Feasibility and Temperature Stability of Low-Complexity Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: A Retrospective Case Series.

Objective This study aimed to evaluate the feasibility and temperature stability of low-complexity therapeutic hypothermia (TH) in neonates with moderate-to-severe hypoxic-ischemic encephalopathy (HIE). Study Design Retrospective case series of neonates born at ≥36 weeks of gestation with moderate-to-severe HIE treated with low-complexity TH in a tertiary-level hospital in Peru (2018-2024). Variables included timing of initiation, achievement and maintenance of the target core temperature, duration of hypothermia, and clinical outcomes. Descriptive statistics were used. Results A total of 13 neonates were included (77% male; median gestational age 38 weeks). TH was initiated at a median of 103 min after birth. Within the first 6 hours, 84.6% reached 34°C; however, only 31% maintained a stable core temperature within the target range (33.5-34.5°C) throughout treatment. Median duration of hypothermia was 75 hours. Complications occurred in 23.1% of cases, and overall mortality was 15.4%. Conclusion Low-complexity TH is feasible and allows timely initiation within the neuroprotective window. However, maintaining stable therapeutic temperatures remains a major challenge, which may compromise its potential neuroprotective effectiveness.