Hypoxic - Ischaemic Encephalopathy

Question 1

What is Hypoxic - Ischaemic Encephalopathy?

Answer 1

• A restriction of blood flow causing a lack of oxygen causing malfunctioning of the brain
• HIE can lead to permanent damage to the brain causing cerebral palsy

Question 2

What are the Causes of HIE?

Answer 2

• Maternal Shock
• Intrapartum Haemorrhage
• Prolapsed cord (compression of the cord during birth)
• Nuchal cord (cord is wrapped around the neck of the baby)

Question 3

What are the clinical features of HIE?

Answer 3

• Sarnat Staging:
• Mild (Poor feeding, generally irritable, resolves within 24 hours)
• Moderate (Poor feeding, lethargic, hypotonic and seizures)
• Severe (Reduced consciousness, apnoeas, flaccid and reduced reflexes)

Question 4

What is the management of HIE?

Answer 4

• This involves supportive care such as neonatal resus and ongoing optimal ventilation with circulatory support, nutrition and treatment of seizures
• Children require an MDT team

Question 5

What is Therapeutic Hypothermia?

Answer 5

• Therapeutic Hypothermia involves actively cooling the core temp of the baby
• The baby is transferred to the Neonatal ICU and actively cooled using cooling blankets and cooling hat
  -The intention of therapeutic hypothermia is to reduce inflammation and neurone loss after the acute hypoxic injury
• it reduces the risk of cerebral palsy

Question 6

What is the aimed temperature for the baby with HIE?

Answer 6

• The temperature is aimed between 33 and 34 and monitored with a rectal probe

Question 7

How long is the baby cooled for?

Answer 7

• 72 hours

Question 8

Over how many hours is the baby warmed?

Answer 8

• 6 hours