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Scientists Reverse Brain Damage in Drowned Toddler?

563 pointsby Deinosalmost 8 years ago

26 comments

dumbneurologistalmost 8 years ago
Disclaimer: I am a neurologist<p>The enthusiastic replies on this thread are understandable, but disappointing to see: we all need to be less credulous regarding the lay science press, and especially the lay medical press.<p>I would love nothing more than to have this kind of therapy be a reality for my patients. However, I am deeply skeptical of this report.<p>Why? Because<p>- hyperbaric oxygen therapy has a big industry of quackery behind it[1][2]<p>- oxygen is a standard part of medical care and can just as easily be harmful as helpful<p>- because there is just no way in hell that oxygen is going to reverse cell death.<p>- this is in newsweek, and not a peer-reviewed journal.<p>And if there was no cell death, then the recovery is almost inevitable.<p>Some posters are skeptical because 15 minutes is impossible.<p>On the contrary: the key point is the temperature. The article says the water was 4 degrees C. That is cold enough that you <i>can</i> recover fully. In fact, the most amazing recovery is also one of the best-documented: with a 66-minute submersion in Utah that was followed by complete recovery[3] (this is a far more interesting article than the original post - it was in 1988, and utilized extracorporeal rewarming). This observation was used to pursue hypothermia in other causes of anoxic injury, which is clinically used today. I&#x27;m sure the 66-minute case also got oxygen during the recovery, but to say that it was due to oxygen (which is standard of care) rather than the temperature is silly.<p>Sorry to be a wet blanket, but this article is just clickbait junk.<p>1. <a href="https:&#x2F;&#x2F;www.fda.gov&#x2F;ForConsumers&#x2F;ConsumerUpdates&#x2F;ucm364687.htm" rel="nofollow">https:&#x2F;&#x2F;www.fda.gov&#x2F;ForConsumers&#x2F;ConsumerUpdates&#x2F;ucm364687.h...</a><p>2. <a href="https:&#x2F;&#x2F;www.quackwatch.org&#x2F;01QuackeryRelatedTopics&#x2F;HBOT&#x2F;hm01.html" rel="nofollow">https:&#x2F;&#x2F;www.quackwatch.org&#x2F;01QuackeryRelatedTopics&#x2F;HBOT&#x2F;hm01...</a><p>3. <a href="http:&#x2F;&#x2F;www.nytimes.com&#x2F;1988&#x2F;07&#x2F;26&#x2F;science&#x2F;the-doctor-s-world-ingenuity-and-a-miraculous-revival.html?pagewanted=all" rel="nofollow">http:&#x2F;&#x2F;www.nytimes.com&#x2F;1988&#x2F;07&#x2F;26&#x2F;science&#x2F;the-doctor-s-world...</a>
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nerdponxalmost 8 years ago
This is approaching Star Trek levels of medicine. Congratulations to the team who discovered and pull this off, and of course my heart goes out to the family and their child. Drowning is very serious and very scary.<p>Edit: somewhat unrelated since this girl fell into an unattended pool, but it&#x27;s important to know the signs of drowning, which are not what you see in movies: <a href="http:&#x2F;&#x2F;www.cbsnews.com&#x2F;news&#x2F;how-to-spot-signs-of-a-child-drowning&#x2F;" rel="nofollow">http:&#x2F;&#x2F;www.cbsnews.com&#x2F;news&#x2F;how-to-spot-signs-of-a-child-dro...</a><p>Edit 2: I get that people have a right to downvote whatever they want, but seriously, did I say something wrong here?
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madilontsalmost 8 years ago
Well, this event happens enough that it might be worth studying the benefit of oxygen therapy, but I&#x27;d be very careful about the conclusions you draw from this.<p>Maybe the oxygen had a substantial positive effect, or maybe the child would&#x27;ve recovered on her own. We really don&#x27;t know, since there are other reports of children who have good neurological outcome despite terrible prognosis [1] [2].<p>I&#x27;m suspicious because of the unusual and&#x2F;or stereotyped responses in the Medical Gas article and the linked YouTube videos: &quot;doctors said she had 48 hours to live&quot; (doctors don&#x27;t say things like that) and &quot;this demonstrates that we&#x27;re inducing 8101 genes!&quot; (ummm, OK...), etc.<p>Also, be suspicious when something like this hits all the pseudo-news sites simultaneously. It reminds me of the articles that go something like &quot;16 year-old cures cancer...DOCTORS HATE HIM!&quot;.<p>Finally, I&#x27;m very happy this little girl has been given a second chance and hope for her continued recovery. However, don&#x27;t forget that a toddler was left unsupervised and submerged in a pool for 15 minutes. Some people call that an accident; some people call it neglect.<p>[1] <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed?term=3379747" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed?term=3379747</a><p>[2] <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed?term=10665559" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed?term=10665559</a>
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davidiachalmost 8 years ago
&gt;Concluding, the researchers say that to their knowledge, this is the first reported case of gray matter loss and white matter atrophy (types of brain damage) reversal with any therapy and that treatment with oxygen should be considered in similar cases. “Such low-risk medical treatment may have a profound effect on recovery of function in similar patients who are neurologically devastated by drowning.&quot;<p>I always believed that brain damage cannot be reversed. If version 1 means reversing it in toddlers, maybe version 10 will do miracles for many other people. Truly amazing and congratulations to the medical team!
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matt4077almost 8 years ago
&gt; was in the 5 degree Celsius water for up to 15 minutes before being discovered.<p>as my professor used to say: If you&#x27;re going to drown, drown in almost-freezing freshwater.
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amykharalmost 8 years ago
What frustrates me is that in the United States, most insurance companies won&#x27;t pay for hyperbaric oxygen treatment for traumatic brain injuries. My son, 26, was injured in a car accident last November. I would love to be able to get Oxygen therapy for him, but cannot.
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slr555almost 8 years ago
Drowning is from a medical standpoint more complex than the simple notion I grew up with which was in essence &quot;water fills your lungs so you can&#x27;t breathe air&quot;.<p>In fact drowning does not require filling the lungs completely. Even a volume of a few milliliters&#x2F;Kilogram of body weight is enough to cause drowning. Additionally, drowning can cause serious damage to the lungs themselves even if the patient survives initial attempts at resuscitation. The alveoli (functional unit of the lungs) are lined with a surfactant that is critical to the exchange of air to the blood stream. Water can severely disrupt the surfactant and impair function not just while the water is present but until the body is able to restore the surfactant layer. Damage to the patient&#x27;s lungs in this case seems to have been mild enough that the oxygen therapy could do it&#x27;s job.<p>Also notable is the 5 degree celsius water temperature (41 degrees Fahrenheit). This water temperature compared with the temperature of an olympic practice pool (~76 degrees Farenheit) is cool enough (though not as cold as many other reports) to trigger the so called &quot;diving reflex&quot; where stimulation of thermo-receptors in the skin triggers a vagal response that shunts blood away from the periphery and to vital organs.<p>Minimal surfactant damage and the diving reflex (as well as the patient&#x27;s age) seem likely to some degree to have facilitated successful treatment of the patient.
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mechnesiumalmost 8 years ago
This is really awesome. I am curious if this therapy would have been augmented by cognitive enhancers or nootropic substances such as piracetam. Piracetam in particular exhibits neuroprotective effects and improves cerebral vascular function. Several studies have found it to improve recovery following acute&#x2F;transient ischemic stroke. It has actually been prescribed in several countries for this purpose.<p>References: <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;22972044" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;22972044</a> <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;10338105" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;10338105</a> <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;9412612" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;9412612</a> <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;9316679" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;9316679</a>
zevebalmost 8 years ago
Egad the JavaScript on that page is terrible! Every time I scroll to read the first paragraph, it hides the video or something, causing it to scroll away.
samfisher83almost 8 years ago
It seems like they fed the body a lot of oxygen and the body healed itself. I think the body is pretty amazing at regeneration when we are young.
sehuggalmost 8 years ago
Can anyone knowledgeable about medicine explain this article further? For example, I&#x27;m wondering why they waited 55 days to give normobaric oxygen therapy. Wouldn&#x27;t it be given immediately for a patient with brain injury?
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mabboalmost 8 years ago
I was worried this would be a case of neural plasticity, where the brain just rewires itself around the damage (which is a thing, and it&#x27;s super cool). But then I read this part:<p>&gt; An MRI scan a month after the 40th HBOT session showed almost complete reversal of the brain damage initially recorded. Researchers believe the oxygen therapy, coupled with Eden having the developing brain of a child, had activated genes that promote cell survival and reduce inflammation—allowing the brain to recover.<p>We can reverse brain damage. Wow.
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timcamberalmost 8 years ago
This is amazing. Does anyone think the cold temperature of the water (5C) had anything to do with the feasibility of recovery? I don&#x27;t necessarily have a reason to think it would be beneficial or not, just a thought that crossed my mind. I don&#x27;t think it was mentioned in the article.
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wvhalmost 8 years ago
[...] and two hours where her heart did not beat on its own.<p>Impressive. I wonder if there are ways to force this level of regenesis in adult brains with less generative power and neuroplasticity.<p>I don&#x27;t think there&#x27;s anything sweeter to a human being than &quot;here&#x27;s your child back&quot;.
sunwoozalmost 8 years ago
Is there data out there about infants in a similar situation who didn&#x27;t receive oxygen therapy? Is it possible that the developing child brain is what almost solely caused the improvements?
blauditorealmost 8 years ago
First paragraph:<p>&gt; she spent 15 minutes submerged in a swimming pool<p>This seems highly implausible, given she survived. Also, how would they know the moment she dropped in?<p>Further down:<p>&gt; up to 15 minutes<p>Ah ok. From what I know, brain damage starts occurring even after 2-3 minutes without air (for adults), so I suppose it was rather on the lower end. Does anybody know a bit more about this?
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rhinoceraptoralmost 8 years ago
It would interesting to know if better results could be obtained using even more oxygen, in combination a ketogenic diet&#x2F;exogenous ketones (which would negate the risk oxygen seizures).
msiealmost 8 years ago
This is cool but will other people try it or will it be another forgotten technique?
TurboHaskalalmost 8 years ago
How is nationality relevant?
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flamedogealmost 8 years ago
Drowned U.S. Toddler. U.S. is unnecessary here.
wcr3almost 8 years ago
?
ilitiritalmost 8 years ago
Does drowning not imply death? Is there different definition for drowning (or death) in medicine?<p>EDIT: I&#x27;m referring to the fact that the title says the girl drowned, not that she was at some point &quot;drowning&quot;.
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Karunamonalmost 8 years ago
It is also <i>completely irrelevant</i> to the correctness or incorrectness of the argument, which is often what gets missed. Authority is a heuristic, nothing more.<p>The evaluation of P -&gt; Q happens independently of the speaker. If you&#x27;re trying to refute P -&gt; Q by mentioning an attribute of the speaker, you&#x27;re necessarily answering some other question entirely, while making an excuse to ignore the original question.<p>You can say that someone making such an argument is <i>more likely</i> to be incorrect based on their beliefs, but that&#x27;s still an untested hypothesis (more bluntly, a rationalization) until you actually sit down, stop making excuses, and verify it yourself.<p>Excuses aren&#x27;t logic. You can say you don&#x27;t have time, and that&#x27;s valid, you can say you don&#x27;t want to, and that&#x27;s valid, but don&#x27;t say you&#x27;re doing logic. You&#x27;re coming up with reasons to avoid doing logic.
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wfunctionalmost 8 years ago
&gt; Disclaimer: I am a neurologist<p>&gt; {informed comments}<p>A little off-topic but I see this so often I feel like I should mention this at some point:<p>I think you mean &quot;disclosure&quot; and not &quot;disclaimer&quot; (and most likely it&#x27;s best if both are omitted and you just mention you&#x27;re a neurologist).<p>&quot;Disclaimer&quot; means refusing to accept responsibility, which doesn&#x27;t make sense when it&#x27;s a preface to what looks like a comment based on expertise. If, on the other hand, you&#x27;re really trying to say that you&#x27;re refusing any responsibility for what you say, then the disclaimer should probably be something more along the lines of &quot;I&#x27;m NOT {a qualified lawyer&#x2F;neurosurgeon&#x2F;whatever}&quot;, and not &quot;I AM {a qualified whatever}&quot;.
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mrkraboalmost 8 years ago
I swear to God, from the three videos I&#x27;ve seen, the drowning kid was always black. Was that luck, or was that an actor?
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mellingalmost 8 years ago
No, not really. You&#x27;re making a hyperbolic statement. I&#x27;ve been watching Star Trek for 40 years. We&#x27;re definitely still in the Dark Ages:<p><a href="https:&#x2F;&#x2F;www.youtube.com&#x2F;watch?v=MMaGnpVaSGQ" rel="nofollow">https:&#x2F;&#x2F;www.youtube.com&#x2F;watch?v=MMaGnpVaSGQ</a>
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