INTRODUCTION: Randomised studies have demonstrated the efficacy of hypothermia 
for the treatment of perinatal hypoxic-ischaemic encephalopathy (HIE) in term or 
late preterm infants. In August 2006, the Neonatology Department at 
Rigshospitalet, Copenhagen, introduced total body cooling for infants born at 
term with HIE.
MATERIAL AND METHODS: This retrospective study comprises data from medical 
records of newborn children born with HIE during a period of 32 months. Relevant 
data for cooling were recorded. Structured neurological examinations were 
carried out on survivors when they were ten and or 18 months old.
RESULTS: A total of 32 infants fulfilled the criteria for cooling, the incidence 
being 0.4/1000 births. Twenty infants were cooled for 72 hours. Eleven infants 
had cooling discontinued before 72 hours because of their grave prognosis. One 
infant had cooling discontinued because of pulmonary hypertension. Most infants 
were cooled before six hours of age (median four hours). The mortality rate was 
41%. A total of 45% were cooled without being placed in a ventilator. The side 
effects were of no major concern. Eight children had a neurological follow-up. 
One child had developed cerebral palsy and two children suffered delayed 
development.
CONCLUSION: Total body cooling was carried out before six hours of age in the 
vast majority of infants born with HIE. Side effects were of less concern. 
Respiratory support with a ventilator could be avoided in 45% of the infants 
cooled for 72 hours. The mortality rate was 41%.