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Neonatal Care Academy

April is Worldwide HIE Awareness Month

HIE (Hypoxic Ischemic Encephalopathy)

The NCA supports HOPE FOR HIE’s initiative to increase awareness.

WHAT IS HIE?
HYPOXIC ISCHEMIC ENCEPHALOPATHY

HYPOXIC (LACK OF OXYGEN)
ISCHEMIC (RESTRICTING BLOODFLOW)
ENCEPHALOPATHY (AFFECTING THE BRAIN).

When the brain is deprived of oxygen, brain cells are injured.  Some may recover, some may die.  The most common causes of oxygen deprivation to the brain are low levels of oxygen in the blood or a reduced flow of oxygen to the brain. This can happen in a variety of ways prior to birth, during the birth process, after birth, and during childhood. Different alternate diagnoses include perinatal encephalopathy, perinatal asphyxia, neonatal encephalopathy or birth asphyxia.

There are two stages of injury with HIE: The first stage happens immediately after the initial oxygen deprivation. The second occurs as normal oxygenated blood flow resumes to the brain. This is called “reperfusion injury” and occurs as toxins are released from the damaged cells.

What causes HIE?

HIE has many causes, including placental insufficiency, uterine rupture, placental abruption, true umbilical knots, cord compression, maternal blood clotting disorders, fetal maternal hemorrhage, extremely low maternal blood pressure, trauma during delivery, placental blood clots, shoulder dystocia, cord prolapse, aneurysm rupture, cardiac arrest and near SIDS events.

How is HIE diagnosed?

Diagnosis of HIE in a newborn baby is done using a few different diagnostic tools.  The Sarnat Scale, which is based upon how the baby appears after birth or injury, or presentation at the hospital is one of them, in addition to imaging such as EEG, ultrasound and MRI, and checking cord blood gas levels.

(source: hopeforhie.org)


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