Studying the effect of passive versus Blanket roll III modality of therapeutic hypothermia (TH)on myocardial function of asphyxiated neonates through using tissue Doppler (TD).

A clinical trial study of 100 Gestational-age-matched asphyxiated cooled neonates will divided into two groups, 50 in each group for comparison the myocardial function using passive cooling and BLANKET ROLL III as modality of TH.

Inclusion Criteria:

• Evidence of perinatal/intrapartum hypoxia, as indicated by at least one of:

  • Apgar score of less than or equal to 5 at 10 minutes
  • Needing mechanical ventilation or ongoing resuscitation at 10 minutes
  • PH in cord blood gas is less than 7.00 or a base excess worse than or equal to minus 12 mmol /L on cord/arterial/venous/capillary blood gas obtained within 60 minutes of birth.

• Evidence of moderate or severe encephalopathy.

• Greater than or equal to 35 weeks gestational age.

• Birth weight greater than or equal to 1800 g.

• Able to begin cooling before 6 hours of birth.

Exclusion Criteria:

• Congenital cyanotic heart disease.
• Multiple congenital anomalies.
• Birth asphyxia's babies after start of cooling with cardiovascular instability.