Practice Points:
- Neonatal encephalopathy due to a hypoxic ischemic event is commonly associated with cardiac dysfunction and acute pulmonary hypertension
- Therapeutic hypothermia and rewarming modify loading conditions and blood flow and careful adjustment of inotropic agents is recommended.
- Delineating the physiology during therapeutic hypothermia clinically is difficult
- Comprehensive, quantitative echocardiography can assist with delineating pulmonary vascular and cardiac contributions to illness state
- Commonly used cardiovascular agents can have unintended consequences and should be used cautiously taking physiologic principles into account
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