Will mild hypoxic encephalopathy in newborns heal on its own?

For newborns, if hypoxic encephalopathy occurs due to some reasons, the specific impact depends on the child's reaction. If the child's reaction is good and the feeding is good, then after some active treatment and conditioning, and the use of some brain cell nourishing drugs, etc., the prognosis is generally good. He will be the same as other children and will not have his own problems. Of course, if the hypoxia is severe, it will be more difficult to treat.

The purpose of treatment is to improve the metabolic function of damaged neurons as much as possible and maintain the stability of the internal environment. At the same time, special treatments such as controlling convulsions, reducing cerebral edema, and improving cerebral blood flow and brain cell metabolism should be provided.

1. General treatment:

①Correct hypoxemia and hypercapnia, use artificial respirator if necessary ②Correct hypotension: ensure adequate cerebral blood perfusion, commonly use dopamine 5-10μg/kg intravenous drip per minute ③Supply enough glucose to meet the energy metabolism needs of brain tissue: can be given at 6-8mg/kg per minute ④Correct metabolic acidosis: sodium bicarbonate 2-3mEg/kg 10% glucose diluted and slowly dripped intravenously ⑤When blood calcium is lower than 1.9mmol/L, intravenous calcium gluconate can be used ⑥Appropriately limit fluid intake: daily amount 50-60ml/kg infusion rate within 4ml/kg/h

(ii) Control of convulsions:

Phenobarbital sodium is the first choice. The first dose is 15-20 mg/kg. If the seizure does not stop, 5 mg/kg can be added 1-2 times with an interval of 5-10 minutes. The total load is 25-30 mg/kg. Starting from the second day, the maintenance dose is 4-5 mg/kg per day (one or two intravenous injections). It is best to monitor the blood drug concentration and stop using it one week after the seizure stops. If seizures occur frequently, diazepam or chloral hydrate can be added.

(III) Controlling increased intracranial pressure:

Use dexamethasone 0.5mg/kg and furosemide 1mg/kg intravenously for 4-6 hours, then repeat the application after 2-3 times. If the intracranial pressure is still high, switch to mannitol 0.25-0.5g/kg intravenously for 4-6 hours at intervals. Try to significantly reduce the intracranial pressure within 48-72 hours.

(IV) Central nervous system stimulants, etc.

Cytochrome C triphosphate uridine coenzyme A and other drugs can be used for daily intravenous drip until the symptoms are significantly improved; 100-125 mg/day of cytidine diphosphate can also be used for intravenous drip, starting from the second day after birth; 5 ml of cerebrolysin diluted with normal saline can be used for intravenous drip to improve brain tissue metabolism. Treatment must be continued until the symptoms disappear completely. Moderate HIE should be treated for 10-14 days, and severe HIE should be treated for 14-21 days or longer. The earlier the treatment starts, the better. Generally, treatment should be started within 24 hours after birth, and various pathological factors after birth should be avoided as much as possible to aggravate brain damage. Seven prognosis Some factors leading to poor prognosis include: ① severe HIE; ② the appearance of brainstem symptoms: such as changes in pupils and breathing; ③ frequent convulsions that cannot be controlled by drugs, and the symptoms have not disappeared after one week of treatment; ④ after two weeks of treatment, the EEG still has moderate or above changes; ⑤ brain B-ultrasound and brain CT show grade III-IV intraventricular hemorrhage, large area of ​​hypoxic-ischemic changes in brain parenchyma, especially those with cystic cavities after 1-2 weeks.