Cool Prime Comparative Effectiveness Study for Mild HIE

Inclusion Criteria:

Infants must meet all 3 inclusion criteria

   1. Neonates born at ≥ 35 0/7 weeks

   2. Mild Encephalopathy on neonatal neurologic exam within 6 hours after birth: defined as
   presence of at least 2 signs of mild, moderate, or severe encephalopathy with no more
   than 2 signs in the moderate or severe category.

   3. Perinatal Acidosis based on at least one of the following (A or B):

      1. pH ≤ 7.00 in any cord or first infant gas (arterial, venous, or capillary) within
      ≤ 60 min OR base deficit ≥ 16 in any cord or first infant gas (arterial, venous
      or capillary) within ≤ 60 min

      2. If pH is between 7.01 and 7.15, OR base deficit is between 10 and 15.9
      mmol/liter, OR blood gas is not available, an acute perinatal event is an
      additional criteria required (see below definition)

An acute perinatal event is defined by at least one of the following:

   1. Apgar score at 10 min ≤ 5

   2. Continued need for resuscitation at 10 min (chest compressions, bag mask ventilation,
   or positive pressure ventilation)

   3. Uterine rupture, placental abruption, cord accident (prolapse, rupture, knot or tight
   nuchal cord)

   4. maternal trauma, maternal hemorrhage, or cardiorespiratory arrest

   5. fetal exsanguination from either vasa previa or feto-maternal hemorrhage, shoulder
   dystocia

Exclusion Criteria:

   1. Gestational age at birth < 35 0/7 weeks

   2. Birth weight < 1800gm

   3. Head circumference <30cm

   4. Congenital or chromosomal anomaly associated with abnormal neurodevelopment or death

   5. Moderate or Severe HIE of 3 or more moderate or severe abnormalities on COOLPRIME
   Sarnat exam within 6 hours of life

   6. Any seizures within first six hours of life

   7. Redirection of care is being considered