This systematic review by Jacobs et al. (2013) evaluates the effectiveness of therapeutic hypothermia in reducing mortality and long-term neurodevelopmental disability in newborns with hypoxic-ischaemic encephalopathy. The review includes 11 randomized controlled trials involving 1505 term and late preterm infants with moderate to severe encephalopathy and evidence of intrapartum asphyxia. Therapeutic hypothermia significantly reduced the combined outcome of mortality or major neurodevelopmental disability to 18 months of age, with a typical risk ratio (RR) of 0.75 (95% CI 0.68 to 0.83) and a risk difference (RD) of -0.15 (95% CI -0.20 to -0.10). It also reduced mortality (RR 0.75, 95% CI 0.64 to 0.88, RD -0.09, 95% CI -0.13 to -0.04) and neurodevelopmental disability in survivors (RR 0.77, 95% CI 0.63 to 0.94, RD -0.13, 95% CI -0.19 to -0.07). Adverse effects included increased sinus bradycardia and thrombocytopenia. The authors conclude that therapeutic hypothermia is beneficial for term and late preterm newborns with hypoxic-ischaemic encephalopathy, reducing mortality without increasing major disability in survivors. Further trials are needed to refine techniques and optimize patient selection, duration, and method of cooling.This systematic review by Jacobs et al. (2013) evaluates the effectiveness of therapeutic hypothermia in reducing mortality and long-term neurodevelopmental disability in newborns with hypoxic-ischaemic encephalopathy. The review includes 11 randomized controlled trials involving 1505 term and late preterm infants with moderate to severe encephalopathy and evidence of intrapartum asphyxia. Therapeutic hypothermia significantly reduced the combined outcome of mortality or major neurodevelopmental disability to 18 months of age, with a typical risk ratio (RR) of 0.75 (95% CI 0.68 to 0.83) and a risk difference (RD) of -0.15 (95% CI -0.20 to -0.10). It also reduced mortality (RR 0.75, 95% CI 0.64 to 0.88, RD -0.09, 95% CI -0.13 to -0.04) and neurodevelopmental disability in survivors (RR 0.77, 95% CI 0.63 to 0.94, RD -0.13, 95% CI -0.19 to -0.07). Adverse effects included increased sinus bradycardia and thrombocytopenia. The authors conclude that therapeutic hypothermia is beneficial for term and late preterm newborns with hypoxic-ischaemic encephalopathy, reducing mortality without increasing major disability in survivors. Further trials are needed to refine techniques and optimize patient selection, duration, and method of cooling.