Hypoxic-Ischemic Encephalopathy (HIE): A Review for the Bedside Nurse of a Complex Clinical Problem

Hypoxic-ischemic encephalopathy (HIE) is a potentially devastating complication related to events in the prenatal and/or intrapartum period that lead to a depressed infant, or worse, a stillbirth. Prompt recognition of risk factors for HIE is required, followed by rapid delivery of the infant to ensure an optimal outcome. Clinical indicators can be applied to determine which infants are at risk of compromised long-term developmental outcomes and are helpful in guiding bedside care. Cooling is the standard of care when complications from HIE are expected, but it has not eliminated the sequelae in all cases. Novel adjuncts to cooling are being developed, with a common theme of neuroprotection. This article will focus on key aspects of clinical care that are important for the bedside nurse to recognize and understand, and will present information on the current standard of care, as well as provide insight into future directions that are currently under investigation.