Background During birth, asphyxia occurs when the child suffers a combination of oxygen deficiency and reduced blood supply. In serious cases of asphyxia, the infant can develop symptoms of brain damage shortly following birth, i.e., hypoxic ischemic encephalopathy (HIE). In moderate to severe asphyxia the lack of oxygen can cause serious damage to the brain and other organs, and some of the infants die. Children who survive are at higher risk for moderate or severe functional impairments, e.g., cerebral palsy (CP) or impaired vision and hearing. Therapeutic hypothermia is a new method for treating HIE following birth asphyxia and is used to complement standard treatment.

• In full-term newborns affected by moderate or severe symptoms of brain injury (HIE) due to severe birth asphyxia, therapeutic hypothermia reduces the risk of death or severe functional impairment in the child. However, the scientific evidence is insufficient to appraise the method’s effect beyond 18 months.
• The scientific evidence is insufficient to draw firm conclusions on the adverse effects and complications related to therapeutic hypothermia. No serious adverse effects or complications have been identified in the studies reviewed for this report, but the studies were not specifically designed to investigate this.
• The scientific evidence is insufficient to draw firm conclusions on the cost-effectiveness of the method. However, the fact that the extra costs for this method are relatively moderate and the outcomes are good would suggest that the method is cost-effective.
• The optimum way (best practice) to deliver treatment is not clear. Hence, it is important to monitor the experiences and outcomes of treatment, e.g., via a central quality register. Also, continued research is essential to gain knowledge about best practices as well as the potential complications and adverse effects.