The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Drainage, irrigation and fibrinolytic therapy (DRIFT) for post-haemorrhagic hydrocephalus in preterm infants.


Bleeding in the brain is a serious complication in babies born prematurely. It can result in obstruction of the flow of fluid (called cerebrospinal fluid [CSF]) within the cavities of the brain leading to progressive enlargement of the head (hydrocephalus). Death or permanent brain damage may follow. There are very few treatments for this condition.

This procedure aims to remove the blockage and reduce its harmful effects by draining excess CSF from the brain, washing out the blood, and breaking down blood clots using drugs (fibrinolytics).

Coding recommendations

A20.1 Drainage of ventricle of brain NEC

Y22.3 Irrigation of organ NOC

Y37.8 Other specified introduction of other substance into organ NOC

Appropriate High Cost Drug code for fibrinolytic agent if available

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)