Aims: to determine the practicality and systemic effects of head cooling with mild or minimal systemic hypothermia in term neonates with moderate to severe hypoxic-ischemic encephalopathy.

Methods: Study Group: Infants ≥ 37 weeks gestation(mean 39±1 for all groups) with umbilical artery pH≤7.09 or Apgars≤6 at 5 min, plus evidence of encephalopathy. Infants with major congenital abnormalities were excluded. Trial Design: Infants were randomized to either no cooling (controls, rectal temp=37.2 to 36.8°C, n=10), minimal cooling (rectal temp 36.5 to 36.0°C, n=6) or mild cooling (rectal temp = 35.9 to 35.5°C, n=6). Head cooling was accomplished by circulating water at 10°C through a coil of tubing wrapped around the head, for up to 72 hours. All infants were warmed by servo-controlled overhead heaters to maintain allocated rectal temperature. Rectal, fontanelle and nasopharyngeal temperatures were continuously monitored.

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