The decision to start cooling is made within the first six hours of birth and is based on a combination of clinical findings. Eligible babies are term or near-term infants, at least 36 weeks of gestation, who show evidence of significant birth asphyxia: a low Apgar score at five or ten minutes, a need for prolonged resuscitation at birth, or abnormal results on blood gas testing showing the baby was acidotic. In addition to evidence of asphyxia, the baby must have neurological signs of Hypoxic-Ischaemic Encephalopathy on examination, including abnormal tone, abnormal level of consciousness, or seizures. An EEG may be used to assess brain electrical activity and support the classification. All eligible criteria must be met within the six-hour window, which is why rapid assessment and, where needed, urgent transfer to a centre with hypothermia capability is so important.
Related reading:
Birth Asphyxia and Therapeutic Hypothermia: What Parents Need to Know
High-Risk Newborn Care: A Complete Guide to NICU, Premature Babies, and Critical Neonatal Conditions
Written by Dr. Kabir Nanda, MD Paediatrics, Fellowship in Neonatology (NNF Accredited), Pediatrician and Neonatologist, Sukhmani Hospital, Safdarjung Enclave, New Delhi, and Westend Hospital, Tilak Nagar, New Delhi. Phone: +91 8076178418.
