Nontherapeutic neonatal hypothermia.

The case presented advocates for prolonged resuscitation, and aggressive rewarming in neonates with severe hypothermia (core temperature <32.0°C). The importance of rewarming has not been extensively studied in current guidelines, whereas the importance of cardiopulmonary resuscitation is well established. This abandoned, severely hypothermic (found with temperature of 27.9°C) newborn had an excellent neurological outcome at two years of age with aggressive resuscitation and rewarming techniques initiated at the time of presentation. Active core rewarming with warm saline lavages, intravenous fluids and warm air may be used at a rate of 1.8°C/h to 5.3°C/h according to most guidelines. Rewarming guidelines for asphyxiated infants undergoing therapeutic hypothermic may not be applicable to infants with accidental exposure, as in the present case. The present case of a near-term severely hypothermic infant reinforces the current recommendation of continuing resuscitative measures, irrespective of response to resuscitation, until the infant has been rewarmed.