Hypoxic-Ischemic Encephalopathy (HIE) Clinical Pathway, ICU – Initiate Neuroprotective Care

Hypoxic-Ischemic Encephalopathy (HIE) Clinical Pathway — ICU

Initiate Neuroprotective Care

Temperature Management by Gestational Age
  • 35-35 6/7 wks:
    • Active body temperature management to 37°C using Arctic Sun
    • Turn off radiant warmer
  • ≥ 36 wks:
    • Active body temperature management to 33.5°C using Arctic Sun
    • Turn off radiant warmer
Temperature Probe
  • Insert esophageal temperature probe, confirm placement with chest X-ray
    • Place at the level of the lower third of the esophagus
  • Note: Temperature probe must be removed prior to MRI
Neuro Monitoring
  • cEEG (or aEEG when cEEG is not available)
  • Neurology consult
Vital Signs
Temperature (esophageal and axillary)
HR, RR, BP, Pulse Ox
  • Obtain esophageal and water temperatures at following intervals:
    • Every 15 mins for first 4 hrs
    • Every hour for hours 4-12
    • Then every 2 hrs during cooling
  • Obtain axillary temperatures every 4 hrs
Medications Neonatal Seizure/Status Epilepticus Clinical Pathway
Additional Care Turn neonate every 1-2 hrs and document skin condition
Nutrition Trophic feedings while cooling in an infant with resolved acidosis are at discretion of treating physician