Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode I'm going to be talking to you about hypoxic, ischemic encephalopathy.

And if you want to follow along with written notes on this topic, you can follow along at zero definals.com slash H-I-E

or in the neonatology section of the zero definals pediatrics book.

Let's get straight into it.

Ipoxic 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 the blood flow to the tissues,

and encephalopathy refers to malfunctioning of the brain.

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

Hypoxic ischemic encephalopathy can lead to permanent damage to the brain,

causing cerebral palsy,

and severe HIE can result in death.

You should suspect H.I.E. in neonates

when there are events that could lead to hypoxia during the perinatal

or intrapartum period, where there's acidosis with a pH of less than seven on the umbilical

artery blood gas, where there are poor APGAR scores, where there are features of mild, moderate

or severe HIE, which we'll talk about shortly, or where there are features of mild, moderate or severe H.I.E., which we'll talk about shortly,

or where there's evidence of multi-organ failure. Let's talk about the causes of H.I.E.

Anything that leads to asphyxia or deprivation of oxygen to the brain can cause H.I.E. For example,

maternal shock, intrapartum hemorrhage, a prolapsed cord with compression of the cord during birth,

and a nucal cord, which is where the cord is wrapped around the baby's neck. So let's talk about

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