hypoxic ischemic encephalopathy Flashcards
what is neonatal hypoxic ischemic encephalopathy characterized by ?
difficulty maintaining and initiating respiration along with depression in tone of respiratory muscles
what are the different causes of HIE ?
causes of hypoxia around delivery time placental abruption PROM TORCH maternal hypotension maternal eclampsia
what are the features of birth asphyxia ?
hypoxia
hypercapnia
acidosis
what are the different presentations of HIE ?
mild: irritable
moderate : convulsions
severe : comatosed , hypotonia
what is the APGAR score ?
appearance Pulse Grimace activity respiration
what are the patterns of neuronal damage in HIE ?
may be immediate
may be delayed due to reperfusion injury causing secondary neuronal death
what seizures are often associated with HIE ?
subtle seizures ( cycling)
what is the main method of treatment regarding HIE ?
support
monitoring
therapeutic hypothermia
what are the indications for therapeutic hypothermia ?
decrease body temperature to around 33 degrees within the first 6 hours of life
but only in term babies
gradual rewarming over 72 hours
what is the effect of hypoxia on the blood ?
DIC
what is the effect of hypoxia on the lungs ?
persistent pulmonary HTN
If blood gases were performed in the first hour of life with evidence of metabolic acidosis what is this an indication off ?
baby was compromised in utero
what is the prognosis in each of the presentation of HIE ?
mild : complete recovery
moderate : with good response to treatment good prognosis within 2 weeks , poor response poor prognosis
severe: bad prognosis mortality associated
what investigations should you do for HIE ?
amplitude integrated EEG
ABG
Cranial US
electrolytes
