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ICECAP 2026: cooling duration after cardiac arrest does not improve neurological outcome

What changed

The ICECAP randomized clinical trial was published in JAMA in August 2026. In 1,158 comatose out-of-hospital cardiac-arrest patients who had reached below 34 °C within four hours, extending hypothermia at 33 °C did not improve neurological outcome, mortality or the key secondary outcomes.

Why this matters for AIRCHILL

This result does not answer the AIRCHILL question of very early respiratory cooling versus later or conventional temperature management. ICECAP primarily tests duration after hypothermia has already been achieved. For AIRCHILL, timing, cooling rate, route, temperature depth, duration, thermal distribution and rewarming therefore need to remain separate study variables.

Development implication

The clinical programme should avoid treating “temperature” as a single intervention. Future feasibility and randomized studies should prespecify:

  • time from collapse/ROSC to first cooling,
  • time to target temperature,
  • core versus local thermal effect,
  • duration of cooling,
  • rewarming profile,
  • neurological outcome.

Source: JAMA, ICECAP trial, August 2026. https://jamanetwork.com/

AIRCHILL remains a development-stage technology. External trial results provide context and do not establish AIRCHILL efficacy.