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Rajvir Jawanda Death: Punjabi singer Rajvir Jawanda passed away on Wednesday, October 8, after battling with life on the ventilator for the past 11 days following his major road accident in Himachal Pradesh. The 35-year-old Punjabi singer had suffered severe head and spinal injuries in a road accident near Baddi, Himachal Pradesh, on September 27, when his motorcycle collided with stray cattle that suddenly appeared on the road. According to his doctors, Jawanda’s neurological condition remained critical, with minimal brain activity and no significant improvement despite intensive medical care. Doctors described his condition to be “extremely critical” soon after the accident and he had been on life support since admission at the hospital. Rajvir Jawanda, who was married and had two young children, succumbed to his injuries in Mohali, Punjab. Reportedly, Punjabi Singer Rajvir Jawanda died after hypoxic changes to his brain. Here’s everything you need to know about Hypoxic-ischemic encephalopathy (HIE) or hypoxic changes to the brain.

What Is Hypoxic-Ischemic Encephalopathy (HIE)?

Hypoxic-ischemic encephalopathy (HIE) is a brain injury that occurs when the brain doesn’t get enough blood and oxygen. This can permanently change how the brain functions. This usually affects newborns who had a difficult birth, but it can also affect older children and adults who experience severe respiratory distress, like drowning or any accidental injury.

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HIE is a life-threatening condition and calls for immediate medical emergency. The most common clinical presentations include disorders of consciousness (e.g. coma or vegetative state), seizures and myoclonus.

Causes Of Hypoxic-Ischemic Encephalopathy (HIE)

The most common cause of HIE is cardiac arrest, which is commonly secondary to cardiac etiologies such as infarction or arrhythmia. Other causes of cardiac arrest include respiratory, neurological and metabolic conditions as well as trauma, intoxication and environmental exposure.

Asphyxia is classically defined as the mechanical disruption of airflow, resulting in hypoxia and hypercapnea with subsequent cardiac arrest and death. This term usually encompasses hanging, drowning, strangulation, suffocation and choking.

The various causes of HIE share an overall common pathophysiologic mechanism where the global brain injury is a result of a lack of oxygen and glucose supply. Brain injury in primary cardiac arrest results from a sudden reduction or cessation of blood flow that is followed by hypoxemia as respiratory failure sets in.

Symptoms Of Hypoxic-Ischemic Encephalopathy (HIE)

The predominant presenting clinical features of HIE are alteration of consciousness, most commonly a comatose state, in addition to cardiovascular instability, respiratory insufficiency and loss of protective airway reflexes.

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Treatment Of Hypoxic-Ischemic Encephalopathy (HIE)

After successful resuscitation with return of spontaneous circulation (ROSC) per ACLS guidelines, patients who remain unresponsive and are presumed to have HIE should be rapidly evaluated for therapeutic hypothermia and ongoing care. If not yet done, the airway should be definitively secured with endotracheal intubation and mechanical ventilation should be instituted.