The essential component to neonatal adaptation after birth is the initiation of adequate respiratory effort. Approximately 10–15% of newborns require support for respiratory transition at birth, 3% require positive pressure ventilation by mask, 2% intubation, and only <1% cardiopulmonary resuscitation with chest compressions or epinephrine to establish cardiorespiratory function .

The major cause for delivery room cardiopulmonary resuscitation is birth asphyxia, a condition of insufficient oxygen supply to vital organs that results in hypoxia, hypercarbia, and metabolic acidosis and, if prolonged, may progress to multiorgan failure, including the developing brain, which is then referred to as hypoxic ischemic encephalopathy.

 Birth asphyxia accounts for 900,000 neonatal deaths worldwide annually and hypoxic– ischemic encephalopathy is estimated to cause up to a quarter of all postnatal deaths . In developed countries, birth asphyxia occurs in 1.5–2.5 per 1000 live births and is one of the major causes for the development of cerebral palsy . In 2002-2003, the National Neonatal Perinatal Database (NNPD), a network of neonatal units in India comprising of 18 units across the country, reported that the incidence of HIE was 1.4% among institutional deliveries, and perinatal asphyxia was the commonest primary cause of neonatal mortality (28.8%) and stillbirth (45.1%) [9].A recent systematic analysis of global, national, and regional causes of child mortality identified HIE as the third important cause (20%) of neonatal deaths in India . However, data about the various factors influencing the outcome are lacking.Therapeutic hypothermia (TH) is the standard of care for HIE in developed countries, but the adoption rate and techniques may differ in low- and middle income countries (LMICs).This study is aimed to look at short term outcomes and factors associated with decreased survival in term infants with moderate to severe HIE.

Vasopressors and inotropes, together referred to as cardioactive therapies, are frequently used for the management of cardiovascular dysfunction in the neonatal intensive care unit (NICU). Previous work has highlighted the association between exposure to cardioactive therapies and higher incidences of adverse outcomes in preterm neonates, including mortality and neurodevelopmental impairment. But the same has not been validated in terms with asphyxia

The aim of the present study was to evaluate the accuracy of the VIS score for predicting in-hospital mortality (sensitivity, specificity) following moderate to severe hypoxic–ischemic encephalopathy