Medical technique improves survival chance for babies

The process involves removing toxic fluid potentially harmful to infants born early and suffering from large brain haemorrhages.

The research, led by Andrew Whitelaw, Professor of neonatal medicine at the University of Bristol, and Ian Pople, paediatric neurosurgeon at North Bristol NHS Trust, showed the technique reduced the number of deaths and severe disabilities in a group of premature babies.

Prof Whitelaw said: “Premature babies are particularly at risk of bleeding because in the middle of pregnancy, the foetus has many fragile blood vessels in the centre of the brain.

“These blood vessels shrink by full term and bleeding is rare in babies born at 40 weeks.”

From 2003 to 2006, 77 premature babies with large brain haemorrhages in Bristol, Glasgow, Katowice in Poland and Bergen in Norway were studied.

Thirty-nine babies had the ventricles washed out and 38 had standard treatment.When they were two years old, independent assessors examined the survivors.

Of 39 infants assigned to being washed out, 21, or 54 per cent, died or were severely disabled versus 27 of 38, or 71 per cent, in the standard group.

Among the survivors in the group which underwent the treatment, 11 of 35, or 31 per cent, had severe cognitive disability versus 19 of 32, or 59 per cent, in the standard group.

The median mental development index was 68 out of 100 in the washout group, and below 50 with standard care.

Prof Whitelaw and Mr Pople have researched the condition, known as hydrocephalus, for the past 20 years and pioneered the technique in 1998.

Two tubes are inserted into the ventricles in the brain of a premature baby suffering from a large haemorrhage and expanded ventricles. One tube continuously drains out fluid while the other tube lets clear fluid flow in.

The pressure in the brain is measured continuously and more fluid is drained out than flowed in so the brain slowly decompresses.

When the fluid draining out has cleared, the two tubes are removed. The whole procedure takes about three days.

The trials, funded by grants from research charity Cerebra and the James and Grace Anderson Trust, are published online today in Pediatrics, the journal of the American Academy of Pediatrics.

Mr Pople said: “This is the first time that any treatment anywhere in the world has been shown to benefit these very vulnerable babies.

“Initially known as Drainage, Irrigation and Fibrinolytic Therapy (Drift) this treatment is now called ‘ventricular lavage’ and it is hoped that in the very near future it will be set up as a service at Southmead Hospital in Bristol.”