Hypoxic Ischemic Encephalopathy FAQ

Q: Birth injury attorney Jesse Reiter answers a frequently asked question: What is hypoxic ischemic encephalopathy (HIE) and what is the treatment for it?

A: Hypoxic Ischemic Encephalopathy (HIE), sometimes called birth asphyxia, occurs when babies are deprived of oxygen during labor and delivery and cell death and damage within the brain and spinal cord results. Hypoxic ischemic encephalopathyThe deprivation is due to a lack of oxygen in the baby's blood (hypoxemia) and tissue (hypoxia) and restricted blood supply (ischemia) to the brain. Mental and physical disabilities are likely. The extent and severity of the damage depends on the length of time that the baby was deprived of oxygen. Generally speaking, the longer an infant goes without oxygen, or with decreased oxygen, the more severe and permanent the injury will be.

Some of the long-term disabilities that can occur as result of HIE include: cerebral palsy, intellectual disabilities, seizures, blindness, hearing loss, and developmental and learning disabilities.

Treatments for HIE

Traditionally, the treatment of HIE has been supportive care. This included conventional measures like: 

  • resuscitation at birth.
  • mechanical ventilation- a machine that temporarily helps the baby to breath and controls the oxygen and carbon dioxide levels within the baby's blood.
  • treatments for the circulatory system, heart function, and the control of blood pressure to ensure that the flow of blood to the vessels in the baby's brain (perfusion) is maintained.
  • control of seizures through anti-seizure medications.
  • NICU care and care from specialty physicians.

The goal traditionally, was to allow the baby’s body and brain to repair itself. Recently, however, a new therapy called hypothermia, or brain cooling, has been introduced. Used specifically for HIE, it has shown to improve the outcome of HIE babies by reducing the severity of neurological injury.

Hypothermia treatments show promising results

Hypothermia treatmentIn brain cooling therapy, a cooling cap is applied to the baby’s head and/or the baby is laid on a cooling mat. A machine circulates cold water through the cap and mat in order to cool the baby to around 91 degrees F. This is done for 72 hours and then the infant is warmed back to normal temperature. By lowering the baby’s temperature, the metabolic rate slows allowing cell recovery over a longer period of time, avoiding further damage that can occur if normal oxygenation or blood flow is restored too quickly to injured cells.

Timing is very important when using this hypothermia treatment. The most favorable outcomes are seen when brain cooling is started as soon as possible after the birth injury occurs, preferably within 6 hours of birth. It also requires that the newborn is at least 36 weeks gestation.

Call the experts for help

The attorneys at Reiter & Walsh ABC Law Centers are leaders in the field of birth injury law. We are recognized for our compassionate yet aggressive representation of HIE-injured children. If your child was diagnosed with HIE at birth and is now physically or mentally disabled, or if doctors failed to offer hypothermia treatments to your HIE child at birth, please call us at (888) 419-BABY. We will evaluate your case for free and never charge a fee unless we win your case.

By: Jesse Reiter