• Hypoxic Ischemic Encephalopathy

    (Cerebral Hypoxia; HIE)


    Hypoxic ischemic encephalopathy (HIE) is a condition in which the brain does not receive enough oxygen.
    HIE can be fatal. Brain cells can begin dying after 4 minutes without oxygen.
    Blood Supply to the Brain
    Copyright © Nucleus Medical Media, Inc.


    There are a variety of causes of HIE. Any injury and many health conditions can cause a lack of oxygen to the brain. Some common causes are:

    Risk Factors

    Any injury, complication, or condition that causes the brain to have a reduction in blood flow and oxygen is a risk factor for HIE.


    Symptoms include:
      Mild case:
      • Difficulty paying attention
      • Poor judgment
      • Poor coordination
      • Intense emotions
      • Extreme drowsiness
      Severe oxygen deprivation:
      • Seizures
      • Loss of consciousness
      • Blue-colored skin or lips
      • Difficulty breathing


    A physical exam will be done. Typically, the history is the most important factor in making the diagnosis.
    Your bodily fluids may need to be tested. This can be done with blood tests.
    Images may need to be taken of your bodily structures. This can be done with:
    Your heart and brain activity may be tested. This can be done with:


    Treatment depends on the underlying cause of the condition, as well as the severity of the damage to the brain. Treatment options include:
    • Life-sustaining treatment—If brain function has stopped, but damage is not yet extensive, life-sustaining treatment is given.
    • Mechanical ventilation —This may be used if you are unable to breathe without assistance.
    • Treatments for the circulatory system—Treatments are given to maintain heart function and control blood pressure.
    • Seizure control—Medication and general anesthesia may be given to control seizures.
    • Cooling—Hypoxic brain damage is often caused by heat. Cooling blankets or other means of cooling may be applied to reduce the body's temperature.
    • Hyperbaric oxygen treatment —This treatment is used in cases of carbon monoxide poisoning.


    In most cases, HIE is sudden and cannot be prevented. CPR may be given to prevent significant or long-term brain damage after the oxygen supply has been reduced.


    Brain Injury Association of America http://www.biausa.org

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov


    Health Canada http://www.hc-sc.gc.ca

    Ontario Brain Injury Association http://www.obia.on.ca


    Hypoxic ischemic encephalopathy (HIE). Neurographics website. Available at: http://www.asnr.org/neurographics/2/1/1/4.shtml. Accessed August 1, 2013.

    Itoo BA, Al-Hawsawi ZM, Khan AH. Hypoxic ischemic encephalopathy. Incidence and risk factors in North Western Saudi Arabia. Saudi Medical Journal. 2003;24(2):147-153.

    MacDonald S. Brain injury secondary to carotid intervention. J Endovasc Ther. 2007;14(2):219-231.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.