Newborn brain hemorrhage – “landmark” study shows benefits of new treatment
It is called DRIFT - Drainage, Irrigation and Fibrinolytic Therapy. And according to a study published in the peer-reviewed journal Archives of Diseases in Childhood, DRIFT significantly reduces learning disability in premature babies born with newborn brain hemorrhage. Newborn brain hemorrhage is also called intraventricular hemorrhage (or IVH).
This is a truly remarkable study because the only no known "treatment" for IVH is a lumbar puncture. The lumbar puncture is supposed to relieve pressure on the brain and reduce death and disability. However, the effectiveness of lumbar puncture has never been very clear.
What is newborn brain hemorrhage?
A newborn brain hemorrhage is essentially when the ventricles in the brain burst. This causes bleeding, or hemorrhaging, into other parts of the brain. This process can cause brain tissue to die. When this occurs, a child can suffer from developmental delay, learning disabilities, and cerebral palsy.
While newborn brain hemorrhage is most often seen in the setting of prematurity, it is not the prematurity itself that causes the bleeding. Instead, there must be a link between prematurity and IVH. The two most common causes of newborn brain hemorrhage are infection and ischemia (i.e., a lack of blood flow).
The best way to avoid a brain bleed is to avoid prematurity altogether. Unfortunately, a premature birth is sometimes unavoidable. Furthermore, some premature births can be the result of negligence or medical error.
What medical errors lead to premature birth and brain damage?
There are several ways in which a medical error can lead to premature delivery and newborn brain hemorrhage. Below is a list of negligent acts that can cause these conditions:
- Failure to timely diagnose pre-term labor;
- Failure to timely diagnose and treat pre-term contractions;
- Failure to give tocolytics (i.e., drugs that stop contractions);
- Failure to timely administer steroids and magnesium sulfate;
- Failure to give progesterone or 17p; and
- Failure to place a cerclage (i.e., cervical stitch)
For a long time, it was believed that injuries from prematurity, such as newborn brain hemorrhage, could not be the result of a medical error. This is not true.
More on DRIFT
DRIFT therapy is accomplished by injecting a fibrinolytic (i.e., a clot busting drug) into the ventricles. After the clot buster is injected, the ventricles are continuously lavaged (i.e., washed out) until they are clear. Of course, this sounds complicated. But it is probably no more complicated or risky than a lumbar puncture.
The results of the DRIFT study are amazing. Not only did DRIFT therapy show short-term benefit in premies with newborn brain hemorrhage, but the study followed children for 10 years (!) to demonstrate enormous long-term benefit. Apparently, the group of children treated with DRIFT (as opposed to the traditional lumbar puncture) were twice as less likely to suffer severe cognitive deficits at 10 years old.
Hopefully, the data will continue to show how the benefits of this therapy. One would hope that this will become standard of care in the not-to-distant future. Limiting the impact of newborn brain hemorrhage would help thousands of children around the globe.
