[Cooling as treatment of birth asphyxia]

In about 10 per cent of children with cerebral palsy, the most probable cause is birth asphyxia. The brain injury following birth asphyxia evolves in part over hours or days--as a secondary process. This opens a 'window of opportunity' for intervention. Decreasing the temperature by as little as 3 degrees C appears to be effective. It is possible to identify babies with a 50 per cent risk of death or survival with cerebral palsy within 3 to 6 hours after birth. Pilot trials of cooling suggest that the side-effects of cooling can be managed. Randomized controlled trials are underway. Obtaining informed consent from the parents for these trials represents a particular challenge.