How do you grade hypoxic ischemic encephalopathy?

How do you grade hypoxic ischemic encephalopathy?

There are various HIE scoring systems [7–10]. In scoring system described below, a score of 0 is normal and a maximum score is 22 which signifies the worst possible status of HIE. Infants scoring 1–10 are considered to have mild HIE, 11–14 have moderate HIE and 15–22 are considered to have severe HIE.

What is HIE grading?

HIE is graded (i.e., mild, moderate or severe) by clinical examination (Sarnat staging or Thompson score) [8, 9]. The clinical HIE grade combined with other measures, e.g., electroencephalogram (EEG) and neuroimaging, are used for estimating the severity and the risk of adverse neurodevelopmental outcome [10,11,12,13].

How is hypoxic ischemic encephalopathy treated?

At present, there is no true cure for hypoxic-ischemic encephalopathy (HIE). However there is one treatment, called therapeutic hypothermia, that can reduce the extent of permanent brain damage if given very shortly after birth or the oxygen-depriving incident.

What is severe hypoxic ischemic?

Hypoxic ischemic encephalopathy (HIE) is a type of brain dysfunction that occurs when the brain doesn’t receive enough oxygen or blood flow for a period of time. Hypoxic means not enough oxygen; ischemic means not enough blood flow; and encephalopathy means brain disorder.

What is sarnat scale?

In medicine Sarnat staging, Sarnat Classification or the Sarnat Grading Scale is a classification scale for hypoxic-ischaemic encephalopathy of the newborn (HIE), a syndrome caused by a lack of adequate oxygenation around the time of birth which manifests as altered consciousness, altered muscle tone, and seizures.

Which exams should be included in the workup of hypoxic-ischemic encephalopathy?

Brain magnetic resonance imaging (MRI) MRI is the imaging modality of choice for the diagnosis and follow-up of infants with moderate-to-severe hypoxic-ischemic encephalopathy (HIE).

What are the signs and symptoms of hypoxic-ischemic encephalopathy?

Some signs and symptoms of HIE during this period include:

• Premature birth.
• Organ damage or failure.
• Very acidic umbilical cord blood (also known as acidemia)
• Seizures.
• Comatose state.
• Unusually responses to light or lack thereof.
• Feeding problems.
• Extreme lethargy.

What is mild hypoxic-ischemic encephalopathy?

Hypoxic-ischemic encephalopathy (HIE) is a type of newborn brain damage caused by oxygen deprivation and limited blood flow. HIE is a type of birth injury; this is a broad term used to refer to any harm that a baby experiences at or near the time of birth.

What is Thomson score?

The HIE score (Thompson score) is a clinical tool comprising of a set of clinical signs associated with CNS dysfunction. It is used to assess status of a child following birth asphyxia [10–13]. In the scoring system, a score of 0 is normal and the maximum score is 22 which signifies the worst possible status of HIE.

What is Downe score?

Downes score is used as an alternative. to evaluate clinical respiratory distress if blood gas analysis. instrument or pulse oxymetry is not available. Objective To evaluate the validity of Downes score for assessing. hypoxemia in neonates with clinical respiratory distress.

How is HIE detected?

MRI is the best imaging method for diagnosing moderate to severe HIE. MRIs can be performed as early as 12-24 hours after birth. They accurately show injury patterns as early as 1 day after birth (sometimes sooner) and are especially useful after day 4.

Who is at risk for hypoxic-ischemic encephalopathy?

Multiples pregnancy (twins, triplets, or more) Autoimmune disorders. Use of tobacco or alcohol during pregnancy. A mother who is under 20 or over 35.

Can the brain heal itself after lack of oxygen?

Without oxygen, brain cells die, and a brain injury can occur. It can happen even when enough blood reaches the brain, such as when you breathe in smoke or carbon monoxide. Treatments can help people who have brain injuries from cerebral hypoxia. But no one can bring back dead brain cells or reverse a brain injury.

Does HIE show on MRI?

MRI allows to reveal a number of lesions associated with HIE that are invisible on the ultrasound scans (i.e. cortico-subcortical lesions within the central region, bilateral parasagittal lesions and brain stem, thalamus, cerebellum and hippocampus lesions).

How is mild HIE diagnosed?

Doctors use imaging tests like MRIs that look for areas of damage in the brain. Doctors also look at the pH of a sample of umbilical cord artery blood. If it is less than seven, this supports a diagnosis of HIE.

Does mild HIE go away?

Most babies with mild HIE recover quickly. If your baby has mild HIE, doctors will monitor them closely to check that they are stable and do not need any more treatment. If your baby has moderate to severe HIE, there is a risk of death or long-lasting damage to the brain.

What is HIE medical?

Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care.