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Study: Brain haemorrhage treatment cuts long-term disability in premature babies

Researchers in Bristol developed the drainage, irrigation and fibrinolytic therapy technique in 1998 and it was first trialled in 2003.
Researchers in Bristol developed the drainage, irrigation and fibrinolytic therapy technique in 1998 and it was first trialled in 2003. Researchers in Bristol developed the drainage, irrigation and fibrinolytic therapy technique in 1998 and it was first trialled in 2003.

Premature babies with serious brain haemorrhages were twice as likely to survive without severe learning disabilities when treated with a pioneering technique, a study has found.

Researchers in Bristol developed the drainage, irrigation and fibrinolytic therapy (Drift) technique in 1998 and it was first trialled in 2003.

They say it is the 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.

The surgical technique aimed to reduce disability in premature babies with serious brain haemorrhage by washing out the ventricles in the brain to remove potentially toxic fluid and reduce pressure.

A 10-year follow-up study, funded by the National Institute for Health Research, saw researchers assess 52 of the 65 survivors of the original cohort of 77 premature babies with severe brain haemorrhage who took part in 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.

The research team, led by Bristol Medical School, traced and assessed the children at age 10.

They found those who received Drift were almost twice as likely to survive without severe cognitive disability and more likely to attend mainstream education than those who received standard treatment.

Dr Karen Luyt, 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.

“We hope that these results will be used to inform UK and international healthcare guidelines and support implementation of Drift as a clinical service to help improve outcomes for vulnerable babies.

“We would also like to thank the families and the children who took part in the study for their support and significant contribution that has helped advance our treatment of this condition.”

The follow-up study used results from cognitive, vision, movement and behaviour assessments as well as interviews with parents or guardians and educational attainment scores.