Friday, March 12, 2010

Preemie Brain "Washing"

This is NOT about Tyler and a really nice bath, but about a study that has been sitting on my Firefox explorer for several days. I seem to keep coming back to it and reading, and re-reading. I am not sure if that is because I think it is a good idea. Or maybe it is because it is one of the first "new" things that has come up for severe brain bleeds. (There was something about Epsom salt AKA magnesium sulfate. This is the first "treatment" after they have already happened.)

The treatment/study was done in Bristol England. When a premature baby was shown by repeated ultrasound scans to have had a large hemorrhage ( from what I can see in several reports, the bleeds were of grade 3 and 4 and resulted in hydrocephalus or at least swelling and pressure KNOWN as hydrocephalus) and then expanded ventricles, the baby was anaesthetised and two tubes were inserted into the ventricles in the brain. One tube was used to continuously drain out the cola-colored fluid while the other tube was used to let clear fluid flow in. The pressure in the brain was measured continuously and more fluid was drained out than flowed in so the brain slowly decompressed. When the fluid draining out cleared, the two tubes were removed. This took on average three days.

From 2003 to 2006, 77 premature babies with large brain hemorrhages in Bristol, Glasgow, Katowice (Poland) and Bergen (Norway) were recruited. Thirty-nine babies had the ventricles washed out using the Drainage, Irrigation and Fibrinolytic Therapy (DRIFT) and 38 had standard treatment.

When they were two years old, independent assessors examined all the survivors. Of 39 infants assigned to being washed out, 21 (54 per cent) died or were severely disabled versus 27 of 38 (71 per cent) in the standard group. Amongst the survivors, 11 of 35 (31 per cent) in the DRIFT group had severe cognitive disability versus 19 of 32 (59 percent) in the standard group. Median Mental Development Index was 68 (out of 100) in the washout group, and below 50 with standard care. These results are statistically and clinically significant. ( Study Found HERE!)

So these are my thoughts. I hope that they do find something that will help their little brains. They are so fragile. They have so much against them when they are fighting for the right to get big that having brain damage makes things twice as hard to overcome the stuff that comes down the road.

There is no "cure" for brain damage. There is no cure for the seizure that come from their broken wires in their brain. If there was something that they could do to help why not try?

The study didn't show any major downfalls. It didn't seem to be detrimental to them in any way. I would opt to have had it tried on my child. I think clinical trials such as the above could only HELP.

What are you thoughts? Is the study something they should bring the the United States?


Tasha said...

I would be curious to see what the American study would show if they brought it here. After having Bree I don't know what I would do if it was offered to me. Bree had Grade III bleeds with signs of ventricular enlargement, but (glory be to God) she now shows no evidence of it in her MRI. However, if it shows statistically better results, why wouldn't you as a parent use it?

Anonymous said...

My son was part of this trial and has done amazingly well as a result. He had a grade 4 bleed and although he has a shunt, cognitively he is doing very well. It's an amazing treatment that is being offered as standard in the UK now. Although very distressing for us as parents I think my son's life would be very different otherwise.