H Y P O X I C - I S C H E M I C E N C E P H A L O P A T H Y ( H I E )
Hypoxic-ischemic brain injury may occur during the perinatal period. These injuries may
often be independent of any symptoms during labor or delivery period. In fact, some of
these injuries occur antenatally or may result of specific conditions or abnormal
anatomy. It is often difficult to pinpoint when exactly the event did occur.
Babies with HIE may preset with lethargy, hypoglycemia, bradycardia, seizures,
abnormal breathing patterns, ↑ renal function tests, ↑ liver function tests.
The prognosis for HIE is highly variable and only the most severe and tragic cases are
the easiest to assess. Several generalizations for HIE are as follows.
- The fewer symptoms, the better
- The quicker the recovery, the more optimistic the outcome
- Uncontrollable seizures portend a bad outcome.
- Brainstem effects indicate a higher degree of severity
- Absence of gray-white matter differentiation on CT suggestive of poor outcome
HIE is treated with supportive care, such as treating seizures and normalizing blood
pressure abnormalities In 2005, three multicenter randomized controlled trials were
published showing that induction of mild hypothermia
resulted in significantly improved neurodevelopmental outcome in neonates 36
weeks gestation with acute perinatal HIE.