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In the previous section, we talked about the Diagnosing Hypoxic-Ischemic Encephalopathy, or HIE. In this section, we will continue with covering prognosis and life expectancy for people who are affected by HIE and related conditions like Cerebral Palsy.

This information has been compiled from government sources, medical sources, and from consulting with experts on HIE.

Keep reading to learn more about prognosis and life expectancy for HIE.

What is the prognosis for HIE?

In some cases, the prognosis for HIE can start to take shape during the pregnancy itself. Doctors can pick up fetal distress signals and get an idea of the extent and cause of brain damage. However, some cases of HIE are not diagnosed until immediately after the child is born.

There are two main ways to decide the prognosis of a child with HIE after they have been born. These include Sarnat Staging and the APGAR Score.

Getting help for a child with HIE or Cerebral Palsy
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Because early intervention is often key to helping improve a child’s wellbeing, it’s important to act swiftly. At the Brown Trial Firm, our Houston birth injury attorneys can help you investigate your case, find answers to your questions, and determine whether you are entitled to compensation. We offer case reviews at no cost or obligation. Many birth injuries that cause cerebral palsy could have been prevented.

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Sarnat Staging

As we covered in our section on Diagnosing HIE, Sarnat Staging is a method of classification used specifically to diagnose HIE. There are three levels to this staging process— Grade I Mild, Grade II Moderate, and Grade III Severe. The components assessed with this tool include alertness, condition of muscles, presence of seizures, vision response, breathing ability, and the overall duration of symptoms.

In terms of prognosis, some children that classify as Grade I Mild sometimes deal with very mild symptoms that do not affect their life. Children with Grade III Severe symptoms may have to deal with lifelong disabilities.

The APGAR Score

The APGAR Score is similar to Sarnat Scale with some key differences. The APGAR process is usually administered in normal and healthy births in addition to complicated births. This is done to evaluate the condition of the child and to assess any cause for treatment.

APGAR is an acronym that stands for Appearance, Pulse, Grimace, Activity, and Respiration. The skin condition of the child is assessed along with heart rate, reflexes, tone of the muscles, and respiratory ability. In general, a low score coupled with more than five minutes without symptom resolution can help lead to an HIE diagnosis. It is worth noting that an APGAR score on its own cannot properly determine HIE.


HIE recovery stories

The journey for families facing HIE can be filled with uncertainty and fear, but with advancements in medical treatment and the support of dedicated health care professionals, many children are able to overcome these challenges and thrive.

Below are some inspiring stories of children who have recovered from HIE, showcasing their resilience and the incredible progress they’ve made.

From life-saving interventions to ongoing therapies, these stories highlight the strength of these young patients and their families, offering hope and encouragement to others navigating similar paths.

Kiley’s story

Tashia Martina and Kevin Hampton’s first child, Kiley, was born on February 12, 2011, at Tallahassee Memorial Hospital. Initially, the pregnancy and delivery seemed normal until Kiley’s heart rate began to drop, prompting an emergency cesarean section (C-section).

Born without a heartbeat and with hypoxic-ischemic encephalopathy (HIE), Kiley was immediately taken to pediatric critical care and later flown to the University of Florida, where she could receive systemic hypothermia treatment.

Despite the intense worry her parents experienced during the cooling and rewarming process, Kiley began to show progress, even starting to suck on her pacifier at six days old.

Fortunately, Martina and Hampton were able to stay close to their daughter during her treatment and were overjoyed to bring Kiley home about a week after delivery, where she continues to thrive and meet milestones.

Avery’s story

Like Tashia Martina, Michelle Bullard’s labor took a terrifying turn when her baby’s heart rate plummeted during contractions, leading to an emergency C-section.

Born with an APGAR score of 1 and diagnosed with hypoxic-ischemic encephalopathy (HIE), Avery was quickly transported to Children’s National Health System for whole-body therapeutic cooling to reduce the risk of long-term brain injury.

The initial uncertainty was overwhelming, but after 72 hours of cooling treatment, Avery began to show signs of improvement, transitioning from a critical condition to a more stable state.

Despite early challenges, Avery’s recovery has been remarkable, and she continues to thrive, supported by a multidisciplinary care team that provides therapies to aid her development. Avery, who once struggled with seizures and delayed milestones, is now a vibrant and active child, even participating in races with her family.

Her journey, filled with uncertainty and fear, turned into a story of resilience and hope, exemplifying the transformative power of therapeutic cooling and dedicated medical care.

Weston’s story

Weston Joujoute’s life also began with an emergency C-section at 39 weeks after his mother, Kiera, noticed reduced fetal movement. Weston wasn’t breathing at birth, and doctors were unsure how this oxygen deprivation might impact his brain.

He was immediately transferred to the NICU at MassGeneral for Children, where, like Kiley and Avery, he underwent therapeutic hypothermia. For three days, his body was cooled to 91°F to minimize brain damage while he was on a ventilator with EEG leads monitoring his brain activity.

After the cooling treatment, an MRI revealed no brain damage, much to the relief of his parents and doctors. However, despite the positive MRI results, Weston required significant support to recover from the stiffness and swelling caused by the hypothermia treatment, which included extensive occupational therapy, but he went on to meet his developmental milestones and is thriving.

 

Prognosis Outcomes

The long term outcomes of children with HIE can vary. The possible outcomes depend on a handful of key factors, including:

  • The extent of the birth injury
  • How long the baby was deprived of oxygen
  • The condition of the baby during pregnancy before HIE occurred
  • How quickly care was administered
  • When the HIE diagnosis was made
  • What part of the brain was damaged
  • How quickly therapeutic hypothermia was administered
  • The extent of medical and therapeutic care the child receives post-diagnosis

In some cases, children with HIE can live long and enjoyable lives with mild to moderate physical or intellectual disabilities.

Some disorders and conditions that can stem later in life from HIE include:

  • Cerebral Palsy (though it is worth noting that HIE is not the sole cause of CP)
  • Seizures
  • Developmental disabilities
  • Learning disabilities
  • Cognitive disabilities
  • Physical disabilities
  • Intellectual disabilities
  • Feeding and nutritional problems
  • Mental health illnesses
  • Chronic pain
  • Breathing problems
  • Skin problems
 

The only way to be sure of what conditions your child may have as a result of HIE is to visit a medical professional for a full diagnosis.

What is the Life Expectancy for Someone with HIE?

The life expectancy of someone with HIE can be difficult to calculate. Symptoms and the severity of HIE varies quite a bit. In some cases, infants with moderate or mild HIE injuries can heal during the first few days after birth when carefully treated by medical professionals.

In some cases, however, severe HIE and undiagnosed HIE can become increasingly dangerous. This is because when brain cells are killed due to oxygen deprivation, those cells release toxic matter. That toxic matter can “infect” and damage other healthy cells in the brain. Unless a baby with a birth injury is quickly treated with therapeutic hypothermia, the damage from HIE could potentially be life-threatening.

Children with HIE who are diagnosed later in their first year of life can be treated to improve their quality of life. With all these factors put together, the life expectancy for someone with HIE can range drastically from a few hours to a full long typical life. However, most infants with mild to moderate HIE tend to survive and do not develop lifelong effects.

Sources:

Allen, K., & Brandon, D. (2011). Hypoxic Ischemic Encephalopathy: Pathophysiology and Experimental Treatments. Newborn And Infant Nursing Reviews, 11(3), 125-133. doi:10.1053/j.nainr.2011.07.004

UpToDate. (2019). Uptodate.com. Retrieved 18 November 2019, from https://www.uptodate.com/contents/clinical-features-diagnosis-and-treatment-of-neonatal-encephalopathy

Help for Children with HIE – Brown Trial Firm. (2019). Brown Trial Firm. Retrieved 18 November 2019, from https://browntrialfirm.com/hypoxic-ischemic-encephalopathy-hie/

Long Term Prognostic of Neonatal Hypoxic Ischemic Encephalopathy With Hypothermia Treatment – Full Text View – ClinicalTrials.gov. (2019). Clinicaltrials.gov. Retrieved 18 November 2019, from https://clinicaltrials.gov/ct2/show/NCT02676063

Heinz, U., & Rollnik, J. (2015). Outcome and prognosis of hypoxic brain damage patients undergoing neurological early rehabilitation. BMC Research Notes, 8(1). doi:10.1186/s13104-015-1175-z

What is the prognosis of hypoxic-ischemic encephalopathy (HIE)?. (2019). Medscape.com. Retrieved 18 November 2019, from https://www.medscape.com/answers/973501-106462/what-is-the-prognosis-of-hypoxic-ischemic-encephalopathy-hie

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