Definition

Hypoxic ischemic encephalopathy (HIE) is a brain injury. It happens when the brain does not get enough oxygen.

HIE can cause death. Brain cells start to die after 4 minutes without oxygen.

Blood Supply to the Brain

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Causes

Many health problems can a lack of oxygen to the brain. Some common causes are:

• Cardiac arrest
• Blocked or ruptured blood vessel
• A blocked airway due to:
  • Swelling, such as from an allergic reaction
  • Trauma
  • Drug use and drug overdose
  • Drowning
  • Choking
• Carbon monoxide or cyanide poisoning

Risk Factors

Any injury or health problem that causes the brain to have a drop in blood flow and oxygen is a risk factor for HIE.

Symptoms

You may have:

• Mild symptoms:
  • Focus problems
  • Problems making decisions
  • Clumsiness
  • Strong feelings
  • Excess drowsiness

• Severe symptoms:
  • Seizures
  • Loss of consciousness
  • Blue-colored skin or lips
  • Problems breathing

Diagnosis

A physical exam will be done. A health history is the biggest factor in making the diagnosis.

Blood tests may be done.

Pictures may need to be taken of your body. This can be done with:

• CT scan
• MRI scan
• Ultrasound

Your heart and brain may be tested. This can be done with:

• Electroencephalogram (EEG)
• Evoked potential tests

Treatment

Treatment depends on the cause of HIE. It also depends on how severe the damage is to the brain.

You may have:

• Life-sustaining treatment—If brain function stops, but damage is not great, then life saving treatment is given. This may include CPR.
• Cooling—Cooling blankets or other means of cooling may be used to lower the body's temperature.
• Temperature control—Cooling and rewarming the body.

Prevention

HIE can’t be prevented.