Acute cardiac care & resuscitation
Duration of Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: The ICECAP Randomized Clinical Trial
Authors' conclusion
Among comatose survivors of out-of-hospital cardiac arrest treated with therapeutic hypothermia at 33 °C, increasing cooling duration did not improve neurological outcomes.
Study context
- Population
- Comatose adults after OHCA reaching target temperature <34 °C within 4 hours, 71 US hospitals, June 2020–June 2025883 nonshockable, 275 shockable
- Participants
- 1,158 adults
- Comparison
- Therapeutic hypothermia at 33 °C for cooling durations of 6 to 72 hours
- Primary endpoint
- Neurological function (weighted modified Rankin Scale score); posterior probability that each duration was optimal (shortest duration consistent with best outcome)
- Follow-up
- 90 days
Methodological detailsmulticentre, adaptive-allocation, response-adaptive randomisation, bayesian duration-response model, prespecified stopping rule at interim analysis
- Multicentre
- Adaptive-allocation
- Response-adaptive randomisation
- Bayesian duration-response model
- Prespecified stopping rule at interim analysis
Primary result
As reported in the abstract
Posterior probability that 6 hours was the shortest duration achieving the maximal mean weighted mRS score
Nonshockable rhythm cohort: posterior probability 6 hours optimal
0.51
Secondary outcomes
Secondary outcomes and mortality
- No differences across cooling durations
Original publication
Duration of Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest: The ICECAP Randomized Clinical Trial. JAMA. Published 5 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it