What are physical findings characteristic of multiorgan dysfunction in hypoxic-ischemic encephalopathy (HIE)?

Updated: Jul 18, 2018
  • Author: Santina A Zanelli, MD; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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Multiorgan systems involvement is a hallmark of HIE. [33, 34]  Organ systems involved following a hypoxic-ischemic events include the following:

Heart (43-78%)

May present as reduced myocardial contractility, severe hypotension, passive cardiac dilatation, and tricuspid regurgitation.

Lungs (71-86%)

Patients may have severe pulmonary hypertension requiring assisted ventilation.

Renal (46-72%)

Renal failure presents as oliguria and, during recovery, as high-output tubular failure, leading to significant water and electrolyte imbalances.

Liver (80-85%)

Elevated liver function test results, hyperammonemia, and coagulopathy can be seen. This may suggest possible GI dysfunction. Poor peristalsis and delayed gastric emptying are common; necrotizing enterocolitis is rare. Intestinal injuries may not be apparent in the first few days of life or until feeds are initiated.

Hematologic (32-54%)

Disturbances include increased nucleated RBCs, neutropenia or neutrophilia, thrombocytopenia, and coagulopathy. Severely depressed respiratory and cardiac functions and signs of brainstem compression suggest a life-threatening rupture of the vein of Galen (ie, great cerebral vein) with a hematoma in the posterior cranial fossa.

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