Hypoxic-Ischemic Encephalopathy

Hypoxia is generally characterized as a partial or complete reduction of oxygen in the tissue or major organ systems of the body. Decreased oxygen in the bloodstream is sometimes referred to as hypoxemia.

Ischemia is generally defined as a reduction or the complete cessation of blood flow to the body’s tissue or major organ systems.

Hypoxic-ischemic encephalopathy refers to a constellation of neurological abnormalities exhibited during the early days of life by a baby who has suffered a hypoxic or ischemic injury at or near the time of delivery.

It is generally believed that the extent and severity of a hypoxic-ischemic brain injury is related to several factors, including the severity and duration of the hypoxic event and the gestational age of the baby at the time of the hypoxic or ischemic injury.

Many researchers believe that the pattern of brain injury, as revealed on neonatal neuroradiology, is directly related to the extent and duration to the injurious hypoxic event. In other words, in those cases where the hypoxic event is acute and severe, certain distinct areas of the brain will be injured. On the other hand, if the hypoxic event is partial and prolonged over a longer period of time, different areas of the brain will typically be injured. In many cases, however, those babies who have suffered the most severe hypoxic-ischemic insults will have diffuse damage to all areas of the brain.

Hypoxic-ischemic encephalopathy during the neonatal period is typically characterized by abnormalities in the baby’s tone and reflexes. Many babies will have abnormal levels of consciousness and may be characterized as being in a “coma.”

Frequently, babies with the most severe forms of hypoxic-ischemic encephalopathy will suffer seizures sometime during the neonatal period.

Depending upon the nature of the hypoxic-ischemic injurious event, a baby with hypoxic-ischemic encephalopathy may also exhibit injuries to other organ systems. Thus, many babies who have suffered hypoxic-ischemic events sufficient to cause hypoxic-ischemic encephalopathy will also exhibit respiratory difficulties and many will have cardiac, renal, gastrointestinal or hepatic dysfunction.

Severe neonatal hypoxic-ischemic encephalopathy is typically associated with a very poor outcome. The brains of those babies suffering from severe hypoxic-ischemic encephalopathy typically do not develop normally, resulting in a condition called microcephaly.

Many babies who suffer severe hypoxic-ischemic encephalopathy will go on to develop cerebral palsy and suffer from varying degrees of mental retardation.

Severe permanent neurologic injuries associated with hypoxic-ischemic encephalopathy may also result in feeding or swallowing dysfunction, thereby requiring the use of direct gastrointestinal tube feeding to provide the injured baby with nourishment.

Many babies who suffer severe hypoxic-ischemic encephalopathy will develop a continuing seizure disorder, thereby requiring the long-term use of antiseizure medications.

Unfortunately, there is no real treatment or “cure” for hypoxic-ischemic encephalopathy. Thus, most careful and safe health care providers appreciate that the best “treatment” for hypoxic-ischemic encephalopathy is to prevent those conditions which are associated with the development of hypoxic-ischemic encephalopathy in the first place.

Safe and careful obstetricians and obstetrical nurses will promptly respond to any evidence of fetal hypoxia which, in many instances, will require the prompt delivery of the baby by cesarean section.

Unfortunately, in many cases, prolonged fetal hypoxia caused by a delay in delivery can directly lead to hypoxic-ischemic encephalopathy.

The Law Firm of Dugan, Babij, Tolley & Kohler, LLC has extensive experience in representing families whose loved ones have died or been injured as a result of medical malpractice resulting in hypoxic-ischemic encephalopathy.

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