Loading icon
Press enter or spacebar to select a desired language.
Health Information Center

Hypoxic Ischemic Encephalopathy

  • Cynthia M. Johnson, MA
Publication Type:


Hypoxic Ischemic Encephalopathy

(Cerebral Hypoxia; HIE)


Hypoxic ischemic encephalopathy (HIE) is a brain injury. It happens when the brain does not get enough oxygen.

HIE can be deadly. Brain cells start to die after 4 minutes without oxygen.

Blood Supply to the Brain.

http://services.epnet.com/getimage.aspx?imageiid=25702570si55551215.jpgBlood Supply to the BrainNULLjpgBlood Supply to the BrainNULL\\filer01\Intellect\images\si55551215.jpgCopyright © 2002 Nucleus Communications, Inc. All rights reserved.24NULL2002-10-01255391Copyright © Nucleus Medical Media, Inc.


Many health problems can cause a lack of oxygen to the brain. Some common ones are:

  • Cardiac arrest
  • Blocked or ruptured blood vessel
  • A blocked airway due to:
    • Swelling, such as from an allergic reaction
    • Trauma
    • Drug use and drug overdose
    • Drowning
    • Choking
  • Carbon monoxide poisoning

Risk Factors

The risk of HIE is higher in people who have an injury or health problem that causes the brain to have a drop in blood flow and oxygen.


A person with HIE may have:

  • Clumsiness
  • Problems with focus or trouble making decisions
  • Mood swings
  • Fatigue
  • Signs of seizures, such as confusion and muscle jerking
  • Loss of alertness
  • Blue-colored skin or lips
  • Problems breathing


The doctor will ask about symptoms and health history. A physical exam will be done.

Blood tests may be done.

Images may need to be taken of the brain and body. This can be done with:

The brain and spinal cord may be tested. This can be done with:

Heart function may also be tested.


The goal of treatment is to get oxygen to the brain to prevent more damage. How this is done depends on why oxygen is not getting to the brain.

Some things the doctor may do are:

  • Treatments like CPR to get blood and oxygen flowing to the brain again.
  • Using cooling blankets or other means of cooling to lower the body's temperature.
  • Using cooling and rewarming methods.


HIEs cannot be prevented.





  • Busl, K.M. and Greer, D.M. Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation, 2010; 26 (1): 5-13.
  • Hypoxic-ischemic brain injury in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypoxic-ischemic-brain-injury-in-adults.
  • Hypoxic ischemic encephalopathy (HIE).UFHealth website. Available at: https://ufhealth.org/hypoxic-ischemic-encephalopathy-hie.


  • Rimas Lukas, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.