[Hypoxic-ischemic syndrome]

OBJECTIVE: To review the literature on the hypoxic-ischemic syndrome, emphasizing its physiopathology, clinical manifestations, and treatment. SOURCES: Electronic search in the Medline and LILACS databases, with selection of the most relevant articles. SUMMARY OF THE FINDINGS: The hypoxic-ischemic syndrome is a multisystem disease with generalized manifestations. The physiopathology is based on hypoxic-ischemic brain injury and reperfusion with cellular injury caused by failure of ATP production secondary to ischemia, and overproduction of oxidative substances caused by reperfusion. Neurological, cardiovascular, respiratory, metabolic, gastrointestinal, renal, and hematological manifestations are frequent. Multisystem clinical management is complex; the neuroprotective approach is still experimental; and the prognosis is not good for those patients with severe hypoxic-ischemic encephalopathy. CONCLUSIONS: The management of the hypoxic-ischemic syndrome is a great challenge to pediatricians., since treatment requires multisystem intervention.