Neonatal Neurocritical Care in Low-Resource Settings: Challenges and Innovations in Hypoxic-Ischemic Encephalopathy

Many neonatal neuroprotective strategies have been developed to reduce the impact of hypoxic-ischemic encephalopathy on mortality and long-term neurodevelopmental outcomes. The most effective strategy to date is therapeutic hypothermia, which has been shown to improve survival rates and neurologic outcomes. However, a recent International Liaison Committee on Resuscitation statement recommends using therapeutic hypothermia only in specialized neonatal neurocritical care facilities, which are not universally accessible. Low-resource settings are particularly disadvantaged due to a lack of trained professionals, financial constraints, equipment scarcity, and inadequate infrastructure. While adjunctive neuroprotective therapies and telehealth tools may help to bridge this gap, more evidence is needed to establish effectiveness of these therapies.