Clinical Research Directory

Inclusion Criteria: * Infants will be assessed sequentially by criteria A and B listed below: Criteria A: Infants ≥ 36 completed weeks gestation admitted to the NICU with at least one of the following: * Apgar score of ≤ 5 at 5 and/or 10 minutes after birth. * Signs of fetal distress before delivery (including bradycardia. \<100/bpm or tachycardia \>160/bpm or meconium-stained amniotic fluid). * Continued need for resuscitation, including endotracheal or mask ventilation, at 10 minutes after birth. * Acidosis within 60 minutes of birth (defined as any occurrence of umbilical cord, arterial or capillary pH \< 7.1). * Base Deficit ≥ 16 mmol/L in umbilical cord or any blood sample (arterial, venous or capillary) within 60 minutes of birth. All infants who meet criteria A will be further assessed whether they meet the neurological abnormalities included in criteria (B). Criteria B: Moderate to severe encephalopathy, consisting of altered state of consciousness (lethargy, stupor or coma) and at least one of the following: * Hypotonia. * Abnormal reflexes including oculomotor or pupillary abnormalities. * Absent or weak suck. * Clinical seizures. Exclusion Criteria: * Obvious major congenital abnormalities. * Evidence of head trauma causing major intracranial hemorrhage. * Severe respiratory distress (difficulty maintaining a transcutaneous oxygen saturation \[StO2\] \>95% or a PaO2 \>50 mmHg in spite of a fractional concentration of inspired oxygen equal to 1 during mechanical ventilation). * Severe hypotension with mean blood pressure \<30mmHg despite full support (repeated administration of volume expander and maximum inotrope support). * Severe growth restriction, with birth weight less than 1800 grams. * Thrombocytopenia \<30 000/mm. * Infants expected to be \> 6 hours of age at the time of randomization.