What is the role of therapeutic hypothermia in term infants with hypoxic-ischemic encephalopathy?

• A. Reduces death and disability when initiated within 6 hours of birth
• B. Worsens outcome if delayed beyond 12 hours
• C. Has no effect
• D. Is only used in preterm infants

Answer: (A)

Therapeutic hypothermia helps protect the brain after hypoxic-ischemic injury by slowing metabolic demand and interrupting the cascade of secondary brain damage that follows the initial event. For term or near-term infants with moderate to severe hypoxic-ischemic encephalopathy, initiating cooling within about 6 hours of birth and continuing for roughly 72 hours has been shown in major trials to reduce the combined risk of death and substantial neurodevelopmental disability. The benefit is tightly time-sensitive; starting cooling after this early window diminishes the protective effect, so delaying beyond 6 hours does not provide the same improvement in outcome. This therapy is applicable to term or near-term infants and is not used for preterm babies, where evidence and safety data differ.