Neonatal hypoxic ischemic encephalopathy hie is the result of a global hypoxic ischemic brain injury in a term neonate, usually after asphyxia. Hypoxic ischaemic encephalopathy hie clinical guideline presentation v3. Mar 01, 2010 in this article, we briefly present the epidemiology of neonatal encephalopathy due to hypoxicischemic injury, describe the rationale for the use of hypothermia therapy for hypoxicischemic encephalopathy, and present results of the clinical trials that have demonstrated the efficacy of hypothermia. Risk factors for hypoxic ischemic encephalopathy in children. Ijms free fulltext treatment of neonatal hypoxicischemic. Prognostic utility of magnetic resonance imaging in neonatal. Perinatal hypoxic ischemic encephalopathy hie is the leading cause of acute mortality and morbidity in newborns with an incidence of one to eight cases per term births. Describe the appropriate imaging workup for suspected hypoxicischemic brain injury. The hie help center serves as an informational resource guide for families of children with hypoxicischemic encephalopathy hie.
Tagin ma, woolcott cg, viincer mj, whyte rk, stinson da. While hie is associated in most cases with oxygen deprivation in the neonate due to birth asphyxia, it can occur in all age groups, and is often a complication of cardiac arrest. Jul 18, 2018 despite major advances in monitoring technology and knowledge of fetal and neonatal pathologies, perinatal asphyxia or, more appropriately, hypoxic ischemic encephalopathy hie, remains a serious condition that causes significant mortality and longterm morbidity. In this article, we summarize the nichd neonatal research network nrn trial of wholebody hypothermia for neonates with hypoxicischemic encephalopathy in relation to other randomized controlled trials rcts of hypothermia neuroprotection. Mri performed in the neonatal period has made a huge contribution to recognition of different patterns of injury. Screen term infants for eligibility if they had poor respiratory. Twenty five percent of neonates with hie develop severe and permanent neuropsychological sequelae.
Longterm effects of hypoxic ischemic encephalopathy. Antenatal and intrapartum risk factors for neonatal. A single center, retrospective cohort study was conducted for 25,494 singleton births. However, important developmental norms have to be taken into an account when describing the pathophysiology of perinatal hypoxic ischemic encephalopathy. Sep 01, 2011 hypoxic ischemic encephalopathy hie is a serious birth complication affecting full term infants. Hypoxic ischemic encephalopathy hie is a condition that occurs when the entire brain is deprived of an adequate oxygen supply, but the deprivation is not total.
Perinatal hypoxicischemic encephalopathy hie remains a major cause of morbidity and mortality. Neonatal encephalopathy ne, also known as neonatal hypoxic ischemic encephalopathy neonatal hie or nhie, is defined by signs and symptoms of abnormal neurological function in the first few days of life in an infant born at term. The incidence of neonatal encephalopathy depends on how the syndrome is defined, but published estimates vary between 2 and 9 per term births. This is an open access article distributed under the terms of the creative commons attributionnoncommercialsharealike 3. Combined therapy in neonatal hypoxicischaemic encephalopathy. May 26, 2010 dixon g, badawi n, kurinczuk jj, et al. Other times, however, the brain damage from hie is.
Doctor answers on symptoms, diagnosis, treatment, and more. Hypoxic ischemic encephalopathy hie is one of the most serious birth complications affecting full term infants. Out of these 84 neonates, the 34 healthy neonates served as control. Hypoxicischaemic encephalopathy hie queensland clinical guideline. Hypoxic ischaemic encephalopathy refer to online version, destroy printed copies after use page 2 of 27. It is very important to remember that hypoxicischemic encephalopathy hie occurs due to oxygen deprivation. Veres on hypoxic ischemic encephalopathy in adults. Objective to investigate the effects of hypothermia treatment on magnetic resonance imaging mri patterns of brain injury in newborns with hypoxicischemic encephalopathy compared. Prognostic utility of magnetic resonance imaging in. Along with prematurity and infections, it is one of the three main causes of neonatal mortality. Pathophysiology of perinatal hypoxicischemic encephalopathy. Hypoxicischemic encephalopathy hie or birth asphyxia is responsible for some, but not all, cases of neonatal. Neonatal encephalopathy can result from a wide variety of conditions. Hypoxic ischemic encephalopathy in adults answers on.
Encephalopathy due to hypoxicischemic injury hypoxicischemic encephalopathy hie is defined as brain injury caused by the combination of inadequate blood flow and oxygen delivery to the brain. Hypoxic ischemic encephalopathy hie following perinatal asphyxia is the most common cause of neonatal encephalopathy. Terminology it is important to remember that neonatal encephalopathy may result from a variety of. Among fullterm newborns with moderate or severe hypoxic ischemic encephalopathy damage to cells in the central nervous system from inadequate oxygen, receiving deeper or longer duration cooling. Hypoxic ischemic encephalopathy hie, also known as neonatal encephalopathy ne, is one systemic manifestation of a. Autologous cord blood cell therapy for neonatal hypoxicischaemic. The 50 neonates were divided into two groups each containing 25 neonates.
A recent phase ii clinical trial on neonatal infants with hie reported better 12month motor outcomes for. Postresuscitation management of asphyxiated neonate. Perinatal hypoxia is a vital cause of longterm neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, andor cerebral palsy in the newborn. Group 1 comprised of 25 neonates suffering from hypoxic ischemic encephalopathy of mild degree. Hypoxic ischemic encephalopathy hie is the consequence of systemic asphyxia occurring at birth.
However, unbound iron can contribute to the development of free. Objective to establish the evidence of therapeutic hypothermia for newborns with hypoxic ischemic encephalopathy hie. Imaging of neonatal hypoxic ischemic encephalopathy hie. Statewide maternity and neonatal clinical network queensland. Imaging of neonatal hypoxic ischemic encephalopathy hie prof. Objective to establish the evidence of therapeutic hypothermia for newborns with hypoxic ischemic encephalopathy hie data sources cochrane central register of controlled trials, oxford. To exclude other causes of neonatal encephalopathy consider. Other times, however, the brain damage from hie is not discovered until years after the hypoxic event, when a child fails to meet certain developmental milestones. Hypoxic ischaemic encephalopathy hie is a condition that occurs more commonly in term babies, but it may also be seen in premature babies. Outcome of fullterm infants with neonatal encephalopathy of hypoxic ischemic origin is often assessed in infancy or early childhood and data on outcome in childhood and adolescence is limited. Hypoxicischemic encephalopathy hie is a type of newborn brain damage caused by oxygen deprivation and limited blood flow. Hypoxic ischaemic encephalopathy queensland health.
Hypoxic ischemic encephalopathy in adults answers on healthtap. Hypoxic ischaemic encephalopathy hie can be a devastating neurological injury and prompt recognition of it can result in significant changes in patient. It is sponsored by abc law centers, a birth trauma law firm that has represented families of children with hie and other birth injuries for over 20 years. Neonatal encephalopathy may have specific etiologies other than hypoxia.
Postresuscitation management of asphyxiated neonate perinatal asphyxia pa is a major public health problem. Describe the appropriate imaging workup for suspected hypoxic ischemic brain injury. Early prognostic indicators of outcome in infants with neonatal cerebral infarction. Background the brain is our most essential organ but also the most sensitive to oxygen deprivation.
Perinatal hypoxicischemic encephalopathy hie is an important cause of brain injury in the newborn and can result in longterm devastating consequences. Melatonin produces a powerful antioxidant and antiinflammatory effect, acting as free radical scavenger and regulating proinflammatory. Hypoxic ischaemic encephalopathy is a clinical condition that presents with neurological signs in term infants, during the early neonatal period. Perinatal hypoxicischemic encephalopathy hie is the leading cause of acute mortality and morbidity in newborns with an incidence of one to eight cases per term births. To identify antenatal and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy hie. Massaro an1, murthy k2, zaniletti i3, cook n4, digeronimo r5, dizon ml6, hamrick se7, mckay vj8.
Neonatal hypoxic ischemic encephalopathy hypoxic ischemic encephalopathy hie is a type of brain dysfunction that occurs when the brain doesnt receive enough oxygen or blood flow for a period of time. If blood flow to brain is interrupted or oxygen is unable to enter the blood, the injury can occur. Hypoxicischemic encephalopathy hie in neonates is often difficult to diagnose in real time at the bedside because of the variety of disorders that can cause neonatal seizures and other. All infants survived the neonatal period, and all but two infa. The hie is similar to choking enough to stop breathing for an extended. Pdf hypoxicischemic encephalopathy hie occurs in 1 to 8 per live births in developed countries. Pdf neonatal hypoxicischemic encephalopathy hie is a devastating condition. Early developmental outcomes after newborn encephalopathy. Hypothermia therapy for newborns with hypoxic ischemic. Mechanism and treatment related to oxidative stress in neonatal.
Cost variation for perinatal hypoxicischemic encephalopathy in the era of therapeutic hypothermia. Assessment of glutamate levels in neonates suffering from. Hypoxic ischemic encephalopathy hie, or birth asphyxia, can result in longterm physical, mental, and cognitive problems. Objective to investigate the effects of hypothermia treatment on magnetic resonance imaging mri patterns of brain injury in newborns with hypoxic ischemic encephalopathy compared with normothermia, including the prognostic utility of mri for death andor disability at a postnatal age of 2 years. Fortynine term infants were prospectively shown to have hypoxicischemic encephalopathy hie.
Encephalopathy is a pattern of behaviour caused by brain injury. Neonatal hypoxicischaemic encephalopathy hie is a serious. In essence, you are free to copy and communicate the work in its. All infants treated with ucbcs became free from respiratory support, the use.
Hypoxic ischemic encephalopathy hie is a type of neonatal brain injury. Lumbar puncture blood for chromosome analysis, ammonia. Wilkins new bolton center, school of veterinary medicine, university of pennsylvania, kennett square, pennsylvania, usa. It has been indicated for asphyxiated fullterm or nearterm newborn infants with clinical signs of hypoxic ischemic encephalopathy hie. Factors affecting outcome in hypoxicischemic encephalopathy in. Neonatal hypoxic ischemic encephalopathy conditions. Serum biomarkers of mri brain injury in neonatal hypoxic ischemic encephalopathy treated with wholebody hypothermia. The majority of the underlying pathologic events of hie are a result. In this article, we briefly present the epidemiology of neonatal encephalopathy due to hypoxicischemic injury, describe the rationale for the use of hypothermia therapy for. The hypoxic ischemic encephalopathy model of perinatal. Incidence and impact of hie hypoxic ischemic encephalopathy or perinatal asphyxia affects one to three per live births in the united states. Hypoxic ischemic encephalopathy is a clinical syndrome due to lack of perfusion and oxygen to the brain. Bates, md mghfc division of newborn medicine child neurology conference.
Neonatal requirements for brain cooling hypoxic ischemic. Perinatal hypoxic ischemic encephalopathy hie is an important cause of brain injury in the newborn and can result in longterm devastating consequences. Hie is a brain injury that prevents adequate blood flow to the infants brain occurring as a result of a hypoxic ischemic event during the prenatal, intrapartum or postnatal period. Hypoxicischaemic encephalopathy hie is a condition that occurs more commonly in term babies, but it may also be seen in premature babies. Encephalopathy is an acute intrapartum event sufficient to cause neuronal injury evidenced by. Therapeutic hypothermia reduces cerebral injury and improves the neurological outcome secondary to hypoxic ischemic encephalopathy in newborns.1267 334 107 112 28 1344 851 1403 404 787 417 1077 183 739 1440 312 150 1260 1222 1564 136 801 1160 595 347 1475 803 927 1294 455 1264 1064