Hypoxic Ischaemic Encephalopathy

what is it

in neonates, brain damage due to hypoxia at birth, can cause cerebral palsy or death

risk factors

hypoxia during perinatal or inrapartum period, acidosis on umbilical artery blood gas

causes

maternal shock, intrapartum haemorrhage, prolapsed cord causing compression during birth, nuchal cord where it is wrapped around baby’s neck

mild HIE

poor feeding, generally irritable , hyper alert, resolves within 24 hours

moderate

poor feeding, lethargic, hypotonic, seizures, take weeks to resolve, up to 40% develop cerebral palsy

severe

reduced consciousness, apnoeas, flaccid and reduced or absent reflexes, up to 50% mortality, up to 90% develop cerebral palsy

management

supportive care with neonatal resurrection and optimal ventilation, circulatory support, nutrition, acid base balance and treatment of seizures, therapeutic hypothermia

therapeutic hypothermia

actively cooling core temp of baby in neonatal icu with cooling blanket and cooling hat, target of between 33-34 (measured with rectal probe) for 72 hours and then warmed for 6 hours