Hypoxic ischemic encephalopathy (HIE) is a brain injury. It happens when the brain does not get enough oxygen.
HIE can be deadly. Brain cells start to die after 4 minutes without oxygen.
Blood Supply to the Brain
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Many health problems can cause a lack of oxygen to the brain. Some common ones are:
- Cardiac arrest
- Blocked or ruptured blood vessel
A blocked airway due to:
- Swelling, such as from an allergic reaction
- Drug use and drug overdose
- Carbon monoxide poisoning
The risk of HIE is higher in people who have an injury or health problem that causes the brain to have a drop in blood flow and oxygen.
Problems may be mild to severe, such as:
- Problems with focus
- Difficulty making decisions
- Mood swings
- Feeling very tired
- Signs of seizures, such as confusion and muscle jerking
- Loss of alertness
- Blue-colored skin or lips
- Problems breathing
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:
Your brain and spinal cord may be tested. This can be done with:
Your heart function may also be tested.
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
- Cooling—Cooling blankets or other means of cooling may be used to lower the body's temperature.
- Temperature control—Cooling and rewarming methods may be used.
There are no known guidelines to prevent HIE.
Busl KM, Greer DM. Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation. 2010;26(1):5-13.
Hypoxic ischemic encephalopathy (HIE). Neurographics website. Available at: http://www.asnr.org/neurographics/2/1/1/4.shtml. Accessed October 1, 2020.
Hypoxic-ischemic encephalopathy in adults. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/hypoxic-ischemic-encephalopathy-in-adults. Accessed October 1, 2020.
Last reviewed September 2020 by
EBSCO Medical Review Board
Rimas Lukas, MD
Last Updated: 5/21/2021