A 27-Year-Old Woman, Gravida 1 Para 0, at 37 Weeks

A 27-year-old woman, gravida 1 para 0, at 37 weeks gestation comes to the emergency department after spontaneous rupture of membranes with leakage of blood mixed with fluid.  Emergency cesarean delivery is performed due to severe fetal bradycardia.  On delivery, the neonate is apneic and hypotonic.  Resuscitation with endotracheal intubation and assisted ventilation is performed, which improves bradycardia.  Apgar scores are <5 at 5 and 10 minutes.  Umbilical cord blood analysis shows high anion gap metabolic acidosis.  Controlled hypothermia to maintain body temperature at 33-35 C (91.4-95 F) is begun.  This therapy is most likely to provide benefit via which of the following mechanisms?

A) Decreased activation of the coagulation cascade
B) Decreased reactive oxygen species-mediated neuronal injury
C) Increased conversion of bilirubin to less toxic water-soluble isomers
D) Increased hepatic clearance of lactic acid

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