When the brain is deprived of oxygen and nutrients, the resultant damage can be severe and permanent. HIE is one of the leading causes of cognitive impairment, physical disability, and death in infants. HIE is often the result of asphyxia during a traumatic birth. High-risk pregnancies and signs of maternal and fetal distress during labor should be monitored closely to minimize the risk of asphyxia. The following are possible causes of asphyxia:. Within minutes, brain cells are damaged and can no longer function. In severe asphyxia, cell death may occur. Depending on the gestational age of the infant and the severity of the asphyxia, varying degrees of brain damage occur. In premature newborns, the white matter of the brain is most often affected, a condition known as periventricular leukomalacia PVL.
What is HIE? - Hypoxic Ischemic Encephalopathy
Perinatal hypoxic-ischemic encephalopathy HIE is an important cause of brain injury in the newborn and can result in long-term devastating consequences. In the mammalian developing brain, ongoing research into pathophysiological mechanism of neuronal injury and therapeutic strategy after perinatal hypoxia is still limited. With the advent of promising therapy of hypothermia in HIE, this paper reviews the pathophysiology of HIE and the future potential neuroprotective strategies for clinical potential for hypoxia sufferers. Perinatal hypoxic-ischemic encephalopathy HIE occurs in one to three per live full-term births [ 1 ]. The outcomes of HIE are devastating and permanent, making it a major burden for the patient, the family, and society. It is critical to identify and develop therapeutic strategies to reduce brain injury in newborns with HIE. The underlying pathophysiology of perinatal HIE is difficult to study in the human, thus the neonatal rat model for HI brain injury has been developed to model this human condition. Much of what we know is derived from studies conducted in animal models. Rodents were the most frequently used animals in HIE research, followed by piglets and sheep [ 3 ].
Language: English French. While the number of survivors of term hypoxic-ischemic encephalopathy HIE is lower than the number of survivors of extreme prematurity, the proportion of neonates with long-term sequelae is higher. All neonates with Sarnat stages 2 moderate and 3 severe should be enrolled in follow-up programs. The present paper discusses the clinical and imaging diagnostic criteria for HIE, which are essential to decisions about follow-up. Prognostic indicators are also summarized. The recommendations for follow-up and intervention are based on the clinical condition of the baby at the time of discharge from intensive care, including an assessment of feeding, vision, hearing and whether seizures continue to be present. Early assessments at four to eight months focus on head growth, general health and motor neurodevelopment. Assessments at 12 to 24 months focus on cognitive skills and language development. Preschool assessments are also strongly recommended to provide for the identification of children requiring early education programs. Knowledge of long-term outcome and its secular changes enhance prognostication, and the evaluation of new preventive and therapeutic approaches.
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