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Hypoxic-Ischemic Encephalopathy (HIE)

Perinatal asphyxia, clinically known as Hypoxic-Ischemic Encephalopathy (or HIE), is a disorder caused by acute or sub-acute brain injury due to a lack of oxygen or blood flow to the brain during labor or delivery. The disorder can be acute or chronic, depending on the length of time the infant was deprived of oxygen or blood flow. It can also be characterized as regional or global, depending on the area of the brain affected. Perinatal asphyxia is responsible for a large number of fetal deaths and injuries every year.

The outcome of hypoxic-ischemic encephalopathy depends on different factors, including the severity of the injury, age of the child, availability of high-level care, as well as many others. Infants with severe hypoxic-ischemic injury may often be diagnosed with cerebral palsy within the first few years of life.

An infant who suffers from a hypoxic-ischemic insult that occurred during labor and delivery may show signs immediately after birth. Signs include, but are not limited to, a lack of crying or excessive crying, sleepiness, seizure activity, poor muscle tone, loss of reflex, difficulty breathing or maintaining temperature, immediate resuscitation, low APGAR scores, and irregular heart rate or blood pressure. Organ dysfunction and problems with vision or hearing are also common. Lab findings may include an acidic arterial cord blood gas reading below 7.2, anemia, and hyperbilirubinemia.

When blood flow to the brain is disrupted, a series of events is set in motion that results in cellular damage. There is a specific period of time that if blood flow is restored, the reintroduction of oxygen and blood flow into an abnormal environment triggers additional events that produce further brain damage. This paradoxical phenomenon is called reperfusion injury. Clinically, the infant may have a period of normal behavior before rapidly deteriorating.

An infant who has experienced hypoxic-ischemic injury will often undergo an MRI or CT scan to determine the extent of the injury. If the child shows seizure-like activity—such as fixed gaze, repetitive movements, or bicycling of the legs—an EEG will be performed to assess seizure activity. Treatment for the disorder includes maintaining adequate ventilation and blood perfusion, maintaining adequate fluids, phototherapy for jaundice, avoidance of hyper- and hypoglycemia, avoidance of fever (as this can increase reperfusion injury), treatment of seizures with anti-seizure medication, and, depending on the severity of the condition, a 72-hour head or body cooling protocol to help avoid secondary reperfusion injury.

If you believe your child has suffered a Hypoxic-Ischemic Encephalopathy (HIE) injury, our expert birth injury lawyers can help you.  Call us at 877-262-9767 to discuss your situation.

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