research team led by Dr Karen Luyt from Bristol Medical School, traced
and assessed the children at age ten and at school, to investigate
whether the treatment had led to reduced neurodisability rates.

Using results from cognitive, vision, movement and behaviour assessments, parent /guardian interviews, and educational attainment scores, the team
found that the pre-term babies who received DRIFT were almost twice as
likely to survive without severe cognitive disability than those who
had received standard treatment.

They also found that infants given the DRIFT treatment were also more
likely to attend mainstream education.

Dr Luyt, the DRIFT10 study's lead author and Reader in Neonatal Medicine
at Bristol Medical School, said: "Bleeding in the brain is one of the
most serious complications of preterm birth and premature babies are particularly at risk of bleeding, the condition can cause significant
brain injury leading to subsequent severe learning disabilities.

"While a two-year follow-up study showed reduced rates of severe
cognitive disability, it was important for us to assess whether the
DRIFT intervention had longer-term benefits.

"The results of this study clearly demonstrate that secondary severe brain injury is reduced in preterm infants by using this neonatal intervention,
and importantly, this is sustained into middle school-age.


========================================================================== Story Source: Materials provided by University_of_Bristol. Note: Content
may be edited for style and length.


========================================================================== Journal Reference:
1. Karen Luyt, Sally L Jary, Charlotte L Lea, Grace J. Young, David
E Odd,
Helen E Miller, Grazyna Kmita, Cathy Williams, Peter S Blair,
William Hollingworth, Michelle Morgan, Adam P Smith-Collins,
Steven Walker-Cox, Kristian Aquilina, Ian Pople, Andrew G
Whitelaw. Drainage, irrigation and fibrinolytic therapy (DRIFT)
for posthaemorrhagic ventricular dilatation: 10-year follow-up of
a randomised controlled trial. Archives of Disease in Childhood -
Fetal and Neonatal Edition, 2020; fetalneonatal-2019- 318231 DOI:
10.1136/archdischild-2019-318231 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200706101832.htm

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