Smaller hospital here, we ship out our really sick or really early babies but we recently had a case that I was wondering if the babe could have been treated with hypothermia therapy but wasn't. I understand the theory behind it, but what about if the hypoxic injury is thought to be more chronic (key word is thought, not known). Case was a classic "ugly-as-it-gets" category 3 strip walked in off the streets. Crash section quickly thereafter and pulled out a severe IUGR term kiddo who needed lots of resus. NICU team was called in. Severe acidosis. vented, bicarb, ivs for B/Ps, seizures, the works. Didn't send it for hypothermia. Neonate's theory being that the severe IUGR indicates a more chronic assault. My thoughts are, what would it have hurt to try? Do protocols for hypothermia in your facilities frequently refuse infants with SUSPECTED chronic asphyxia causes (without proof)? Can these babies be helped by hypothermia?