Hi, this is Tom, and in this episode, I'm going to be going through hypoxic ischemic encephalopathy,

and you can find notes at zero to finals.com slash h-I-E or in the zero-to-finals pediatrics book.

And you can find flashcards and questions at members.0.0.0.com.

So let's jump straight in. Hipoxic ischemic encephalopathy, or H-I-E, occurs in neonates as a result of

hypoxia during birth. Hypoxia is a lack of oxygen.

Ischemia refers to a restriction in blood flow to the tissues.

Encephalopathy refers to the malfunctioning of the brain.

Some hypoxia is normal during birth, however prolonged or severe hypoxia leads to ischemic brain injury.

H.I.e. may result in permanent neurological impairments, including cerebral palsy, developmental delays, cognitive deficits, or in severe cases, death.

Let's talk about the causes.

Anything that leads to asphyxia or deprivation of oxygen in the brain can cause hypoxic

ocemic ancphalopathy.

For example, maternal shock,

intrapartum hemorrhage, a prolapsed cord causing compression of the umbilical cord during birth, and nucal cord, which is where the cord is wrapped around the baby's neck.

Next let's talk about diagnosis.

Factors that suggest possible hypoxic ischemic encyclopathy include hypoxia during the perinatal or intrapartan period,

acidosis with a pH below 7 or a base deficit above 12 to 16

millimoles per litre on the umbilical artery blood gas, poor APGAR scores, for example, less than

five at 10 minutes of age, and features of hypoxic ischemic encephalopathy,

which will go through shortly.

An MRI scan and electroencephalography, or EEG, may be used to help establish the diagnosis.

Next let's go through the Sarnat staging system.

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