Hypoxic-ischemic encephalopathy

Abstract

Hypoxic-ischemic encephalopathy (HIE) or perinatal asphyxia occurs in one to three per thousand live births at term. The results of HIE are devastating and permanent, making it a great burden for the patient, family, and society. The neuropathological characteristics of perinatal asphyxia can vary considerably with the child's gestational age, the nature of the insult, vascular territories, and clinical management. The development of brain injury after hypoxic-ischemic insult is an evolutionary process initiated during the acute insult and extending to the reperfusion phase. Nowadays, therapeutic hypothermia is the intervention with better results. There is evidence from large randomized trials and meta-analysis demonstrating that induced hypothermia (33.5-34.5 °C), when started within the 6-h window after the birth of full-term asphyxiated newborns, is beneficial in reducing mortality and neurodevelopmental delay in the follow-up at 3-5 years of life.