Hypoxic Ischaemic Encephalopathy

Question 1

What is HIE?

Answer 1

It is an interruption of the supply of oxygen (hypoxia) or blood flow(perfusion) to the brain

Question 2

What are the causes of HIE?

Answer 2

1. Compression or kinking of the umbilical cord
2. Compression of the placenta
3. Placenta abruptio
4. Prolonged labour
5. Maternal haemorrhage

Question 3

How is HIE phased?

Answer 3

There are two phases

1. Primary energy failure
2. Secondary energy failure

Question 4

What occurs in the primary brain energy failure phase?

Answer 4

It usually occurs <6 hours
There is a drop in cerebral perfusion leading to
-hypoxia 
-hypglycaemia 
-anaemia 
-metabolic acidosis 
-ischeamia neuronal cell death

Question 5

What occurs in the secondary brain energy failure phase?

Answer 5

This occurs after 6 hours
Characterised by:
-inflammation 
-apoptosis
-oxidative injury 
-decreased growth factors 
-impaired protein synthesis

Question 6

What other systems are effected by HIE except for the brain?

Answer 6

1. Electrolyte derangement
2. Pulmonary hypertension
3. Respiratory depression
4. Cardiac dysfunctional
5. Renal impairment- oliguria
6. Hepatic impairment

Question 7

How is HIE classified?

Answer 7

-according to the Sanrat grading scale

Question 8

What are the symptoms that the baby will present with if they have HIE?

Answer 8

1. Decreased tone
2. Absent pupillary reflex
3. Seizures
4. Apnea
5. Decreased level of consciousness
6. Increased intracranial pressure