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Scientists reverse brain damage in drowned US toddler
by Hannah Osborne, Posted with permission from Newsweek, July 19, 2017
In what is believed to be a world first, scientists have reversed brain damage in a toddler that drowned in a swimming pool. Using oxygen therapy, scientists were able to restore her ability to walk and talk just months after the accident, in which she spent 15 minutes submerged in a swimming pool and two hours where her heart did not beat on its own.
The accident took place in February 2016. Two-year-old Eden Carlson had managed to get through a baby gate and fall into the family swimming pool and was in the 5 degree Celsius water for up to 15 minutes before being discovered.
After being resuscitated and treated in hospital for just over a month, she was unresponsive to all stimuli. She was immobile and constantly squirmed and shook her head. MRI scans showed deep injury to the brain’s gray matter, as well as loss of white and gray matter.
In a bid to reverse the brain damage, researchers at the LSU Health New Orleans School of Medicine and the University of North Dakota School of Medicine began treating her with two types of oxygen therapy.
This includes normobaric oxygen therapy, where levels of oxygen given are the same as at sea level, and hyperbaric oxygen therapy (HBOT), where they are given pure oxygen at pressures higher than that of the atmosphere within a special chamber.
Fifty five days after the drowning accident, doctors started giving Eden normobaric oxygen for 45 minutes twice per day. This appeared to make her more alert and awake, and she stopped squirming. She started laughing more and was able to move her arms and hands, and grasp with her left. Scientists also noted eye-tracking movements and some speech.
After 78 days, Eden began HBOT therapy, with 45 minute sessions five days per week for four weeks. After 10 sessions, her mother said she was almost back to normal other than motor function. After 39 sessions—coupled with physical therapy—Eden was able to walk and her speech had returned to normal. Her cognitive abilities had improved and motor function was almost restored to pre-drowning levels.
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. The case report is published in the journal Medical Gas Research.
Paul Harch, who treated Eden, said in a statement: “The startling regrowth of tissue in this case occurred because we were able to intervene early in a growing child, before long-term tissue degeneration. Although it’s impossible to conclude from this single case if the sequential application of normobaric oxygen then HBOT would be more effective than HBOT alone, in the absence of HBOT therapy, short duration, repetitive normobaric oxygen therapy may be an option until HBOT is available.”
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.”
Eden has several things in her favor. First, this was a cold water drowning. The rule of thumb for emergency care is early CPR and transport to an ER. So long as the victim has no heartbeat, continued CPR until the victims core temperature is 96 F. Drug therapy to start the heart again is withheld until the core temperature in near normal. Drugs are ineffective until the patient has warmed.
The second factor in Eden’s recovery is her age. As the article notes, she was just two years old and her brain is still developing.
The final factor is the innovative care she received from the medical team while she was in the hospital. They weren’t going to give up and they didn’t.
As an emergency care provider, and as a parent, I cannot emphasize enough the need to be trained in CPR and teaching young children how to swim. The younger the better.
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