Hypoxic Ischemic Encephalopathy: Diagnosis and Treatment

How is HIE diagnosed?

If the care team suspects your baby has HIE, your baby will have multiple physical exams to closely track brain function (how their brain works). The diagnosis of HIE is made primarily based on physical exam, along with the results of blood work and some details of the pregnancy and delivery. Additionally, if treated with cooling therapy, your baby will have a series of neuroimaging tests, including a head ultrasound (HUS) and magnetic resonance imaging (MRI). These neuroimaging tests use machines to create pictures of the brain. The purpose of these pictures is to check for brain injury, which can lead to developmental problems in the future.

How is HIE treated?

Therapeutic hypothermia (also known as cooling therapy) is used to treat HIE. For this treatment, the care team uses a cooling blanket and machine to lower your baby’s body temperature. This prevents further brain injury from occurring. Cooling therapy is very safe. It also works well for lessening the chance of developing disabilities or death from HIE.

There are certain criteria that make your baby eligible for the treatment:

• Newborns must be less than 6 hours of age and must have a gestational age greater than 36 weeks.
• Doctors must confirm that the signs/symptoms are due to encephalopathy (swelling or the brain) and that the baby is experiencing effects of hypoxia (low levels of oxygen).

Sometimes newborns who don’t meet these age criteria will still be considered for cooling treatment. This decision will be made by your baby’s care team, based on several factors.

If other organs were affected by low levels of oxygen, your baby may need other therapies or treatments during or after the cooling therapy. These may consist of ventilation (use of a breathing machine), medications for seizures and close monitoring of the heart and kidneys.

What will the outcome be for my baby with HIE?

The outcome of babies with HIE is variable, depending on the severity of the condition and whether a baby was treated with cooling therapy. It is important to remember that cooling therapy improves the chance of surviving HIE and living a life free from disability. Babies with HIE can live long and happy lives, but they can also experience physical and intellectual problems.

Some newborns with HIE may develop more serious impairments later in life, such as cerebral palsy, breathing problems and severe physical and intellectual disabilities.

Rev. 4/2022. MassGeneral for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.