Therapeutic hypothermia, when initiated within six hours of birth, has been shown to significantly improve survival and neurodevelopmental outcomes in neonates with moderate to serve hypoxic-ischemic encephalopathy (HIE). However, not every baby who might benefit from cooling therapy is identified or referred to a regional cooling center in a timely fashion. Early identification of the risk factors for perinatally-acquired asphyxia and recognition of the signs and symptoms of neonatal encephalopathy are challenging even for the most experienced neonatologists.
The goal of the Neonatal Therapeutic Hypothermia Toolkit is to improve early screening at all delivery hospitals so that thoughtful, timely evaluations occur for each baby with significant risk factors for HIE. The criteria presented in this toolkit are for screening purposes only and are meant to improve early identification of at-risk babies who might warrant closer assessment. The criteria are intentionally designed to be more inclusive and are not by themselves qualifying criteria for cooling therapy. It is therefore essential that these guidelines be coupled with ongoing staff education and training.