Our goal is to develop a nationwide consensus practice guideline not only consistent with the international standard protocols but also practical and compatible with the current medical system in Japan.
In summary, TH should be offered to newborn infants born ?6 weeks gestational age and birth weight ?800 g exhibiting clinical signs of moderate to severe NE as well as evidence of hypoxia-ischemia, i.e. 10 min Apgar score ?, a need for resuscitation at 10 min, blood pH < 7.00, or base deficit ?6 mmol/L. TH should be conducted in the NICUs capable of multidisciplinary care and under the standard protocols, i.e. utilization of cooling device, target (rectal or esophageal) temperatures at 33.5 ¡À 0.5 and 34.5 ¡À 0.5 ¡ãC for whole body and selective head cooling respectively, duration of TH for 72 h, gradual rewarming not exceeding the rate of 0.5 ¡ãC/h. Long term follow-up with multidisciplinary approach including standardized psychological assessment is warranted.