hypoxic ischaemic encephalopathy

Question 1

why

Answer 1

occurs in neonates as a result of hypoxia during birth

Question 2

when should HIE be suspected

Answer 2

• perinatal/intrapartum event that could lead to hypoxia
• umbilical artery blood gas shows acidosis
• poor APGAR scores
• features of HIE

Question 3

causes

Answer 3

maternal shock
intrapartum haemorrhage
prolapsed cord
nuchal cord

Question 4

Mild - features

Answer 4

poor feeding
irritable
hyper-alert

Question 5

mild - prognosis

Answer 5

resolves within 24hrs

normal prognosis

Question 6

moderate - features

Answer 6

poor feeding
lethargic
hypotonic
seizures

Question 7

moderate - prognosis

Answer 7

can take weeks to resolve

40% develop CP

Question 8

severe - features

Answer 8

reduced consiousness
apnoeas
flaccid
reduced/absent reflexes

Question 9

severe - prognosis

Answer 9

up to 50% mortality

90% develop CP

Question 10

Mx

Answer 10

supportive care
therapeutic hypothermia in certain circumstances

paediatrician and MDT follow up

Question 11

Therapeutic Hypothermia - who

Answer 11

babies near or at term

Question 12

Therapeutic Hypothermia - what

Answer 12

cooling core temp of bbay
33-34ºC
continues for 72hrs then baby gradually warmed

Question 13

Therapeutic Hypothermia - intention

Answer 13

reduce inflammation and neurone loss after acute hypoxic injury

reduces risk of CP, developmental delay, LD, blindness and death