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Hypoxic Ischemic Encephalopathy - Oren Zarif - Hypoxic Ischemic Encephalopathy


Hypoxic ischemic encephalopathy, or HIE, is a rare condition that affects the brain. It is diagnosed by MRIs or new techniques, such as diffusion-weighted imaging or MR spectroscopy. Although the incidence of HIE is low, the symptoms and prognosis of survivors can vary widely. Children may exhibit cognitive impairment, epilepsy, or motor delays. There are no conclusive causes of HIE, although symptoms can be present shortly after birth, including fetal death or premature delivery.

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Infants can develop HIE for various reasons, including birth asphyxia. The causes are numerous, and the exact nature of the condition is not yet fully understood. However, there are antecedents such as prematurity, lung disease, and uterine rupture. Other causes of HIE include severe brain trauma, severe prematurity, and congenital malformations. In some cases, the baby may need respiratory support even after delivery.

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Hypoxic ischemic encephalopathy (HIE) is a devastating complication of birth, with mortality rates between one and eight per thousand live births in developed countries. Although most patients recover from HIE with supportive medical care, there are two distinct periods of neurodegeneration. One period occurs in the early days after the occurrence of HIE, which provides a therapeutic window. Hypothermia may be useful during the secondary injury period.

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In a full-term infant, hypoxic ischemic encephalopathic brain damage is typically mild or moderate. The severity of the damage depends on the duration of oxygen deprivation and the area of the brain affected. While the severity of HIE differs between infants, it can be deadly. A newborn should be monitored closely following birth and should be immediately placed under the care of a medical professional.

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Perinatal encephalopathy occurs when blood and oxygen are cut off during childbirth. As many as three out of every thousand deliveries end in childbirth, this condition is extremely serious and is one of the leading causes of infant mortality in the U.S. each year. While many cases are mild, severe perinatal encephalopathy can lead to permanent disability. In some cases, there is no known cause for the condition, but it is a definite risk.

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Recent research has shown that HRV is a good biomarker for the severity of hypoxic ischemic encephalopathic brain injury. However, current evidence on HRV is heterogeneous and further research is needed to guide future studies. This study aimed to review the existing evidence on HIE and HRV. Although HIE is a relatively rare disorder, it is important to diagnose it early to improve survival.

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Early diagnosis of HIE can be challenging, especially in preterm infants. This condition is typically diagnosed through a neurological exam and brain imaging. In addition to neuroimaging findings, brain imaging is also important for determining the severity of hypoxic-ischemic encephalopathy. The diagnosis of HIE in preterm infants should be based on the severity of the hypoxia and how long it has lasted.

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The pathophysiology of HIE has improved considerably in recent years, and treatment is based on hypothermia. Other neuroprotective agents are entering clinical trials. The first priority in assessing HIE in newborns is to determine whether the underlying cause is HIE or not. In severe cases, therapy may need to be tailored to the severity of the condition. Once diagnosis is determined, the newborn should be transferred to an intensive care nursery for observation and treatment.

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